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Federal Judge Turns Down the ‘Conscience Rule’: What This Means for Clinicians

On Wednesday, a federal judge declared that the Department of Health and Human Services’ rule allowing clinicians to refuse to provide certain services based on religious or moral grounds is unconstitutional.

The legal authority who made the decision is Judge Paul A. Engelmayer of New York’s Southern District, MedPage Today reports. While he wrote that the rule “[recognizes and protect] undeniably important rights,” he noted that it violates the Constitution and federal Administrative Procedures Act.

The Trump administration originally planned for the rule go into effect on July 22, 2019, but courts delayed it until November. As of Wednesday, it was unclear if the administration will appeal the ruling.

What is the “conscience rule”?

Formally titled “Protecting Statutory Conscious Rights in Health Care,” the “conscience rule” is a 440-page document issued by the U.S. Department of Health and Human Services (HHS). It encourages healthcare workers to file a complaint with HHS’s Office of Civil Rights if their employer forces them to participate in a procedure they morally disagree with, such as abortion, gender confirmation surgery or assisted suicide. The rule allows them to do so in emergencies and without providing advance notice, NPR reported earlier this year.

The rule is part of the Trump administration’s fight to protect religious freedom for healthcare providers. Critics fear it will largely limit access for patients, especially those in already-underserved communities. They also argue it encourages healthcare providers to refuse or to intentionally limit treatment solely based on a patient’s identity, especially if they’re LGBTQ.

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The HHS originally proposed the rule in 2018, and it received immense backlash, including three federal lawsuits from a total of 15 states, including New York and California.

What changes under the “conscience rule”?

If the rule were to go into effect, the primary shift would relate to medical facilities ability to staff procedures that clinicians may feel fall in moral grey area.

It has potential to change hiring practices, as well. For example, a hospital could not inquire, prior to hiring nurses, if they personally objected to administering a measles vaccination — even if this was a core duty of the job in the middle of an outbreak.

RELATED: Poll: Where Do Healthcare Professionals Stand on Medicare for All?

In opposition to religious exemption laws, including the “conscience rule,” a number of nonprofits, such as Planned Parenthood, the American Civil Liberties Union and the National Family Planning & Reproductive Health Association, have also sued the Trump administration.

The following are some examples of religious refusal provisions, according to Planned Parenthood:

  • A pharmacist could refuse to fill a prescription for birth control or antidepressants, or not administer a vaccine because of their personal beliefs.
  • A hospital administrator could cancel a woman’s cancer treatment because it might harm her pregnancy.
  • A transgender patient could be denied hormone therapy or emergency medical care, because their provider refuses to treat transgender people.

Do you agree with the “conscience rule”? Share your thoughts in our poll.

Courts Order Delay Of Trump Administration’s Health Care ‘Conscience Rights’ Rule, NPR.
Federal Judge Voids ‘Conscience Rule’, MedPage Today.

Last updated on 11/6/19.

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