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 The national survey found that 46 states had laws protecting medical
professionals and institutions from being sued for harm to patients
related to a refusal to provide services out of conscience,
researchers report in JAMA.
"The biggest takeaway from this research is that while people are
aware that conscience laws may impact a woman's right to access
reproductive services, they may not know that these laws also may
impact access to the legal system when they are injured as a result
of conscientious refusal," said the study's author, Nadia Sawicki,
Georgia Reithal Professor of Law at the Loyola University Chicago
School of Law.
"The majority of patients have no idea whether their local hospital
is religiously affiliated," Sawicki said. "So they don't know if
there are providers who can't provide services. I hope this research
brings to light the very real impact that conscience laws have not
just on access to care but also on the right to legal recovery in
cases where the patient is injured."
While the current report analyzed laws affecting abortion, Sawicki
noted there is a larger study that looks at other reproductive
services, including sterilization, emergency contraception and
assisted reproduction. The full dataset is available on the LawAtlas
Policy Surveillance Portal, Sawicki said.
To take a closer look at the prevalence of these conscience laws,
Sawicki combed through Westlaw, the most widely used research
database of state laws and regulations, and state legislative
websites to identify laws in effect as of December 17, 2018, that
protect the right to refuse participation in abortion. (Westlaw is a
product of Thomson Reuters but is otherwise unrelated to Reuters
Health.)
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Altogether, 46 states had one or more laws protecting clinicians and
institutions, as well as other individuals and entities, from
adverse consequences that might arise as a result of their
conscientious refusal to participate in abortion. The most common
protection was a prohibition on civil lawsuits against conscientious
refusers, Sawicki reported.
Most states did not have exceptions to the laws, even in cases of
potentially fatal ectopic pregnancy, and most did not require the
clinician to provide a referral or information regarding access to
services. Twenty-six states imposed no conditions on the rights of
refusal.
Some states did limit the immunity from lawsuits in cases of
emergency (13 states), miscarriage (four states), and ectopic
pregnancy (three states).
The study shows that the majority of states have given more weight
to the providers' rights than to the patients' needs, said Dr.
Albert Wu, an internist and professor of health policy and
management at the Johns Hopkins Bloomberg School of Public Health.
It's "disturbing that patients in 37 states do not have a right to
those services and that patients have been injured as a result," Wu
said. "It's a widely held belief that the patients should come
first."
"This crosses a line to the point where employee rights are
encroaching on patients' rights," Wu said. "I think patients need
more safeguards to make sure their right to health is not trumped by
the preferences of medical professionals."
SOURCE: http://bit.ly/2qj06dt JAMA, online November 19, 2019.
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