Last year, I wrote about the new Conscience and Religious Freedom Division established by the Trump administration in the Office for Civil Rights to enforce already existing “federal laws that protect conscience and the free exercise of religion and prohibit coercion and discrimination in health and human services”. The division specifically mentioned “issues such as abortion and assisted suicide in HHS (Health and Human Services)-funded or conducted programs and activities”. The division also included a link to file a conscience or religious freedom complaint “if you feel a health care provider or government agency coerced or discriminated against you (or someone else) unlawfully”.
The rule mandates that institutions receiving federal money be certified that they comply with more than two dozen laws protecting conscience and religious freedom rights.
Despite fierce opposition by groups like Compassion and Choices and Planned Parenthood, HHS announced on May 2, 2019 that the Final Conscience Rule Protecting Health Care Entities and Individuals would go into effect July 22, 2019.
However, lawsuits were quickly filed by groups like Americans United for Separation of Church and State and the Center for Reproductive Rights, delaying implementation of the Final Conscience Rule until at least late November. The first lawsuit was filed by San Francisco within hours of the announcement of the Rule.
WHAT IS THE PROBLEM WITH CONSCIENCE RIGHTS?
While Roger Severino, the head of the HHS Office for Civil Rights has said that the Final Rule did not add any new laws but rather strengthened the enforcement of rules already on the books, the San Francisco lawsuit alleged that if San Francisco does not comply with the rule “”it risks losing nearly $1 billion in federal funds that support critical health care services and other vital functions.”
In a press release, San Francisco city attorney Dennis Herrera stated the Final Conscience Rule:
“would have allowed health care professionals to refuse to provide service to patients based on the staffer’s personal beliefs, threatening medical access for women, lesbian, gay, bisexual, and transgender people, and other medically or socially vulnerable populations.”
“Hospitals are no place to put personal beliefs above patient care. Refusing treatment to vulnerable patients should not leave anyone with a clear conscience.”(All emphasis added)
Of course, ethical healthcare professionals respect all patients without bias. The problem is being forced to participate in actions that violate our consciences.
ARE CONSCIENCE AND RELIGIOUS RIGHTS NECESSARY?
Dr. Donna Harrison, director of the American Association of Pro-Life Obstetricians and Gynecologists (AAPLOG) makes the crucial point that:
“Those who oppose the HHS Conscience Rule demonstrate their clear intention to squeeze out of the medical profession any doctor who still abides by the Hippocratic Oath, and to squelch any opposition to forcing doctors to kill human beings at the beginning and end of life.”
Those of us who are nurses have been especially vulnerable.
As I have written before, I was threatened with termination when I refused to cause a patient’s death by increasing a morphine drip “until he stops breathing”. I know many other nurses who have had similar experiences.
And in 2013, 12 New Jersey nurses who had a long-standing, in-writing agreement exempting them from participating in abortions apart from a medical emergency were nevertheless threatened with termination when the hospital initiated a new mandatory policy to participate in all abortions. These nurses were finally vindicated in court but litigation is time-consuming and expensive.
And even the liberal NPR recently noted the rise in conscience complaints for health care workers since the Division of Conscience and Religious Freedom was established.
Obviously, there is a great need for this conscience rights protection for all healthcare workers. Now there is a way to stand up to bullying and discrimination so that we can properly care for our patients.
A few years ago, a worried student nurse asked if there was any area of nursing where her conscience rights would not be threatened. This was an important question because over the past several decades, new threats to conscience rights have widened from refusing to participate in abortions to other deliberate death decisions like withdrawal of feedings from people with serious brain injuries, VSED (voluntary stopping of eating and drinking), terminal sedation and physician-assisted suicide.
Most recently, the American Nurses Association wrote a draft position paper potentially changing its’ opposition to assisted suicide to neutrality and requiring that nurses must be nonjudgmental in discussing assisted suicide with a patient and even participate if no other willing nurse is available.
As assisted suicide and other such death decisions continue trying to expand, it is more necessary than ever to support ethical healthcare professionals both in law and in practice.
We all need the Conscience Rights Protection rule to ensure that ethical healthcare professionals can continue in their professions and help to restore trust in our healthcare system.