Refusal rules often allow doctors and other health care workers to refuse to treat or help patients because of religion, which discriminates against patients and denies people health care.
So-called “religious refusal” laws — or “conscience protections” — allow most any health care worker, including pharmacists and volunteers, to deny patients access to services the health care worker deems contrary to their personal beliefs.
Refusal laws and conscience protection acts are already implemented in several states and are nothing more than a license to discriminate in health care. Under the Trump-Pence administration’s refusal policies, health care workers in the U.S. and around the globe can deny patients services like birth control, abortion, sterilization, hormone therapy, and HPV vaccines. There are no protections for patients, not even in an emergency.
Examples of religious refusal provisions include:
A pharmacist could refuse to fill a prescription for birth control or antidepressants, or not administer a vaccine simply because of their own personal beliefs.
A hospital administrator could cancel a woman’s life-saving treatment for cancer 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.
Discrimination in Health Care
LGBTQ people — who already face systemic barriers to accessing health care, as a result of homophobia and transphobia — can be denied potentially life-saving health care. Refusal rules also significantly increase barriers to accessing, safe legal abortion. Already, nearly half of women of reproductive age have to travel between 10 to 79 miles to access an abortion, with some women in rural Midwest areas forced to travel 180 miles or more.
According to one survey, the overwhelming majority of voters don't believe health care workers should be able to deny people care based on personal objections. The measures compound existing barriers to health care faced by transgender patients. Thirty-three percent of transgender people have reportedly been mistreated while getting care, and 29% say they have been refused care due to their gender identity. Religious refusal laws also mean women of color — who have historically been denied access to quality health care due to racist and discriminatory policies — face decreased access to health care because hospitals in their neighborhoods are more likely to be religiously affiliated.
Mainstream medical groups have recognized the negative effects that refusal laws can have on patients and have called for patient protections. The American College of Obstetricians and Gynecologists (ACOG) says refusals should be “limited if they constitute an imposition of religious or moral beliefs on patients, negatively affect a patient's health, are based on scientific misinformation, or create or reinforce racial or socioeconomic inequalities.”
Religious Refusal Laws and Conscience Protections Function as Excuses to discriminate
The Trump-Pence administration, which promotes employers’ religious beliefs over a worker's ability to access affordable birth control, has repeatedly fought to eliminate Obama’s bypass measure. In 2017, the Trump-Pence administration issued birth control rules that would allow virtually any employer or university to deny coverage to its employees and students. In early 2018, the administration proposed its broader religious refusal rule, expanding health care workers’ ability to discriminate and deny people care. Doctors could refuse to treat patients because of their religious beliefs; other health care workers could withhold prescriptions or treatments.
Not stopping there, the U.S. Department of Health and Human Services (HHS) set up a new office, called the “Conscience and Religious Freedom Division.” That’s right — the government agency charged with protecting the health of all Americans will devote its resources to denying essential, potentially life-saving care to people of all identities.
Though some politicians have pushed religious refusal laws since the 1970s, they gained momentum in 2014 when the U.S. Supreme Court, in Burwell v. Hobby Lobby, allowed certain privately owned companies to deny their employees birth control coverage for religious reasons. In response to the disastrous ruling, the Obama administration created a workaround that permitting these employees to access coverage directly through their health insurance company.
The bottom line?
The truth is, no matter what they might be called, these laws aren’t being used to protect the free exercise of religion. Instead, they allow religious and moral beliefs to be used as an excuse to discriminate against others.