Medical Choices 

New law puts personal medical freedoms in legal limbo

While Idahoans celebrate their independence on the Fourth of July, some say a new law, which goes into effect on Thursday, July 1, is undermining those very freedoms.

SB-1353, the Freedom of Conscience for Health Care Professionals, allows pharmacists the right to refuse to fill prescriptions based on their own moral objections. The change could have a dramatic impact on some extremely varied demographic groups and has many worried about what it will mean for Idahoans.

"[The bill is] not respective of the rights of Idahoans," said David Irwin, spokesman for AARP of Idaho.

Under the new law, patients could find health-care providers unwilling to carry out their end-of-life wishes. The Gem State chapter of AARP has nearly 180,000 members, about half of Idaho's 50 and older population.

The law also has a direct impact on women with prescriptions for RU-486--a drug that ends pregnancy--and it's this conflict that has created the most controversy.

"It's a ridiculous law," said Rebecca Poedy, vice president of Idaho Operations for Planned Parenthood.

But those who wrote the legislation see things in a very different light.

David Ripley, executive director of Idaho Chooses Life--and one of the authors of the original legislation--calls the new law "heroic" and added that the real victory "belongs to the Lord."

Still, Freedom of Conscience is just one item on a laundry list of new laws that reach into every corner of Idaho. From now on, voters will need to show photo ID at the polling place or sign an affidavit swearing to their identity. Certain Idaho Department of Fish and Game records will be made confidential to curb intimidation and threats. If you're a new state employee, you'll have to wait 90 days to be eligible for health insurance, up from 30 days. Convicted criminals will have to pay higher court fees to help fund the judicial branch.

None of these matches the angst hovering over Freedom of Conscience, which was approved by the 2010 legislature by a vote of 21-13 in the Senate and 51-18 in the House.

The bill's history goes back to 1973, when the Idaho Legislature enacted limited conscience protection for hospitals and doctors. But that changed dramatically in 2005, when much of the nation was gripped by debate over the case of Terri Schiavo, a Florida woman whose feeding tube was removed after a high-profile right-to-die legal battle.

Days later, the Legislature passed the Medical Consent and Natural Death Act, granting individuals the right to dictate which medical procedures should or should not be used to prolong their lives. It also allowed patients to name those who can make those decisions for them in the event they can't.

Opponents waited to find a legal maneuver to dilute the measure. They got their wish earlier this year, when the Freedom of Conscience legislation was crafted by State Republican Sens. Chuck Winder, from Boise, and Russ Fulcher, from Meridian, with some help from Ripley. The first draft of the bill aimed to shield nurses and pharmacists opposed to providing medications that stop pregnancies, cause abortions or deal with stem cell therapy. Soon after, the end-of-life clause was added.

Irwin said much of his organization's membership is outraged over the new law. Second only to the state's budget challenges, a recent AARP poll indicates that repealing the Freedom of Conscience Law is one of Idaho seniors' highest priorities.

"They want to make sure that whoever is caring for them will honor their wishes. But those wishes can be taken out of their hands effective this week," Irwin said. "At a critical time in your life--and an emotional time for your family--a doctor or nurse can walk away from you. Is that a time when you want to start interviewing health-care professionals to find out who will honor your advance directives or end-of-life wishes?"

The bill has become a political hot potato. It will be a key element of a soon-to-be-published voter guide sent to the 180,000 AARP members. The association is asking each state legislative candidate where he or she stands on the issue, and if he or she supports repealing the new law.

But proponents have made the issue political as well. In his blog published on May 29, Ripley cheered the recent GOP primary defeat of Twin Falls Republican Sen. Chuck Coiner, one of a handful of Republicans who voted against the bill. Ripley called Coiner's defeat a "very exciting development."

"Sen. Coiner had, without possible dispute, one of the most liberal voting records in the Idaho Senate. We are very hopeful that [Lee] Heider will provide the kind of family friendly leadership Idaho deserves," Ripley wrote.

"We have anti-choice candidates who like nothing more than to make these issues political," Poedy said. Her opposition to the new law focuses on the clause that will allow pharmacists to deny certain prescriptions, such as RU-486. Poedy said 95 percent of women in the United States use contraception at some point in their lifetime.

"Denying patients the right to medical care prescribed by their own physician should not be tolerated. A pharmacist who does this interferes with a doctor-patient relationship, in an effort to forward their own personal agenda ... and if that happens, they should not be pharmacists," Poedy said.

So what will happen when an Idaho pharmacist refuses to fill a prescription?

"We're not sure," Poedy said. "We're thoroughly investigating all possible legal options."

In the meantime, opponents have sent more than 700 communications to the Governor's Office, and Planned Parenthood is finishing a newly commissioned statewide poll on the issue.

There is no legal precedence in Idaho according to Irwin. "This forces the debate. It will result in a very real and unfortunate study on this issue."

In the meantime young Idaho women and seniors are unlikely shipmates in uncharted legal waters.

CLARIFICATION: RU-486, a drug that ends pregnancy, is a treatment that can only be given directly from a physician and requires no prescription. Therefore, pharmacists would not be involved in the distribution of any treatment involving RU-486. The new law states "Abortifacient means any drug that causes an abortion as defined in 18-604, Idaho Code, emergency contraception or any drug the primary purpose of which is to cause the destruction of an embryo or fetus." However, 18-604, Idaho Code never refers to emergency contraception (such as Plan B or The-Morning-After Pill) as an abortifacient. In addition, the American Medical Association and even the Idaho Department of Health and Welfare do not classify emergency contraception as an abortifacient. For more on this issue, visit citydesk.

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