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 The U.S. Department of Health and Human Services said on Thursday it
will create a division within its Office of Civil Rights to give it
"the focus it needs to more vigorously and effectively enforce
existing laws protecting the rights of conscience and religious
freedom."
Healthcare workers, hospitals with religious affiliations, and
medical students among others have been "bullied" by the federal
government to provide these services despite existing laws on
religious and conscience rights, the top HHS official said.
"The federal government has hounded religious hospitals...forcing
them to provide services that violate their consciences," Acting HHS
Secretary Eric Hargan said. "Medical students, too, have learned to
do procedures that violate their consciences."
Some of the services at issue include abortion and euthanasia,
according to HHS documents. Politico reported on Wednesday that the
protections would extend to care for transgender patients seeking to
transition.
Democrats criticized the move as a denial of healthcare for women
and others, while legal and medical ethics experts said that such
exemptions have legal limits and would be challenged in court.
Democratic Senator Patty Murray said in a statement she was "deeply
troubled" by reports of the new division and that "any approach that
would deny or delay health care to someone and jeopardize their well
being for ideological reasons is unacceptable."
LEGAL AND ETHICAL QUESTIONS
The division would enforce the legal protection and conduct
compliance reviews, audits and other enforcement actions to ensure
that health care providers are allowing workers with religious or
moral objections to opt out.
As the division seeks to back exemptions, it is likely to face legal
and ethical challenges.
“There will be challenges to any step along the way for any
expansion of religious exceptions,” said Marci Hamilton, a professor
at the University of Pennsylvania. She said such challenges would be
“pretty strong.”
Hamilton said that while courts had frequently upheld religious
exemptions in recent years, they have recognized limits. For
example, she said, courts have rejected a church’s bid to be exempt
from federal marijuana laws, and a Pennsylvania order of nun’s
effort to avoid eminent domain.
Professionals take an oath to serve people who are sick, Alta Charo,
a professor of law and bioethics at the University of Wisconsin in
Madison explained. They are also the only ones licensed to provide
those services and must do so without discrimination, she said.
"When the director of the office of civil rights is quoted as saying
that 'No physician should have to choose between helping a sick
person or following their personal conscience,' the director is
simply wrong. That choice was made the moment they became
physicians," she said.
Charo and other medical ethicists raised concerns about patients who
may be denied medically necessary, legally protected care because it
might violate an individual physician's beliefs.
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"What protections exist if a doctor can choose not to take care of
me because of my gender or my sexual orientation or because I have
an ectopic pregnancy and don't know it and I'm at a Catholic
hospital and it's the only hospital in town?" said Dr. Lainie Ross
of the University of Chicago's MacLean Center for Clinical Medical
Ethics.
The American Medical Association declined to comment on the policy
because it has not seen a written proposal. However, the American
College of Physicians said the new policy "must not lead to
discrimination" against any category or class of patients.
The HIV Medicine Association called the policy "regressive" and said
it shifts the foundation for medical decisions "from sound
scientific practice to healthcare providers’ personal beliefs."
Asma Uddin, a fellow at the UCLA Burkle Center for International
Relations and a Muslim, spoke at an HHS press conference about the
need for protection against what she said was a variety of ways
Muslim women patients are forced to violate their conscience,
particularly with respect to modesty.
TRUMP ORDER
The creation of the new HHS division is in accordance with an
executive order signed by Trump last May called "Promoting Free
Speech and Religious Liberty." The order was followed by new rules
aimed at removing a legal mandate that health insurance provide
contraception.
Several proponents of the changes cited the Little Sisters of the
Poor, an order of Roman Catholic nuns which runs care homes for the
elderly, which had challenged a legal mandate under Obamacare, the
common name for former President Barack Obama's 2010 healthcare law.
In October, HHS introduced rules that would let businesses or
non-profit organizations lodge religious or moral objections to
obtain an exemption from that mandate that employers provide
contraceptives coverage in health insurance with no co-payment.
Planned Parenthood said the move was the latest example of the Trump
administration's efforts to block women, transgender people and
other communities from access to care.
Americans United for Life, a group that opposes abortion rights,
said the HHS had taken a strong step forward to allow individuals
and organization to exclude abortions or other services that violate
their conscience.
(Additional reporting by Caroline Humer, Jilian Mincer and Brendan
Pierson in New York, and Julie Steenhuysen in Chicago; Editing by
Alistair Bell)
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