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The rule will be effective 60 days from its final publication and enforced by the health department’s Office of Civil Rights.
The rule will be effective 60 days from its final publication and enforced by the health department’s Office of Civil Rights. Photograph: Alamy Stock Photo
The rule will be effective 60 days from its final publication and enforced by the health department’s Office of Civil Rights. Photograph: Alamy Stock Photo

Trump administration rules health staff can refuse care for religious reasons

This article is more than 4 years old
  • New rule reinforces laws protecting ‘conscience rights’
  • ACLU says religious liberty being used to harm communities

Doctors, nurses and other health workers can opt out of procedures such as abortions and sterilizations which violate their personal or religious beliefs, under a rule issued by the US Department of Health and Human Services on Thursday.

The rule, proposed more than a year ago, reinforces a set of 25 laws passed by Congress that protect “conscience rights” in healthcare, HHS said. Those laws allow health providers and entities to opt out of providing, participating in, paying for or referring for healthcare services that they have personal or religious objections to, HHS said.

Trump chose the National Day of Prayer to announce the new regulation.

“Just today we finalized new protections of conscience rights for physicians, pharmacists, nurses, teachers, students and faith-based charities,” Trump told an interfaith audience in the White House Rose Garden. “They’ve been wanting to do that for a long time.”

The rule makes no new law and does not go beyond statutes passed under administrations of both political parties, said Roger Severino, director of HHS’s Office of Civil Rights. Rather, the regulation will guarantee that religious and conscience protections already on the books can’t be ignored. The rule will be effective 60 days from its final publication.

“Finally, laws prohibiting government funded discrimination against conscience and religious freedom will be enforced like every other civil rights law,” said Severino.

“This rule ensures that healthcare entities and professionals won’t be bullied out of the healthcare field because they decline to participate in actions that violate their conscience, including the taking of human life,” he said.

Physicians, medical groups and others have warned the rule would erode protections for vulnerable patients in healthcare, including gay and transgender individuals.

“This administration shows itself to be determined to use religious liberty to harm communities it deems less worthy of equal treatment under the law,” Louise Melling, deputy legal director at the American Civil Liberties Union, said in a statement.

“This rule threatens to prevent people from accessing critical medical care and may endanger people’s lives,” Melling said.

The complex rule runs more than 400 pages and requires hospitals, universities, clinics and other institutions that receive funding from federal programs such as Medicare and Medicaid to certify that they comply with some 25 federal laws protecting conscience and religious rights.

Most of these laws and provisions address medical procedures such as abortion, sterilization and assisted suicide. The ultimate penalty can be loss of federal funding for violations of conscience or religious rights, but most cases are settled by making changes in practices and procedures.

In April 2018, the American Medical Association wrote to the HHS secretary, Alex Azar, warning that the rule would further marginalize vulnerable patient populations. The group also said conscience rights for physicians were not unlimited.

Donald Trump’s administration has prioritized expanding religious liberty protections through measures that included an executive order in May 2017. HHS created a new Office of Conscience and Religious Freedom within its Office of Civil Rights more than a year ago, and soon after proposed its conscience rule.

Reuters contributed to this report

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