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Missouri - 1 step forward, 1 step back


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My state, my crazy state. These were both in the local paper last night:

First, a step forward - http://www.columbiatribune.com/news/pol ... f6eda.html (I'm not sure how much they'll let you read for free these days, so I'm quoting the gist of it)

A Senate committee on Monday considered a bill that would make the biggest change in Missouri rape laws since marriage was removed as a defense to the crime.

The bill, sponsored by Sen. Ryan Silvey, R-Kansas City, would remove force or the threat of force as the only required element for imposing the most severe penalties. The bill rewrites the sex crimes statutes, giving inability or incapacity to give consent as much weight as force.

The current laws "reflect an outdated notion of what rape and sexual assault is," said Colleen Coble, director of the Missouri Coalition Against Domestic and Sexual Violence.

(snip)

Current law calls sex crimes forcible rape, sexual assault, forcible sodomy, deviate sexual assault, sexual misconduct and sexual abuse. Silvey's proposal would create first- and second-degree rape, first- and second-degree sodomy and similar tiered offenses for sexual assault and sexual abuse.

Forcible rape now includes giving someone a drug to make them unable to resist. The key changes in Silvey's bill would make rape include taking advantage of someone's incapacity or inability to consent because of illness, inebriation or mental issues regardless of cause.

The bill also makes changes to the approach to treatment of children victims of sex crimes. Unless the abuse occurred within five days, the victim would not be given a forensic rape exam. Instead, a complete physical exam by a trained physician would be the first step.

(snip)

The committee took no action on the bill.

Proposed by a Republican, no less.

But then - on the same page spread - we get this - http://www.columbiatribune.com/news/bil ... f6eda.html

Bill allows workers to refuse duty. Health employees would be shielded from termination.

JEFFERSON CITY (AP) — Missouri health care workers could refuse to participate in procedures and research that run afoul of their religious, moral or ethical beliefs under legislation given first-round approval yesterday by the House.

Physicians, nurses, medical researchers and certain others involved in health care could not be discriminated against for refusing. Objections could be raised for specified medical procedures and research, including abortion, sterilization that is not medically necessary, assisted reproduction, human embryonic stem-cell research and contraception. Health care institutions such as hospitals, clinics and medical or nursing schools also could refuse to perform procedures or conduct research with which it has moral objections.

House Speaker Tim Jones, who is sponsoring the legislation, said conscientious objection rights are a bedrock principle that has been applied for a long time in the United States. He said the legislation protects workers' rights and claimed support from both political parties and men and women. "It's a shield. They don't have to use," said Jones, R-Eureka. "It's not a sword."

The House endorsed the legislation 118-42, and it needs another vote before moving to the state Senate. Similar legislation was approved in the House last year.

Vocal opposition yesterday came from Democratic lawmakers who argued the bill could inhibit access to health care for some Missourians.

Rep. Stacey Newman said the measure could affect couples seeking fertility treatment and rape victims who might want emergency contraception. She said the measure would discriminate against women. "This bill is wrong. It hurts people. It hurts women and families," said Newman, D-St. Louis.

The conscientious objections for medical workers would protect employees from termination, suspension, demotion and the loss of wages if they invoke it. Employees asserting the right would need to provide reasonable notice.

Reassigning employees to positions where they would not need to participate in the objectionable research or procedure would not be allowed, and if a worker files a lawsuit alleging their conscientious rights were violated, the employer could claim the specific procedure or research is so integral to the position's duties that a reasonable person would understand participation would be a requirement.

The opt-out rights would not allow health care workers or facilities to withhold emergency medical treatment needed to save a patients' life. It also would not excuse caregivers from a duty to inform patients about their health conditions, risks and medical options. However, health care workers would not be required to refer for or promote certain procedures.

In addition, if a lawsuit were to be filed challenging the constitutionality of the conscientious objections measure, the General Assembly could approve a resolution appointing some of its members to intervene in the case.

Am I right in interpreting the last bolded part to say - theoretically, if a person had an ectopic pregnancy, they could end up with a health care worker who wasn't required to tell them about a life-saving procedure because it violates the worker's conscientious rights?

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Am I right in interpreting the last bolded part to say - theoretically, if a person had an ectopic pregnancy, they could end up with a health care worker who wasn't required to tell them about a life-saving procedure because it violates the worker's conscientious rights?

Right above that it says:

The opt-out rights would not allow health care workers or facilities to withhold emergency medical treatment needed to save a patients' life.

So theoretically if a person presented with a ruptured ectopic pregnancy or something that presented a similar risk of death, they would have to do it. Though I suppose there would be room for a lot of arguing about just how much of an emergency the emergency really was in that case. Still a disgusting law however you slice it.

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I can understand that based on your belief, you can denied certain treatments. But, I do not undersant the refusal to refer someone to another healthare provider. They want the libertie to choose under their belief but they do not allow the same to the patient. The case of ectopic pregnancy, well, just wrong. Biu also, what is they denied contraception and did not do a referral; later, that woman goes and has an abortion because it was an unwanted pregnancy. Then, theresult would be much worse...

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As a lawyer, this drives me NUTS. We already have robust protection of religious rights. Employers have to make reasonable accommodations for employees' religious beliefs and practices. Depending on the nature of the belief and the size and type of the employer, this could mean rearranging schedules, reassigning people within the organization, or arranging for back up when a specific situation arises. The key word, though, is reasonable. A large pharmacy might be required to accommodate one tech's refusal to dispense birth control; a mom-and-pop operation wouldn't. A hospital might be required to reassign a nurse from its reproductibe health clinic to its urology clinic if she objected to participating in birth control procedures; the same hospital wouldn't have to hire an extra nurse for the reproductive health clinic so the objecting nurse could continue to work there and tag out whenever she felt lile it. This bill would make it impossible for many small hospitals, clinics, and pharmacies to continue providing reproductive health care. Which is the whole point.

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I can understand that based on your belief, you can denied certain treatments. But, I do not undersant the refusal to refer someone to another healthare provider. They want the libertie to choose under their belief but they do not allow the same to the patient. The case of ectopic pregnancy, well, just wrong. Biu also, what is they denied contraception and did not do a referral; later, that woman goes and has an abortion because it was an unwanted pregnancy. Then, theresult would be much worse...

Kansas was working on a law where doctors could lie to a pregnant woman about prenatal testing coming back with bad results if said doctor thought the woman might terminate the pregancy over it-- and that the woman and / or child could not sue for any wrongful life/injury to mother, etc resulting from the doctor not being truthful. ONLY if the woman died, her owner husband could sue for malpractice resulting in her death. That didn't quite pass last year, but once they got rid of most of the remaining moderates, they are running the same ideas up the flagpole again this year. Or, just planning to ban all abortions ASAP. They also want to let the governor just appoint judges without current rules in place, because the current judges keep pointing out things he does are just not constitutional....

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As a lawyer, this drives me NUTS. We already have robust protection of religious rights. Employers have to make reasonable accommodations for employees' religious beliefs and practices. Depending on the nature of the belief and the size and type of the employer, this could mean rearranging schedules, reassigning people within the organization, or arranging for back up when a specific situation arises. The key word, though, is reasonable. A large pharmacy might be required to accommodate one tech's refusal to dispense birth control; a mom-and-pop operation wouldn't. A hospital might be required to reassign a nurse from its reproductibe health clinic to its urology clinic if she objected to participating in birth control procedures; the same hospital wouldn't have to hire an extra nurse for the reproductive health clinic so the objecting nurse could continue to work there and tag out whenever she felt lile it. This bill would make it impossible for many small hospitals, clinics, and pharmacies to continue providing reproductive health care. Which is the whole point.

These are the same people who argue that businesses should be exempt from the ADA or health insurance requirements under the AHCA because it's too costly for them and that leads to job losses. But somehow having to hire extra people to provide basic services is fine as long as it's done in the name of religion.

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As a lawyer, this drives me NUTS. We already have robust protection of religious rights. Employers have to make reasonable accommodations for employees' religious beliefs and practices. Depending on the nature of the belief and the size and type of the employer, this could mean rearranging schedules, reassigning people within the organization, or arranging for back up when a specific situation arises. The key word, though, is reasonable. A large pharmacy might be required to accommodate one tech's refusal to dispense birth control; a mom-and-pop operation wouldn't. A hospital might be required to reassign a nurse from its reproductibe health clinic to its urology clinic if she objected to participating in birth control procedures; the same hospital wouldn't have to hire an extra nurse for the reproductive health clinic so the objecting nurse could continue to work there and tag out whenever she felt lile it. This bill would make it impossible for many small hospitals, clinics, and pharmacies to continue providing reproductive health care. Which is the whole point.

How would the "Reassigning employees to positions where they would not need to participate in the objectionable research or procedure would not be allowed" part work into that, I wonder? If someone's beliefs/religion/whatever changed during their employment, would they have to quit/be fired, since they can't be reassigned (and why does the law disallow reassignment?)? Hiring new people could get really complicated, too. Will the burden be put on the applicant as far as researching what research/procedures an employer does, or will the employer have to come up with a questionaire to cover everything? What if a med school or training hospital starts a new line of research that current employees/students find objectionable?

In bigger cities, you may have more than one hospital (Columbia has at least 2), but in smaller cities there may only be one game in town, and in the small towns, you'll have one doctor if you're lucky, otherwise you're driving 45 minutes to get anywhere. Ditto for pharmacies - my parents have to drive at least 45 minutes to get prescriptions, and in their area, it's not like there's a Walgreens or CVS on every corner. Pharmacists should just dispense the medicines prescribed by the doctor, not get into interfering because of why someone may or may not be taking something. That's between the patient and the doctor (unless, of course, the pharmacist notices drug interaction issues or whatever).

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I love how everyone has to suffer for a Christians faith but the christian never has to suffer. they get everything they want while denying others. how christian of them. of course if someone said a christian had to stop having babies or denied something else they would have a hissy fit the law would be repealed in a heartbeat.

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Am I right in interpreting the last bolded part to say - theoretically, if a person had an ectopic pregnancy, they could end up with a health care worker who wasn't required to tell them about a life-saving procedure because it violates the worker's conscientious rights?

Yes.

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Hey, here's a crazy thought. If you object to something a certain profession may require you to do? DON'T GO INTO THAT PROFESSION.

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Hey, here's a crazy thought. If you object to something a certain profession may require you to do? DON'T GO INTO THAT PROFESSION.

EXACTLY! Doctors and other healthcare providers take an oath to help patients, or at least they do in Mexico. It is so stupid to come up with these laws, just don't become a nurse or doctor!!

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So doctors who are religiously opposed to transfusions may not refuse to perform one, it would appear from that list.

If they're going to cater to Protestant and Catholic anti-choice fundies, but not respect the beliefs of Jehovah's Witnesses, how is that not giving preference to one set of sects over another, in blatant violation of the Establishment Clause?

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Dear Christian, sorry about your heart attack, but I was praying to Mecca at that moment and there wasn't anyone else with defibrillator training.

Except I can't imagine the most devout Muslim actually doing that, and I don't have to imagine Christians deciding not to give birth control pills or Plan B to someone they don't think should have sex (and/or don't believe was raped)

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EXACTLY! Doctors and other healthcare providers take an oath to help patients, or at least they do in Mexico. It is so stupid to come up with these laws, just don't become a nurse or doctor!!

They do here, too. The Hippocratic Oath.

I think I'd punch someone if they refused to fill a birth control prescription for me because of their religious beliefs. Don't be a pharmacist, then. Do you not fill psychotropic drugs because you don't believe in psychiatry? Gah!

'scuse me. My head just exploded. I need to go clean it up.

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