Social Welfare & Services
Social policies are standards, legislation, activities, and guidelines that influence the living settings conductive to the society. These policies are bound to change in time, and their change behavior can be analyzed using the Blau analysis model that includes politics, history, economic, ideology, and social movement as changing factors. Therefore, the purpose of this paper is to analyze critically the conscientious objection in medicine policy using a medical commentary and the Michigan Senate Bill 896 based on the five policy changing factors of Blau analysis model. The paper will also review the various factors influencing social welfare. The factors are:
Social policies change from time to time, and there are distinct elements that facilitate these changes. The history of the social welfare is considered an element of social change. Conscientious objection originated in the military at around the Second World War and was described as the right to refuse an individual’s duties based on the freedom of religion, thought, and conscience. Therefore, during the 19th century, military soldiers would refuse to do their expected military duties on grounds of freedom of thought or conscience; hence were mostly referred to as conscience objectors. This concept has become part of the social welfare especially in medical practice. Medical practitioners are sometimes faced with challenges in understanding their conscience and their medical practice. Medical practitioners may refuse to give treatment to patients based on their moral or other influential values they believe (Morton & Kirkwood, 2009). In the commentary article, Dr. Bradley, argues in a manner that does not support any side, it rather highlights both facts of the medical practitioner and patient. Historically, conscience objection in medicine has generated numerous discussions that have not promoted social welfare. It now looks like a war between patients’ wishes and doctors’ moral values. However, it is significant to take note of conscience warnings rather than using them to justify one’s actions. Thus, the Michigan Senate Bill 896 is legislation requiring all medical practitioners to give medical services to patients, and any practitioner refusing to provide health care under the basis of moral or religious ground should not be deemed a medical practitioner.
Economics play a vital role in social policy changes are it represents the distribution of wealth. Different economic backgrounds influence the way people live, and most of all the policies applied in the society. Conscience objection in medicine has also been influenced by the economy in terms of social classes that emerge from varying economic backgrounds. Some health practitioners may come from the higher social classes with a strong economic background and may use it as a basis of refusing to provide treatment. Moreover, patients can be from a poor economic background and may not afford the necessary treatment; hence denied services based on their economic background. Again, the availability of affordable health care for certain treatments may not be available to everyone in society, meaning there is going to be inequality (Morton & Kirkwood, 2009).
In Dr. Bradley’s commentary, there are no economic factors highlighted. He concentrates on the moral, ethical and legal factors in conscience objection emphasizing on the need for physicians to be keen in their profession and always work for the good of the patient. However, in the Michigan Senate Bill 896, there are some economic aspects in the policies and contracts from health insurers to patients, clearly indicating that health care givers are entitled to have their own guidelines in treatment. Medical profession as a career means that one has affirmed to the ethics and principles of medical care that include helping others. Genuine medical practitioners should not use economic status or background as a basis of not giving health care. Such actions are changing the social policy and are not effective in promoting social welfare.
Social movements facilitate political tension that develops into social policy changes. In health care, social movements focus on efficient and affordable health care. In conscience objection, in medical health care, there are numerous social movements that have shaped social policies. For instance, abortion has been a popular topic as religious and other interest groups highlight their views on abortion (Bradley, 2009). In the past abortion had not been legalized, this is due to the wide debate on the legal and ethical factors surrounding it. Thus, the commentary does not highlight social movements in any way as it concentrates on basic facts conscience objection in medicine.
The author argues on a neutral ground posing some examples of conscience objection in medicine between 3 different situations involving patients and physicians. Most developing countries still consider abortion illegal terming the practice as murder, but as social movements like the National Organization of Women and Planned Parenthood continue advocating for abortion rights, some of the countries are slowly beginning serious discussions on abortion (Hill, 2010). In the United States, social movements advocated for abortion rights that saw many anti-abortion laws removed following the Supreme Court’s1973 verdict in Roe vs. Wade case. However, social groups like the American Medical Association had remained opposed to abortion rights, but after its legalization, the situation generated political tension that facilitated the legalization of abortion in many aspects (Hill, 2010). This clearly demonstrates how social movements act as factors that influence social policy. The article and Bill do not highlight any social movements related to conscience objection, but they both have some basic facts influenced by social movements.
Ideology can be defined as the comprehensible set of principles about institutions, ideas, and social provisions. The factor is what enables people live in normal patterns that everyone can manage and obtain the meaning of their world. This means that most ideologies people make are linked with their surroundings; hence people have to get assistance so as to come to conclusions on some elements in life. Therefore, different ideologies generate tension that leads to conflict in the form of policy modifications. Conscience objection in medicine can be linked with ideology in numerous ways (Bradley, 2009). Firstly, in situations like abortion, most doctors are well aware of the legality of abortion, but will consciously refuse to give an abortion on the basis of religious or moral beliefs. This can be attributed to their ideologies on abortion and what they think is ethically and morally right.
In contrast, if a woman needs to abort because she cannot take care of the child, and she is aware of the right to get an abortion, then the doctor declines to give the abortion on the same basis; hence a conflict will arise between the two. Such conflict will be discussed as a social policy adjustment since both parties have different ideologies, but will have to follow one ideology so that they can come to an agreement. Dr. Bradley’s is keen to discuss most of the ideologies associated with conscience objection in both the patient’s and doctor’s side. Conscience objection is still a controversy, but there are basic ideologies that make health care more efficient. For instance, if a doctor chooses not abort because of some reasons, he/she should act morally and provide an alternative for the patient (Hill, 2010). In that way, the conflict between the two will transform into a policy change that will be requiring the doctor to seek alternatives for the patient.
Politics influence social policy through the government, which is the agency, organization, and machinery a political entity uses to exercise power. This is done through the enactment of laws and institutions that ensures proper enforcement and regulation of laws. As the government looks to enforce laws, society has its own perception, and tensions may increase leading to policy changes. In conscience objection, in medicine, politics plays a part in shaping laws and regulations that guide physicians in dealing with conscience dilemmas. In some cases, physicians may be stripped of their professions and legally disciplined for their actions (Bradley, 2009). Therefore, physicians should be cautious during conscious situations that may violate the laws and regulations as highlighted in the Michigan Senate Bill 896. Also, it is illegal to deny a patient treatment that he/she is legally supposed to have on the basis of religion, thought, or conscience.
In conclusion, it is very evident that both the articles have not highlighted most of the factors used in Blau analysis model, but some facts have been relevant in identifying social policy changing factors. Conscience objection in medicine still remains a moral dilemma, but as Dr. Bradley advises, medical practitioners should understand medical ethics. Also, legal and moral elements are different in medical practice, and one should take time to understand how they play part in effective health care delivery.
Morton, N. T., & Kirkwood, K. W. (2009). Conscience and conscientious objection of health care professionals refocusing the issue. HEC Forum, 21(4), 351-64. doi: http://dx.doi.org/10.1007/s10730-009-9113-x
Bradley, D. (2009). Commentary on Conscientious Objection in Medicine: A Moral Dilemma. Retrieved from http://www.clinicalcorrelations.org/?p=1487
Hill, D. J. (2010). Abortion and conscientious objection. Journal of Evaluation in Clinical Practice, 16(2), 344-350. doi:10.1111/j.1365-2753.2010.01398.x