Scare quotes scare me

scarequoteThe Washington Post covered a new Bush administration rule that protects the conscience rights of health care workers. Or, as the Washington Post scare quotes it, “right of conscience.”

We get the scare quotes in the headline and again in the second paragraph:

The Bush administration today issued a sweeping new regulation that protects a broad range of health-care workers — from doctors to janitors — who refuse to participate in providing services that they believe violate their personal, moral or religious beliefs.

The controversial rule empowers federal health officials to cut off federal funding for any state or local government, hospital, clinic, health plan, doctor’s office or other entity if it does not accommodate employees who exercise their “right of conscience.” It would apply to more than 584,000 health-care facilities.

Are the words “they believe” in the first paragraph necessary? Obviously if they didn’t believe these beliefs, they wouldn’t be, well, their beliefs. Right? And the regulation isn’t sweeping, as the story goes on to note in great detail.

Anyway, it’s not like conscience rights are previously unheard of or were just invented by Mike Leavitt, the Health and Human Services Secretary behind the ruling. So I really don’t get the scare quotes. One of my best friend’s parents met because her father served as a conscientious objector during Vietnam at a hospital where her mother was interning. Does the Washington Post refer to such Mennonites as “conscientious objectors” or just conscientious objectors? No scare quotes in this 2006 story. Why the difference? Is it one thing to have a conscientious objection to war and another to have a conscientious objection to abortion?

The story notes that abortion rights advocates and others condemned the regulation because it could create obstacles in the provision of abortions and other medical procedures. There’s also this:

The 127-page rule is the latest in a flurry of federal regulations that the administration is implementing before President Bush’s term ends, including a number that would weaken government protections for consumers and the environment.

Although the Obama administration could reverse the rule, it would require a lengthy process. Last month, however, Sens. Hillary Clinton (D-N.Y.) and Patty Murphy (D-Wash.) introduced a bill to repeal the regulation legislatively.

It might be nice to have a bit of context here. It’s worth noting that President Bill Clinton, upon his exit from eight years in office, set a record for the amount of regulatory activity his administration enacted in the final weeks of an administration — 27,000 pages in November, December and January, breaking Jimmy Carter’s 20-year record and representing a 51 percent increase over Clinton’s normal November-January activity. How does Bush’s activity compare? (And it’s Patty Murray (D-Wash.), not Murphy.)

The story gets some balance in there, noting that the rule applies to entities that receive federal funds and not private entities. But what about this paragraph?:

The rule is supported by a variety of conservative groups, including the U.S. Conference of Catholic Bishops, the Catholic Health Association, which represents Catholic hospitals, the Christian Medical Association and the Family Research Council.

Is the U.S. Conference of Catholic Bishops best described as a conservative group? And, if so, on what grounds? Catholic teaching doesn’t fit nicely in conservative or liberal categories. And if we were going to force it into one or the other, I’m not sure I’d pick conservative.

Remember that lede about the new and sweeping rule? Now read these paragraphs:

The language of the rule, which will cost more than $44 million to implement, stressed that it is primarily aimed at making sure that federal laws on the books since the 1970s are enforced and that nothing in the regulation would prevent any organization from providing any type of care.

“The ability of patients to access health care services, including abortion and reproductive health services, is long-established and is not changed in this rule,” it states. “Instead, this rule implements federal laws protecting health care workers and institutions from being compelled to participate in, or from being discriminated against for refusal to participate in, health services or research activities that may violate their consciences. . . . “

Indeed, some of the comments received in response to the proposed rule were that it was unnecessary because it duplicates federal laws on the books. The story goes on to note that the rule isn’t a sweeping new regulation so much as a response to recent efforts by professional medical groups that might infringe on doctor’s conscience rights or, er, “conscience rights.”

I’m also unsure about this paragraph:

The rule comes at a time of increasingly frequent reports of conflicts between health-care workers asserting their religious freedom and patients seeking legal treatments that some providers object to. Pharmacists have turned away women seeking birth control and morning-after pills. Infertility doctors have refused to help unmarried and lesbian women get pregnant by artificial insemination. Catholic hospitals have refused to administer the morning-after emergency contraception pill, perform abortions or treat women having miscarriages.

It is news to no one that Catholic hospitals do not perform abortions or otherwise terminate the lives of unborn children. But do Catholic hospitals really refuse to treat women who are losing their children due to miscarriage? And, if so, could we have any evidence of this? I would love to know how reporter Rob Stein came up with this. It strikes me as patently untrue. Apparently I’m not alone. This blogger wonders if Stein is using this abstract as justification:

Catholic-owned hospital ethics committees denied approval of uterine evacuation while fetal heart tones were still present, forcing physicians to delay care or transport miscarrying patients to non-Catholic-owned facilities.

In other words, Catholic-owned hospitals will treat a woman having a miscarriage but won’t treat her by aborting a baby who is alive and whose heart is beating. This is not the same thing that Stein wrote. So what’s his justification for what he wrote?

This is an important story but coverage of the regulation could be handled better. Hopefully other reporters and subsequent stories will do a bit better.

Note: As I’m about to post this (I wrote it last night), I see that today’s follow-up story — which has a different, updated lede — also corrects the Murray error and removes one set of scare quotes and the bizarre miscarriage line. Both stories use the same URL, which means that the Post considers today’s story to be a better version of the same story. Because yesterday’s article was up throughout the day and is the story that spread throughout the blogosphere, I think it’s appropriate to critique it here. Still, it’s worth noting that earlier stories can improve with time.

Print Friendly

  • LMS

    Whatever happened to separation of Church and State? Is the U.S. turning into the Vatican?

  • rw

    Nice catch, and good anaylsis.

    This is why Mollie rocks!

  • Ed Mechmann

    Psst. LMS. You’re right. We hid the Vatican takeover of America right there in the First Amendment to the Constitution. Just look under “free exercise of religion”. Good catch.

  • FW Ken

    Protecting people from being forced to violate their conscience violates church-state separation? I would have thought the other way around.

    But what I want to ask is: are these “scare quotes” or “sneer quotes”? Is there a difference of usage in journalism? Obviously, the quotation marks I just used were for neither scare nor sneer purposes.

  • Peggy

    I want to do my own scare quotes: I dislike the over-use of “worker.” It’s demeaning to mankind in general, to professionals, in this case in the medical field, and to immigrants, legal or not. Do we only care that people are “workers”? It’s a dehumanizing term.

    I also dislike the use of “health care” instead of “medical.” This term again degrades the many years of education and training that men and women go through to become doctors. Nurses or others who do obtain maybe a bit less training for their medical fields are similarly only “health care workers.”

    I am not in the medical field, but as an economist I see this change of language enabling the degradation of an economic sector with highly-skilled professionals to some low-level public service with low-skilled/paid govt functionaries, ie, a nationalized “health care system.” [The reason our "system" may seem inferior to other countries' by liberal standards is that we don't have a system. We have an industry of individual firms and providers. That's good. A system is run by the government. That's bad.]

    Sorry, that is not at all religion-related. But it’s what about that article that bothered me. I’m sure you may choose to delete this post. But the larger issue of language by the press to manipulate public thinking is at stake here.

  • Jerry

    Where does one draw the line? How about a Hindu who refuses to touch meat? Or a male Muslim emergency room technician who refuses to treat women? Or a Catholic doctor who refuses to treat a women who’s miscarriage might cost her life until the fetal heartbeat stops? Welcome to the slippery slope. So do we need to put large warning signs outside hospitals as to what some there won’t do? Or perhaps we should require all medical facilities that get any form of government payment or subsidy to administer all legal treatments? If anyone can think of more of a mess where rights collide, it would be news to me.

  • Deacon John M. Bresnahan

    The fact of the matter is that those who believe in the Culture of Death want to do everything possible to coerce devout Christians and Jews to be their moral slaves if they wish to be in any health or medical field. They want human amoral robots in those fields. And, of course, much of the media wants just this sort of bondage slavery under law instead of law being used to protect the moral consciences of our country and people.

  • Harris

    I’m not sure you are well served by conflating these rights of conscience with that of conscientious objection. In the days of the draft, long before Mollie, CO status was something adjudicated: one applied for it, and then that application was reviewed by the draft board. It is the absence of the process that is somewhat bothersome about the current situation.

    The problem with the quotes (or their absence) is that this assertion of the rights of conscience, while grounded solidly in the First Amendment, also possesses a public dimension. It appears as a category or class of public action. How then does one distinguish between the broader, general use of the term, and its more specific policy-related use? Typically, some phrase comes to stand in here, a verbal abbreviation (e.g. partial birth abortion) or the specific term pushes out the broader term. Until then, however, the use of “quotes” provides an indicator that something more specific is being referenced.

  • Dr Joan

    First, for Peggy, #5: I do prefer the term health care provider with an explanation as to the position (medical, nursing, etc) when addressing issues such as this. There are MANY providers, each with different background or education (NOT training) to meet that various needs of the patient.
    Second, it is all too elitist to purport that one person or one group of people can determine the importance of another’s conscience. As a Christian I know that I am encouraged to refrain from eating meat offered to idols if another–a “younger” (pardon my quotes) Christian–might become confused or offended by the practice. So, if it bothers me to participate in the process of an abortion (and for this health care provider, it does) and patient care is not compromised, I should be allowed to practice as I believe. But historically this has been encouraged where patients can be cared for either by another person or in another place; if a life is at stake, there are other considerations to be made.
    It seems to me that the history of this practice is what is lacking in this piece. I was a student nurse when contraception as a medical practice was introduced. We were told in no uncertain terms that we were free to disagree and to refrain from participating in contraception prescribing as we saw fit. And this at a secular state university.

  • Peggy

    Dr. Joan,

    I won’t argue with your personal preferences. I will note, however, that I did say “education AND training.” You know as a nurse and doctor (?) that you have to undergo residencies and practicums while a student to get “on the job” type training in addition to study in the classroom and labs.

    The word “provider” is rather vague and could refer to an entity as well as individual professional. I understand that broad use in many contexts. I picked on the press’s over-use of “worker.” It’s so Marxian and utilitarian.

  • Dave2

    Mollie, if you’re a libertarian, surely you should be able to distinguish between (i) the right to stay out of a war, and (ii) the right to call in the state to keep your employer from firing you for not doing the job.

    If I’m a birth control vendor and one of my employees refuses to sell birth control (for whatever reason), then it is just common sense that I should fire that employee. They need to get into a different line of work, and I need to get an employee who’s willing to do the job. If the state tells me I can’t fire them, and that I’m legally required to cater to every last qualm of every last employee, then we have a problem.

  • tioedong

    This is much needed because unlike 40 years ago, doctors now work for HMO’s…ditto pharmacists.
    and of course, waiting in the wings: Euthanasia…

    California law now “mandates” doctors to cover all “medical treatments” for the terminally ill…that means docs could in the near future be forced to “suggest” euthanasia to patients who are already scared and vulnerable, and may take the advice as a command (something similar occurs with frightened pregnant women of course, which is why they want to mandate docs to discuss “all” options)

  • Stephen A.

    First a response to Jerry: Yes. In Canada, I’ve been reading that there is a lot of non-Christian religious accommodation going on. (see: )

    As for the topic at hand, the scare quotes here (“right of conscience”) are inexcusable.

    This is similar to a paper writing “gay rights” in quotes. It’s also reminiscent of the old so-called ______ we see frequently referring to conservative causes, people and actions.

  • Mollie


    That’s why I specifically pointed out that this rule only affects federally-funded entities.

  • puditius

    Underlying this thread is the assumption that the state has the right to regulate, it has the right to prescribe. It is only if the state has the right to prescribe that we reach the point where objectors are entitled to an exemption.

    I say there is no need for an exemption, because the state has no authority to demand the treatment in the first place.

  • Dave2

    Mollie, thanks for the clarification, but it still seems to spoil the ‘conscientious objector’ analogy.

  • Liz B.

    Huh. I read the quotes around “right of conscience” as just highlighting a term with which the reader might not be familiar. I certainly wasn’t. (That’s assuming it’s actually a term that’s commonly used in the discourse about this issue. If the author just made it up, then it’s definitely scare quotes. :) )

  • steve

    It follows then that public library employees can legally refuse to let patrons check out books they morally object to. Or that health care provider can refuse to treat anyone whose lifestyles they morally object to. Or USPO carriers can refuse to deliver material they morally object to. Or tax payers can refuse to pay federal, state, local taxes which support activities they morally object to. Or…the list potentailly goes on and on. This is Pandora’s box being opened.

  • Stephen A.

    steve (18) this is a kind of argument called Reductio ad absurdum – you’ve taken things to extreme to prove that the original, reasonable, objection is equally extreme. I think the right of someone not to be FORCED to perform an abortion rises to a higher level than all of your examples. And there are numerous REAL LIFE objections religious people can make that are not ridiculous at all.

    As I noted above, Canada has had numerous cases in which Sikhs were granted the right to wear a turban or not cut their hair.

    The cases of Jehovah’s Witnesses in the U.S. also comes to mind.

  • Dave

    Stephen A., reductio ad absurdum is not a logical fallacy. It’s a legitimate argument form, precisely to point out how the position being criticized leads to absurdity. You correctly identified the argument steve used; you didn’t rebut it.

  • Stephen A.

    No, Dave, it’s a fallacy to make the assertion that because one thing is true, all other things which are less typical and less serious must also be true. It’s absurd. Hence the name. Someone doesn’t get to make a logically fallacious argument and then expect others to “prove” those absurd statements to be false.

    But I’ll rebut it, just because you asked …

    It does NOT “follow” that if someone isn’t forced to perform an abortion, that immediately, letter carriers get to decide not to deliver “objectionable” mail (now how would THAT be determined, by illegally opening every piece of mail?)

    1) the example is laughably stupid and 2) it does not “follow” in any rational sense because there is no connection to the two examples.

  • Dave

    Stephen, your opinions on logical argument shed some light on our conversations in the past.

  • Stephen A.

    Dave, there’s a right way to convince through argument and discussion, and there’s a wrong way. Saying that postal officials are going to suddenly begin breaking the law by opening the mail and deciding whether or not to mail it based on their moral views (and in the process violate their own consciences) just because doctors at Catholic hospitals are NOT forced to perform abortions is absurd to the extreme.

    Unlike others, I shy away from using extreme arguments, such as “if gay marriage is allowed, why, people will be marrying their dogs next!” That’s exactly the same kind of argument steve used, and it’s not only incorrect, it’s ludicrous.

  • Dave

    But showing that your logic implies that postal workers will be acting that way (which btw they did 50 years ago, so it’s not impossible) is a comment on your logic, not on postal workers.

  • Stephen A.

    But showing that your logic implies that postal workers will be acting that way (which btw they did 50 years ago, so it’s not impossible) is a comment on your logic, not on postal workers.


    I think you’re twisting things a bit here. I in no way suggested that postal workers will be acting this wya.

    And there is no time in our history in which USPS employees EVER sorted thru the mail to decide whether to deliver it based on the morality of the contents.

    I think you’re making a fool of yourself now and it’s time to pull the plug on this line of discussion for your own good