Physicians Are Talking About…

Do We Need a Conscience and Religious Freedom Division at the Department of Health and Human Services?

Brandon Cohen


February 07, 2018

The Trump Administration's recent announcement of a new division of the Department of Health and Human Services has raised some eyebrows in the medical community. The Conscience and Religious Freedom Division has been established to "more vigorously and effectively enforce existing laws" regarding conflicts between medical professionals' jobs and their religious convictions. A flurry of discussion followed the posting of a recent Medscape article by Kerry Dooley Young.

In particular, the issues of abortion and birth control were hotly debated.

One physician assistant spoke for many:

As a nation, we [deem that] all have certain inalienable rights, yet as healthcare providers we have to put our own moral or religious beliefs aside while our patients can inflict their will upon us? ... This is about our right to say, "I'm not comfortable with this."

Another physician assistant was even more specific:

No Christian should be forced to participate in abortion or any other procedure that violates their beliefs.

Others agreed up to a point. One healthcare professional wrote:

No physician should be refused the opportunity to exercise their conscience. But how far is this going to go? Can a physician choose to refuse treatment to a transgendered individual in the emergency room? Can a pharmacist use their personal beliefs to decide who will receive a prescription for controlled substances or hormones?

Another professional saw troubling areas of gray:

My daughter has been on birth control pills for 20 years because of a cystic uterus, not for birth control! If a doctor could refuse her this pill, it could lead to a more dangerous outcome.

Some saw the new division as entirely unnecessary. An ob/gyn wrote:

I have no doubt that there would be many who would perform an abortion, gender reassignment, etc., and there would be many who would not. This has always been the case, with no penalty rendered to either group, and creating a division to protect [the rights of those who object] seems superfluous and, in my opinion, a waste of taxpayers' money. I don't see any court in the land jailing me for not providing an abortion if it is against my belief, as long as I don't prevent the patient from seeking someone willing to do it.

A physician agreed and questioned the motives behind the establishment of this new division:

This scheme seems more like an agenda of the new Conscience and Religious Freedom Division ... masquerading as help for healthcare professionals. Thanks, but no thanks. We don't need your help.

There were some who believed that allowing leeway for religious convictions was a dangerous course. One healthcare professional wrote:

When I walk into a physician's office at a nonreligious medical institution, I expect the best in scientific medical care and not to receive information or care influenced by that personal practitioner's religious belief. Freedom from religion should be a right as much as your freedom of religion.

Another healthcare professional went further still, saying that those who refused certain procedures should not be in the field:

If one cannot perform his or her duties or will not perform them due to an ethical objection, then one should seek another specialty [in which] to practice.

But a physician swiftly countered:

You're saying that somebody should be fired (forced to resign) for having a strong religious belief that conflicts with a small part of the work.

An internist continued with this train of thought:

It is sad to see that there is actually any serious debate surrounding one of the most fundamental of freedoms: the right of conscience. Generally speaking, forcing individuals to go against their conscience in the medical field ... is wrong.

An ob/gyn then pointed out the current state of the law:

It's important to note that with respect to abortion, these protections [against forcing healthcare professionals to participate in abortions] have been in place since the 1970s (the Church Amendments) and more recently were affirmed in the Affordable Care Act.

But some felt that these protections might not be enough. A psychiatrist wrote:

Yes, the right to refuse is protected, but I suspect that it comes with a cost, such as not being considered a team player.

Another physician went even further:

No one physically forces [someone] to do a procedure. They are fired for not doing the procedure. Or the promotion in the Army Medical Corps is not granted. Or their contract is not renewed by the hospital. Or the hospital doesn't renew their residency contract for a second year.

A colleague concurred:

Most physicians coming out of residency are employed by hospitals.... Hospitals won't renew your contract if you refuse to do abortions or prescribe contraceptives.

One wry physician mused over what other individual convictions could be honored:

Does this mean I can turn away those who discriminate against LBGT or hold religious beliefs that are contrary to mine?

A psychologist tried looking at it from a patient's perspective:

All physicians' religious beliefs should be published in their public biography. I do not want to go into surgery with someone whose ... beliefs would affect their behavior should something go wrong.

The specific functions of the new division are not yet entirely clear. As they become more defined, expect even greater passion in a debate that will not be easily resolved.

The full discussion of this topic is available at New HHS Division to Protect Clinicians With Religious Objections.


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