'Conscience Law' For Health Care Providers Worries Some, Pleases Others

May 20, 2019

Earlier this month the federal Department of Health and Human Services announced it had finalized a policy that would protect health care providers against discrimination if they refuse to care for someone based on their “moral convictions.” 

Critics contend the new “Protecting Statutory Conscience Rights in Health Care” rule could create more barriers to medical services for minority populations, while many religious health workers believe it’s an important step.

In a 440-page report, the DHHS’ Office for Civil Rights outlines how the agency will provide “vigorous enforcement” of anti-discrimination laws for those who refuse medical services for ethical reasons. It cites stories from physicians who said they’d been punished or reprimanded for choosing to not perform procedures they found violated their religious beliefs, such as abortions.

Christian Medical and Dental Association CEO David Stevens said members of his organization have experienced discrimination in these situations. He cited a poll by CMDA and the right-wing Christian group Freedom2Care that described incidents of health care workers being fired for praying with patients, referring minors who were struggling with their gender identity to counseling that “confirmed heterosexuality or biological gender” and refusing to provide birth control to an unmarried woman.

Stevens said he felt it was important that this new rule come from the federal level because there hasn’t been enforcement of protections under the First Amendment for such religious providers. 

“Don’t those who aren’t going to do abortions and don’t want a doctor that does abortions have a right to have a health care professional that shares their beliefs?” Stevens asked. “These type of conscience laws protect anyone. Not just people of faith. And if we don’t do that, anybody can be forced to do something that violates their conscience or their moral concerns.”

Hugh Lane Wellness Foundation Executive Director Sarah Rosso, who works with LGBT patients, said that idea is unsupported. LGBT people are already fearful of coming out to their health care providers, Rosso said, and allowing workers to refuse care will only exacerbate the problem.

“This can potentially be a license for medical providers to be able to refuse treatment to gender-diverse, transgender and LGBT members broadly,” Rosso said.

According to a 2016 LGBT Health Need Assessment for the Pittsburgh region, 39.6 percent of those surveyed “sometimes” feared a negative reaction from their health care provider about coming out, while 18.8 percent “often or always” did. Rosso said for transgender or gender non-conforming individuals, this concern is even higher.

“If I’m trans or non-binary identified, I have a very real fear of disclosing my gender identity to my provider and fearing that they’re going to treat me poorly as a result of that,” Rosso said.

Instead, Rosso said states should focus on increasing LGBT-friendly and competent providers. The state of Pennsylvania still does not have anti-LGBT discrimination laws in place, but Rosso said there is a growing movement to pass such legislation.