Wording that would let psychologists not treat or not refer patients because of a moral conflict - opposing homosexuality, for example - met with skepticism Wednesday from the state board of psychology.

After 90 minutes of debate, the board chose not to endorse a proposal put forth earlier by Jim Cunningham, director of the Nebraska Catholic Conference.

While Wednesday's inaction may not be the final word on the issue, board member objections left little room for compromise.

Catholics did not propose the change in regulations in order to ignore patients' needs, said the Rev. Christopher Kubat, director of Catholic Social Services for the Lincoln diocese. He added the proposal had been widely misconstrued.

If, for example, a homosexual client went to a Catholic therapist for help, Kubat told the board, it still would be improper for the therapist to deny treatment for depression or suicidal tendencies.

What the church seeks, Cunningham said, is to protect providers from complaints of discrimination should a psychologist refuse a request to, for example, make a person a more giving homosexual partner.

Similarly, he said, a psychologist should be able to refuse to counsel a woman who asks for help in feeling better about her decision to abort a fetus.

Board members were sympathetic to a portion of the Catholic request: not to require therapists to treat for an outcome they abhor, but they argued such protection exists now.

Psychologist Lori Wall said choosing not to treat because of belief hits at competency because anyone who rejects a goal won't have the skills to help someone reach it.

The sticking point for her was permission not to refer - conceivably to abandon someone seeking help when they are most vulnerable.

Kubat said the referral requirement, as it is now, could cause a psychologist to compromise his or her principles. Hypothetically speaking, he said, it would be as abhorrent to refer someone to a therapist to help him or her feel better about being a pedophile as it would be to treat for it.

The hypothetical nature of Kubat's examples figured prominently in board members' skepticism.

For at least 17 years, said psychologist John Curran, nobody in Nebraska has raised a complaint of this nature.

According to the American Psychology Association, no similar complaints have been raised in any other state, he said, nor has any state board adopted wording that would allow a psychologist to deny treatment or to not refer.

"Is there really a pressing need?" asked psychologist Jerry Van Winkle, who later quipped: "If it ain't broke, don't fix it."

Kubat replied that because something had not occurred did not mean it would not.

Lincoln psychologist Ed Stringham, who supports the Catholics' request, provided examples in other professions where speaking against homosexuality had been construed as discrimination.

While he does and will continue to treat and refer in cases involving sexual orientation, Stringham said, existing anti-discrimination wording could be used against someone who refuses to supervise the water-boarding of criminals or who refuses to refer to someone who would.

Board Chairman David Carver said the wording of the proposed change, while addressing the worries of Catholics, could open the door to real discrimination.

"It opens the doors for a wide range of denials for vague reasons," Carver said.

An individual claiming issues of moral conscience could refuse to treat homosexuals or another group for any health issues.

Further, Carver said, a therapist who had ignored the needs of a suicidal client could later, to absolve himself, claim he had denied treatment or refused to refer based on moral objections.

Van Winkle said the state board's main purpose was to protect patients and that this proposal was about protecting psychologists.

Wall said that dealing with ethical boundaries and the complications of personal issues - such as a psychologist treating a person in a divorce while in the midst of his or her own divorce - was integral to being a psychologist. The expectation is that a psychologist who cannot provide care is obligated to help find someone who can, she said.

Reach Mark Andersen at 473-7238 or mandersen@journalstar.com.