Posted in Rants on July 26th, 2010 by Ed

A few years ago there was a brief spike of interest in "conscience clauses" for pharmacists whose deep, meaningful belief in the scientific opinions of Jerry Falwell led them to conclude that birth control pills are a form of abortion. They argued that they should not be legally required to help a customer perform an abortion, and thus they could refuse to fill prescriptions for oral contraception. Several states adopted relatively meaningless Conscience Clause laws for healthcare providers, meaningless in that A) the accommodations an employer must make for an employee's religious beliefs are limited to a reasonable effort and B) the employee must comply with company policy about objections based on conscience – for example, Wal-Mart and Target require pharmacists to refer the customer to a co-worker who will fill the prescription. The issue rapidly disappeared.

The underlying and more serious problem, however, is that the idea of refusing to perform the most basic – and from the perspective of the public, only – duty of one's job based on moral qualms is an unworkable model. Pharmacy is a profession with a creed and a set of principles, the most basic being that patients are autonomous (i.e., the pharmacist will respect the informed wishes of the patient) and the doctor-patient relationship is inviolable. See, people don't go to the pharmacy to get moral advice or a lecture or a second opinion on medical decisions. We go to get our goddamn prescriptions filled, a job, in an age of pre-filled and factory sealed bottles of pills, that could reasonably be done by a vending machine. If you're not prepared to fill prescriptions, maybe pharmacy ain't for you. I'm not prepared to kill animals all day, so I don't apply for many slaughterhouse jobs. And there's a good chance that if I took one and refused to kill animals they would fire me. For cause. This idea that we will structure the world to accommodate the personal objections of individuals that take jobs with legal responsibilities and professional codes of conduct is as dangerous as it is stupid.

Let's play the slippery slope game for a second. What if my religion is Christian Identity and I don't want to teach any Jews or minorities? If we apply the pharmacy example, the University would have to offer all students fitting that description a separate class and pay me to teach only to Aryan students. Of course in reality they would simply fire me, pointing out that I took the job understanding that it requires me to treat all students equally and carry out all duties under my job description. No one would coddle me. But let's say I was something tamer than a neo-Nazi Christian fringe believer. Let's say I don't believe in evolution. If I taught biology, could I just skip any mention of evolution? No, I'd be asked to do what the job requires: to present the scientific consensus on evolution. That's what the students are paying for.

This brings me, albeit very indirectly, to the case of a Georgia student seeking an MA in Counseling who refuses to accept the scientific consensus in her field as part of her job requirement. Jennifer Keaton is suing Augusta State University because she claims the school is attempting to "force (her) to change (her) beliefs" that homosexuality is a deviant condition that should be cured. ASU is, well, a terrible school (US News labels it "4th Tier"). It is about the 8th best school in Georgia, and Georgia isn't exactly California when it comes to the university system. So with all due respect to their students, I'm going to go out on a limb and guess that Ms. Keaton isn't exactly the cream of the academic crop. She may even be a complete idiot, which is ad hominem on my part but also explanatory of the basic problem with her position.

You can believe whatever you want to believe, dear. You can believe that the world is ruled by alien lizard people, the moon landing was a hoax, or that 9/11 was an inside job. You can believe that down is up. It really doesn't matter. What the profession you seek to enter demands, however, is that you do your job as legal and professional rules dictate. No one gives a shit if you think Teh Gays need to be cured. A psychologist's job is not to impose personal beliefs on a client/patient. There is no scientific evidence for the beliefs in question – being gay is a choice, gays are sick, etc. – and thus you are entitled to believe them but forbidden to use your position of influence to impose them on people who come to you for treatment. A patient seeing a psychologist expects to be treated according to an understanding of recognized medical disorders, not according to what some name they got out of the Yellow Pages thinks. If you cannot understand the problem inherent in letting psychologists ignore the DSM and substitute their personal beliefs at their own discretion, I think I might be able to explain why you are on the verge of getting kicked out of a 4th-rate school.

The University should make it clear that Keaton will receive her degree when she understands the job description of the field she is attempting to enter. I won't hold my breath. There are some reasonable solutions here – seek a degree from Bob Jones University or someplace that will reinforce her worldview and/or get a job at a private school, preferably run by fundamentalists, that will accept her conception of the job as a pulpit for preaching one's own beliefs. What won't fly is to expect ASU and the profession as a whole to let each member write his or her own set of rules, standards, and job descriptions.