Q A technologist
in my lab refuses to perform pregnancy tests from a local crisis
pregnancy clinic. She claims it violates her conscience, because she
feels most of the women getting these tests will go on to have
abortions. She feels the same way about genetic testing. Can we force
her to do these tests? They are in the usual course of her work, and her
refusal is causing problems, mostly because of strong political opinions
on the subject.
A Determining what to do
is more a human resources (HR) problem than a legal one at this point.
Current conscience-law provisions, which are in flux, are intended to
protect an individual with religious objections from being forced into
participating in an abortion as a condition of work in the healthcare
environment. The legal definition of “participate in an abortion” is
generally restricted to active participation: being in the room and
assisting at the procedure, or in some direct way providing it.
Legally, this does not rise to the level of
protection under conscience laws. That will not, of course, stop a legal
challenge if the employee feels strongly and is forced to perform these
tests. The matter of conscience law is not entirely settled, and the
current climate of discourse may make a challenge more likely. Mindful
of the usual legal and HR warnings against setting precedent that will
have to be followed in future cases, consider the following approach.
First, get a clear definition of the
accommodation the tech is seeking, but do not solicit the reason for her
request, because any decision on this matter should be based on
workplace — not personal — needs. Acknowledging the reason for the
request in the formal process of evaluation makes you liable to a charge
of bias. In this case, it is better not to “know.”
Determine if this individual can be reassigned to
another area that does not require her to manage these tests. This might
be possible in the course of a general reorganization, or there could be
an individual who is sympathetic enough to change places. Any inquiries
about a colleague’s willingness to switch responsibilities should be
made discreetly, and, if arranged, should not penalize either party.
Solutions such as these can offer the added benefit of increasing cross
training in the facility.
Accommodating this individual’s request may not affect how work is done at all and may even improve the process.
Second, ascertain if work within this tech’s area
can be rearranged without an actual transfer to another area. Perhaps
clinic specimens can be batched and run on another shift if turnaround
time is not an issue. Can specimens be batched and run at the same time
by another team member?
Third, assess the effect of any proposed changes
on workflow, turnaround time, and efficiency. Accommodating this
individual’s request may not affect how work is done at all and may even
improve the process. Making an honest evaluation of the real working
situation is essential to making a sound decision. Realistically,
individual preferences (for shifts, assignments, working partners) are
accommodated regularly. These preferences, however, are integrated in
the spirit of making the team comfortable only when the work can
continue to be completed efficiently and properly. With all of this
information, evaluate whether or not this tech’s request can be
reconciled within the usual work of the laboratory.
Following this process will have also established
a procedure for evaluating all such future requests, and with diligent
documentation, addressing future requests will be simplified by using an
established way of assessing the situation.
Proceeding in the fashion outlined above reduces
the “precedential” impact of any decision, whether for or against the
request. Evaluate the procedure again in a year to determine how often
it has been used and how many changes have been made. Of course, be on
guard against constant requests for trivial rearrangements that will
defeat the purpose of the plan.
Last, fostering an environment in which
individuals are respected, even when others disagree with them, is
important. We are in a climate of great tension and strife in the area
of healthcare, and topics such as politics and religion can cause
tempers to run high. An atmosphere where everyone’s point of view is
respected — but one in which personal ideologies are put aside for the
workday — is essential. In this case, for example, the tech’s request
not to perform pregnancy tests under these circumstances can be (but
need not necessarily be) supported; angry discussions over political
leanings or religious ideals cannot. The staff should be made to
understand that a personal preference or belief cannot be allowed to
create discord in the workplace. Some training and individual coaching
may be needed on the subject in order to keep the peace.