Obama To Rescind Provider Conscience Regulation The outgoing Bush administration issued a rule that protects healthcare workers who refuse to administer services or prescriptions that go against their beliefs. Abortions and contraceptive medications are at the heart of the ruling, which President Obama plans to withdraw.
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Obama To Rescind Provider Conscience Regulation

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Obama To Rescind Provider Conscience Regulation

Obama To Rescind Provider Conscience Regulation

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This is TALK OF THE NATION. I'm Neal Conan in Washington. Last week, the Obama administration announced plans to rescind protections for health care workers who refused to provide services they find objectionable. The heart of the issue centers around abortion, and like almost everything that involves abortion, it is highly divisive.

What's known as the Provider Conscience Regulation came into effect just last December and prohibits recipients of federal money from discrimination against health care workers who refuse to provide care or fill contraceptive prescriptions because of religious beliefs or moral convictions. We want to hear from those of you who work in the health care businesses: pharmacists, OB-GYNs, emergency room physicians, medical students. What changed when the regulation took effect three months ago?

What would change if the regulation is rescinded now? Tell us your story: 800-989-8255 is our call number. The email address is talk@npr.org. You could always join the conversation at our Web site. The address is npr.org. Click on TALK OF THE NATION.

Later in the program, even those of you in Honolulu or Hialeah may have stories about the greatest of all school holidays: the snow day. Email us now: talk@npr.org. Robert Krulwich will tell us his snowy day story.

But first: conscience and health care. And we begin with Deirdre McQuade, who's the director of planning and information for the pro-life secretariat of the United States Conference of Catholic Bishops. She's with us here in Studio 3A. Nice of you to be with us on a very snowy day here in Washington.

Ms. DEIRDRE MCQUADE (Director Of Planning And Information, The Pro-Life Secretariat, United States Conference of Catholic Bishops): Good afternoon, Neal.

CONAN: And we can tell from your title you're - what's your reaction to this proposed rescinding of this regulation?

Ms. MCQUADE: The Catholic Bishops of the United States are grievely concerned over the possibility that conscience protection will be undermined in any way, including the rescinding of these recent regulations that ensured that longstanding - some very longstanding conscience protection federal laws will not be fully implemented

CONAN: As you say, there are federal laws that say if you are opposed to providing abortion, you don't have to do it.

Ms. MCQUADE: That's right. Actually, the laws cut both ways, and many people aren't aware of that. They also protect those who are willing to do abortions. So - but these conscience protections cut both ways.

CONAN: And so why is this reinforcement, if you will, of this late Bush administration regulation necessary?

Ms. MCQUADE: Unfortunately, these laws, which have been on the books for some time, have not been fully implemented. Or health care practitioners, doctors, nurses, health care institutions have not been fully made aware that such discrimination against their conscience as an exercise of free conscience is against the law. And so it's important to have the regulations to raise awareness about the protective laws, and also to give those who have been violated in some way recourse actually make a complaint.

CONAN: Can you give us an example of the practical effect this has had on somebody's life in the last three months?

Ms. MCQUADE: Well, they only went into effect on the eve of the inauguration. So there hasn't been that much time for them for them to actually…

CONAN: Oh, because it was enacted in December, then 30 days for comment. Yeah.

Ms. MCQUADE: That's right. That's right. And so I personally have not heard of any of those stories yet, but I'm looking forward to hearing them myself. But they are absolutely vital to protect doctors, nurses, health care institutions from this point forward, really, to ensure three things: that religious and ethical convictions would be fully honored, which is something that's deeply at the heart of our American constitution, our American practices - that it would, if you will in this context, stimulate, bring to the health care profession those who are highly qualified in the next 10 years simply due to a retirement.

The health care profession stands to lose 20 percent to 25 percent of its practitioners just because of retirement. And so there should me nothing on the books now that's discouraging good doctors, nurses from entering into the health care field.

CONAN: Well, let's bring another voice into the conversation. Rob Stein is a reporter for the Washington Post who's been following this story. Rob, nice to have you back on the program.

Mr. ROB STEIN (Reporter, The Washington Post): Hi, Neal. Nice to be here.

CONAN: And Rob joins us from the studios at the Washington Post here in Washington, DC. And we mentioned just a moment ago, Deidre McQuade mentioned 30-day period for comment before a proposed regulation goes into effect. Presumably, the Obama administration's regulation is under the same circumstances. So they're in the process of gathering comment at this point?

Mr. STEIN: Exactly. The new rule to rescind the old rule would be officially published in the Federal Register sometime later this week, and whenever that happens, that'll open up a 30-day comment period, at which point people can weigh in and say what they think should be done. And the Obama administration is saying that they're going to listen very closely to those comments and try to decide what to do. They have several options. They can just withdraw the original rule, or they can come back with some sort of compromise rule.

CONAN: So it is not set in stone that they're simply going to do away with the Bush administration regulation.

STEIN: No, not at all. In fact, the Obama administration has made it clear that they're trying to do something that's obviously very difficult, which is find common ground on anything related to this issue of abortion. And this is going to be probably the first real test of that strategy to see whether they can really find common ground on such an explosive issue.

CONAN: You noticed also in your piece that they broke this news very quietly.

STEIN: That's right. And that's sort of the pattern of how they've been handling these issues. They've trying to be very low key about it, trying not to, you know, poke a finger in anybody's eye whenever they do anything related to abortion because they really are trying to figure out if they can sort of walk this line, this careful line and try to figure a way to find common ground on something that really is - nobody's been able to do before.

CONAN: And Rob, do you have examples of how this regulation has actually changed people's lives in, I guess, the very short period of time that it's been in effect, or what would change if it were to be rescinded?

STEIN: Well, that's - yeah. It hasn't been in effect long enough to really have had any effect. But what they're trying to - what the original regulation was trying to address was trying to protect people who feel like they've been subject to some sort of penalty because of their personal religious beliefs or moral beliefs when it comes to anything related to abortion or birth control. For example, I think what a lot of people have heard about has been this issue of pharmacists. There are a lot of pharmacists around the country who object to filling prescriptions for the morning-after pill because they consider it essentially the same as an abortion.

And there have been pharmacists around the country who've been - they've been fined. They've been fired. They've been penalized in some way. They've lost their jobs. And this is the sort of thing that would - the original intent of the rule was to protect people in that sort of situation.

CONAN: And women's rights advocates have argued that, in fact, there are a lot of places in this country where there are not a lot of pharmacies available and that, as a practical effect, this could have the effect of banning the use of the morning-after pill in certain parts of the country.

STEIN: Exactly, and especially with something like this, where time is of the essence to obtain this morning-after pill. You have a woman who shows at a pharmacy in the middle of the night or a woman who's been brought to an emergency room late at night and needed to get access to this medication within 72 hours. And if she can't get access to it, then it could be a real problem.

CONAN: Rob, another question that we also raised with Deirdre McQuade: Given the fact of these federal laws that don't require anybody opposed to abortion to perform abortion, what additional protections did this regulation provide?

Mr. STEIN: Well, this regulation would have - basically the stick is federal funding. It would cut off federal funding to any entity that did not protect healthcare workers who did not want to perform any healthcare service they found objectionable. And the original rule estimated that that would have affected more than 500,000 - we're talking hospitals, clinics, we're talking state governments, local governments - any kind of entity that receives any kind of federal funding could potentially lose that federal funding. So that's, you know, a pretty big stick.

CONAN: Let's see if we can get some callers in on the conversation. Of course, we want to hear people's experiences. Those of you who work in the healthcare professions. If you're a pharmacist, a nurse, OB/GYN, if you work in an emergency room, if you're a medical student give us a call, 800-989-8255. Email is talk@npr.org. How does this play out in your life? Let's see if we can talk with Bob(ph). Bob's with us from Lexington, Kentucky.

BOB (Caller): Yeah, I'm just making the comment (unintelligible) the things I've run into as a pharmacist and a supervisor, also. We do the opt-out procedures - and certainly (unintelligible) in places that are metropolitan areas you don't run into an issue of somebody opting out. But I've also worked out West, where you've got maybe one pharmacy, and then the closest one away from that is 200 miles. And once again, it essentially cuts somebody off from Plan B or any kind of contraceptive.

I've had people who've been on some of these birth controls that are used for emergency contraceptives, and my point is, as most of the practitioners, physicians and pharmacists and everything - go to publicly supported universities, and as a profession, I personally believe that you kind of give up your right to institute your personal morals on the medical process.

You've got somebody who kind of comes in and needs help, then it's your responsibility to provide that help, no matter what your moral convictions are.

CONAN: And Bob, when you talk about the opt-out procedure, that's if you're in a place like Lexington, and if you've got several employees, some George or Sally can say I prefer not to do this?

BOB: Correct, exactly right. And then, like I said, then you can't do any retaliation for that. But we do have a procedure where, like I said, they are obligated to tell the patients what the alternatives are. They can't just say no, I'm not going to do that and say bye. But the procedure there is that they would have to give them guidance on which pharmacies would do that, where they need to go, and take care of the process that way.

But once again out West and, like I said, you've got - and even some rural areas in Kentucky and maybe Tennessee or Virginia…

CONAN: Why don't we ask our guest about that? Deirdre McQuade, this does present a problem. This is sort of the example that people bring up when they say hey, this law, this regulation's not a great idea.

Ms. McQUADE: As I said before, the regulation is giving some teeth to laws that are currently on the books. So who really wants to change the status quo? It's those who are attacking conscience rights.

Without protected conscience rights, there will be less access for women and their children than before because those who have integrity with regard to not destroying human life will either have to - will have to get out of the practice of medicine.

CONAN: So, what you're saying is now the laws on the books - not this regulation - but the laws on the books say if you're a pharmacist in an isolated, rural area, and you don't want to fill a prescription for Plan B, you are already protected.

Ms. McQUADE: You are already protected. But this isn't fundamentally about contraception. This really is about authentic healthcare and the integrity of doctors.

When you step back and think do we really want, as Americans, to have doctors who work contrary to, against their own deepest-held religious and moral beliefs? That's not good healthcare. That's not care for their patients. That's not care for their colleagues.

So, really, to expand, or at least preserve, those doctors who are in healthcare right now, we need to, at least, draw a line in the sand and say those who have these authentic principles, who will not violate human life, can stay in medicine and practice it with authenticity.

CONAN: Should they be required to provide an alternative? I can't do it, but go down the street?

Ms. McQUADE: That's considered involvement in, let's say, abortion, the example of abortion. Providing abortion is one way of being involved. Referring for it is another, and that's also a matter of conscience.

CONAN: Okay, thanks so much. Deirdre McQuade, with us from - the director of the planning and information for the Pro-life Secretariat of the United States Conference of Catholic Bishops, kind enough to join us today in Studio 3A. Appreciate your time.

Ms. McQUADE: Thank you for having me.

CONAN: Rob Stein, stay with us, and we'd like to thank Bob for his phone call. We're going to continue talking about conscience and healthcare. Stay with us. I'm Neal Conan. It's the TALK OF THE NATION from NPR News.


CONAN: This is TALK OF THE NATION. I'm Neal Conan in Washington. We're talking with Rob Stein of the Washington Post, who wrote a story last week about the so-called conscience rule, put in place by the Bush administration in December, to protect healthcare workers against procedures they find morally objectionable.

The Obama administration wants to rescind the rule. We want to hear from healthcare workers today, especially OB/GYNs and pharmacists. Do you feel you need this kind of protection, given the fact that there is a federal law? Give us a call, 800-989-8255, email talk@npr.org. And you can join the conversation on our Web site. Go to npr.org. Just click on TALK OF THE NATION.

And Rob Stein, again getting back to that issue you were talking about, the difficulties the Obama administration is going to have - or any administration for that matter - to find common ground on an issue as divisive as abortion. It's going to be extremely difficult.

Mr. STEIN: That's right, and they're going to face a number of issues that's going to test this new strategy of theirs. They already did. The first week of the administration, the Obama administration lifted another federal regulation that the Bush administration had put in place, and that was a restriction on federal funding of international family-planning organizations that have anything to do with abortion overseas.

And this has been a political ping-pong that's bounced back and forth in different administrations. And the Obama administration lifted those restrictions, which would allow funding, which of course anybody who's opposed to abortion was very upset about.

CONAN: And those conservatives who had hoped to work with the administration said there it is, on the second day they do that, now they do this. I see. Their idea of compromise is we won.

Mr. STEIN: Right, that's the concern. There was big disappointment last week among some folks who are very interested in working with the administration, trying to find this common ground, and you know, it's important to point out that they're not giving up.

They're trying to remain optimistic, and the administration officials are saying that they are trying to find some sort of common ground. And they made a point of emphasizing that they support the current laws that are on the books that protect healthcare workers who do not want to participate in abortion specifically. And that's what these laws were originally intended towards.

What they're trying to do is narrow the regulation. The concern was - is that the Bush confidence regulation broadened this out so it could include all sorts of things, like morning-after pills and birth control pills and even end-of-life care.

CONAN: Well, here we have an email to that point from Eric in Tulsa, Oklahoma. A problem with conscience clauses: Where do they end? Should a scientologist working at a pharmacy be allowed to refuse to provide Prozac because of his or her beliefs? Why should conscience clauses be limited to healthcare workers? Should a computer programmer be allowed to not work on a project developing guidance software for smart bombs because she finds the weapon's ultimate end use to be immoral? Or a clerk at Borders who doesn't want to sell Playboy to a customer because he considers it pornography or offensive to women?

Conscience clauses are currently written that imply some consciences are more important, or at least worthy of more consideration than others. So that's the slippery slope argument there.

Mr. STEIN: Exactly. I've done a lot of reporting on this in the past, and I have even interviewed doctors who refuse to fill prescriptions for Viagra for single men because they thought that would encourage premarital sex, for example.

CONAN: We want to hear from those of you in the healthcare professions today. How does this rule on conscience affect you? Give us a call, 800-989-8255, email talk@npr.org. Victoria(ph) joins us now from Norton, Kansas.

VICTORIA (Caller): Hi. I'm a paramedic, and we picked up a young lady who had been raped. And unfortunately, the only pharmacist that was available refused to offer Plan B. And so this young lady was forced to drive over 200 miles to get medication that she needed.

CONAN: So this is precisely the situation, as you're describing it, that some have raised: That a pharmacist may be the only pharmacist for many hundreds of miles around.

VICTORIA: Yes. And under those circumstances, it created a great deal of controversy because this young lady was obviously upset and felt as though she were being judged and punished for something that was no fault of her own.

CONAN: No fault of her own. And Rob Stein, we heard earlier from Deirdre McQuade, of the Conference of Catholic Bishops, that she thought even the previous laws would've protected that pharmacist from distributing Plan B, something that he objected to on moral or religious grounds.

Mr. STEIN: Well that's one of the issues that's in great debate. I mean, the original laws were intended - were passed right after the Roe versus Wade decision. And the original intent was primarily at protecting healthcare workers who didn't want to participate specifically in abortions.

Now since then, it's you know - and sterilizations is also included in some of the earlier legislation. But now with this new regulation, it was broadened out to include lots of other things, including birth control pills, morning-after pills.

CONAN: And contraception?

Mr. STEIN: Right. And that's the concern - is that it could create all these obstacles to obtaining what essentially are legal healthcare.

CONAN: Victoria, do you happen to know, by any chance, what happened to this young woman? Is she okay?

VICTORIA: She is. Her friend drove her to the next available pharmacy. And she is doing well.

CONAN: Glad to hear it. Victoria, thanks very much for the call.

VICTORIA: Thank you.

CONAN: Bye-bye. Joining us now is Nancy Northup, president of the Center for Reproductive Rights, a pro-choice group. She's with us from her office in New York City. Nice to have you on the program today.

Ms. NANCY NORTHUP (President, Center for Reproductive Rights): Thank you for having me.

CONAN: And you support the repeal of this regulation. How come?

Mr. NORTHUP: Well, I think it's very important, and we applaud the president for rescinding the law, because it was both unnecessary and harmful. What we have to remember is that, as has been talked about on the show earlier, these laws have been on the books for over 30 years - who have protected doctors and nurses who don't want to perform abortions or sterilizations.

So, there is already a protection against religious discrimination in the laws. So it was unnecessary. And it's harmful because this regulation, which was passed at the eleventh hour by the Bush administration on the way out the door, was expanding who could refuse to participate in abortions or sterilizations and also instilled this ambiguity around - that this could also be used to hinder access to contraception and other reproductive health services.

So, for that reason, it was very harmful for women who were seeking reproductive healthcare.

CONAN: Again, the practical impact of this: The regulation only took force about a month ago.

Ms. NORTHUP: Right. And so, luckily, it didn't have an opportunity to be in effect for a long time. And I think the stories that you hear - for example with the woman who was just on the phone or people who work in emergency rooms - again, where the denial of emergency contraception - which we're talking about contraception there, we're not talking about abortion.

And so, if this law had been allowed to stand, it would have vastly expanded the limitations on getting healthcare services for women and would be most harmful to low income women, who rely more heavily on healthcare services provided by government funding.

CONAN: And what you describe as contraception, some people would describe as the equivalent to an abortion. I'm not arguing about who's right or who's wrong, but people feel very strongly about these definitions. And should people - should a doctor, should a nurse, should a pharmacist - be required to violate their conscience, their religious beliefs, what some would argue is their right to religious beliefs, to perform this service?

Ms. NORTHUP: Well, I think that the laws that we've had in place for decades are an appropriate accommodation between religious objections and the right for women to access healthcare.

The Center for Reproductive Rights is a human rights organization. We work around the world, and obviously the rights to conscience and religious freedom are human rights. But so is the right to access healthcare. And our current legal regime has an accommodation between those two rights. And you have to be sure it's - your caller earlier, who talked about seamless access.

When a woman presumes to get reproductive health services, and there's an objection by a pharmacist or by a nurse, they have to be able to get the healthcare that they're seeking and not be left, as your prior guest, Ms. McQuade suggested - that they could be refused to even be given information because that would be involving the healthcare worker in the access to sterilization or…

CONAN: But it also sounds like you're saying that doctors have a right to conscience. They don't have to perform abortions, but pharmacists don't.

Ms. NORTHUP: Well, pharmacists are obviously in a different position than doctors. They are - their doctors have prescribed, for example, emergency contraception to a patient who's going to fill that prescription at the pharmacy or birth control pills. And so they are blocking the relationship between the doctor and patient by stepping in and refusing to provide filling of those prescriptions. So, again, if there are…

CONAN: Don't they have an obligation to block that prescription if they say, wait a minute, this contradicts this other drug I know you're taking. You shouldn't take this. Let me check with the doctor.

Ms. NORTHUP: Oh, of course. If there is a medical contraindication that is there - that is their profession to be raising that issue. But it isn't their profession to be policing the relationship between the doctor and patient. And the woman's right to get access to contraception which she has under our constitution and is part of, you know, fundamentally women who are not looking to have, say, a dozen children…

UNIDENTIFIED MAN: Can you remember one in the recent past?

Ms. NORTHUP: I'm sorry. I'm sorry, what was the question?

CONAN: Rob, was that you?


CONAN: Oh, go ahead, Rob. What was the question?

KRULWICH: I was just talking to my engineer.

CONAN: Ah, okay.

KRULWICH: So, like, I shouldn't be on this program yet.

CONAN: Okay.

KRULWICH: I'll be on later.

CONAN: Okay. This is - this is Robert Krulwich, who's going to be on later talking about snow days. And we - it was a technical problem and I apologize for that. But it still sounds like what you're saying is that the conscience involved in the prescription is the conscience of the doctor and the - if the pharmacist has a conscience or not, it's not - it's not operable.

Ms. NORTHUP: Right. Now, if there is a way to accommodate the pharmacist's objection to filling a prescription for birth control pills because there's someone else on staff that can do it, then that's fine. What is important is that the woman who has presented herself, who's gone to a doctor, who has a valid prescription, can get that filled at that pharmacy and not be sent to the next county.

CONAN: Two-hundred miles away. Thank you very much for your call and do you expect a compromise or do you expect that the rule will be simply rescinded by the Obama administration?

Ms. NORTHUP: I would expect and hope that the rule will be rescinded. Again, this was not a necessary regulation. We've had these regulations in effect that protect rights of conscience. It was the 11th hour rule that should be rescinded. There isn't a need for some kind of compromise in this area. The law currently accommodates religious objections on conscience and women's right to healthcare access.

CONAN: Okay. Nancy Northup, thanks very much for your time.

Ms. NORTHUP: Thank you.

CONAN: Nancy Northup is president of the Center for Reproductive Rights and joined us from her office in New York City. Jay, in Santa Rosa, California, emails, any drug store or provider of medicine should have to clear the state in a way obviously visible to a customer before that customer enters the establishment that the establishment will not honor certain prescriptions for reasons for morality.

It shouldn't be left up to arbitrary employees scattered throughout the business to thwart a purchase if they see fit. The business needs to take a stand and if one of their employees can stop the purchase, then the store can't act like it's in the business of supplying prescriptions when it actually won't.

And Rob Stein, that is exactly the point raised by some of the large pharmaceutical chains across the country.

Mr. STEIN: Right, this issue of referral is, is really important. It's - it's one thing for - and a lot of these large chains of drug stores have put in place policies to address just that issue and make sure that even if they have employees and staff who morally are opposed to, say, the morning after pill or birth control pills. They have a procedure in place where that person will step away and then another pharmacist will step in and take over for them.

Or they'll have a list of other pharmacies nearby that they can give to their customers so they know where to go get whatever it is they're looking for. But that's where it can break down sometimes because there are a lot of healthcare workers out there who feel that they don't even want to be a party to that. That they feel like that's violating their personal beliefs even to refer a patient elsewhere.

CONAN: Rob Stein of The Washington Post. We're talking about conscience and healthcare. You're listening to TALK OF THE NATION from NPR News. And Beth is on the line. Beth with us from Valdosta, Georgia.

BETH (Caller): Hi. I just wanted to say that I think pharmacists in general need a little more sensitivity when it comes to this subject, that prescribing the actual medication can be seen as something that is a sin on their part for some of these religious beliefs. Not just that you're helping someone else commit a sin, but that you're actually committing a sin. It's like asking a Muslim coworker to eat pork with you at a lunch at the cafeteria or something like that to me. That's what I compare it to.

CONAN: So, that's the violation of religious beliefs - a part of it. Do you see that people have a right to healthcare, that if they have a doctor's prescription and they walk into a pharmacy - shouldn't they have the right to have that prescription filled?

BETH: Yes, but they - I don't see why it's a problem to have them go to a pharmacist that is not violating their religious beliefs in doing so.

CONAN: And if there's…

BETH: I think, if that's your religious belief I think you're entitled to it and it's protected by the Constitution.

CONAN: And if it's the middle of the night or if that's the only pharmacy for 200 miles?

BETH: I feel sensitive towards women who feel they need this pill, but to my religious belief, it's morally wrong to take it and it's morally wrong to provide it. They're the same.

CONAN: Beth, thanks very much for the call, appreciate it.

BETH: Yup.

CONAN: Bye-bye. Let's see if we can go now to Deborah(ph). Deborah in Madison, Wisconsin.

DEBORAH (Caller): So…


DEBORAH: Hi. I'm a nurse here and my whole thing is we take care of people with all different kinds of health needs. And they're in the hospital for all sorts of reasons - all the way through prison population, people who didn't take care of themselves, people who abused medication. We do not - we are not supposed to pass judgment. This is not our judgment. And it's not a moral standing that when pharmacies say, I don't think they get to say that morally we won't do this.

They may say we personally decided not to, you know. When that person was saying, well, a pharmacist can always say, well, morally. It's not a moral. It's their personal decision. But it's not - it implies that no one else is unless they share their particular outlook.

I - my feeling is that medical and nursing personnel, if you're a pharmacist, if you're prepared to go into the profession, you better be prepared to go to work and work for your patient and do what needs to be done. If they're allergic to it, of course, I'm not going to give them the medication.

CONAN: Right.


CONAN: But should that apply to - should doctors, OB/GYNs be required to perform abortions?

DEBORAH: That I think they would have to answer on their own, I guess.

CONAN: So they get a conscience and the pharmacist doesn't.

DEBORAH: The - I - boy, that's a tough one. I think that the - maybe they should go into dermatology.

(Soundbite of laughter)

CONAN: Deborah…

DEBORAH: You know, I mean, really, you know, if you only have one hand, perhaps surgery is not your job. If you're not prepared to do the job fully and completely as medical science, this is not a religious thing, this is a science. And whatever science allows you to do at that time, if you're not prepared to do it, you should be looking at a different field that's more appropriate.

CONAN: Deborah, thanks very much for the call. We appreciate it.


CONAN: And Rob Stein, it is - it is science. She's right about that. It is also religion and she's not right about that. It's also politics and that's where it really does get sticky.

Mr. STEIN: Absolutely. I mean this is - this has really become one of the new flash points in the culture wars and it's only going to become a bigger issue as time goes on. I mean, we've been talking mostly about abortion and contraceptive access, but this issue has popped up all over the places and a number of issues. We've had doctors in California who refused to treat gay women with infertility treatments because they object to it.

We've had doctors and nurses who were refusing to provide end-of-life care because they find it objectionable. And we are looking towards time when, you know, embryonic stem cells presumably will start to filter their way into the clinics and there are a lot of people who have deep moral objections to embryonic stem cells therapies because they involve the destruction of embryos.

CONAN: Sounds like…

Mr. STEIN: So this is only going to become a bigger issue as time goes on.

CONAN: And it sounds like we're going to be in no shortage of dermatologists.

(Soundbite of music)

CONAN: Rob Stein, thanks very much for your time today.

Mr. STEIN: Well, thank you, Neal. Pleasure to be here.

CONAN: Rob Stein of The Washington Post with us today from the studio at the newspaper here in town. Coming up, well, it happened - well, not for public school children in Washington, D.C., most of them stayed home, but they didn't have to. Almost everybody else up and down the east coast had a snow day as millions of kids today discover the surprise break and the joy. What are your memories of your favorite and most memorable snow day? talk@npr.org. I'm Neal Conan, stay with us.

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