Message from the President

Catholics for Choice Opposes Flawed “Provider Conscience Regulation” Proposed by the Department of Health and Human Services

Jon O'Brien, President Catholics for a Free Choice
Jon O’Brien, President, Catholics for Choice.
Photo Credit: Eric Haase.  This picture is copyrighted and cannot be reproduced without the express permission of Catholics for Choice.

Catholics for Choice submitted comments yesterday opposing the “Provider Conscience Regulation” proposed on August 26, 2008, by the Department of Health and Human Services (HHS). CFC found the proposed regulation not only to be unnecessary, but also that it sought to use the guise of religious freedom to create unreasonable barriers for women and men to access reproductive healthcare services. We strongly believe that if the proposed regulation goes into effect, patients’ access to critical healthcare services and information will be significantly undermined

Over the last several years, those opposed to reproductive freedom have become more creative in placing hurdles in front of women seeking safe and legal reproductive health services. The tactic of significantly expanding the concept of refusal clauses beyond protecting the religious and moral beliefs of healthcare providers is one of these hurdles. In effect it acts as a means to refuse some treatments and medications to all comers. We strongly support the reasonable accommodation of employees’ religious beliefs in the workplace, but individuals, regardless of their religion, age, income, race or geographic location must have access to the healthcare services they need, including the full range of sexual and reproductive health options and information.

The proposed rule set forth by HHS puts ideology before healthcare—broadening the scope and reach of existing federal refusal laws beyond Congressional intent. There exists a sincere struggle for institutions to formulate policies that balance the needs of patients with the beliefs of providers. If implemented, however, the proposed regulation would not eliminate this need. It would instead significantly expand the ability of healthcare providers to withhold treatment, counseling or medical information based on their religious or moral beliefs—without any regard for the needs of patients. It would also leave the door open for entire healthcare institutions, including insurance plans and hospitals, to deny access to or even information about reproductive health services, including birth control.

Conscience clauses have gone through many permutations since they first appeared after the Roe v. Wade decision. Traditionally, these clauses sought to protect healthcare workers who refused to participate in certain healthcare practices such as the provision of sterilization or abortion, claiming that participation in these services violated their consciences. However, the concept of conscience has been repeatedly manipulated, especially in the context of reproductive health and rights. While some have pointed to Catholic teaching and the support of the US Conference of Catholic Bishops and the Catholic Health Association (the trade association of the Catholic health industry), to support the imposition of ever-more restrictive refusal clauses, such as those in the proposed rule, they do not, in fact, reflect the Catholic position. Catholic teachings on conscience are much more nuanced than is usually presented in legal and policy debates. The goal of any reasonable conscience clause must be to strike the right balance between the right of healthcare professionals to provide care that is in line with their moral and religious beliefs and the right of patients to have access to the medical care they need.

Behind this proposed regulation is a claim that it will protect individuals who feel they are being denied rights. However, in doing so, it goes too far and tramples the rights of those who will be consequently denied medically appropriate treatment. Current federal conscience clauses—often referred to as the Church Amendment, the Coats Amendment and the Weldon Amendment—already provide more than enough protection for those medical professionals who refuse to provide services to which they object. There is no need to introduce any more such clauses that may conflict with existing law and will undoubtedly lead to confusion among employees, employers and patients regarding their rights surrounding these refusals.

In order for conscience to be fully exercised we must also be fully aware of how our decisions affect and are affected by external reality. For any individual provider or institution to lay claim to be the arbiter of any person’s good conscience is clearly disingenuous. healthcare providers must not dismiss the conscience of the person seeking care. In fact, Catholic teaching requires due deference to the conscience of others in making decisions—meaning that, for examples, the pharmacist must not dismiss the conscience of the person seeking emergency contraception or the doctor dismiss the conscience of the woman seeking an abortion. One does not need to deny a patient emergency contraception or abortion in order to remain a good Catholic. When a pharmacist refuses to fill prescriptions for contraception, they are negating the right to conscience of the woman, or man, standing in front of them. This does not fall under anybody’s definition of what a good conscience is. When the government, through regulation and support of those who are willfully denying necessary medical treatment to individuals, is party to such an expansion, it is negating the right to conscience of the person seeking care.

The expansion of these clauses goes beyond protecting the religious and moral beliefs of healthcare providers; they act as a means to refuse treatments and medications to all. The proposed regulation allows a provider to refuse to counsel patients for services or provide medical information and options for any medical treatment without any mechanism to ensure patients get the information they need to make informed healthcare decisions. It also expands the universe of healthcare workers and institutions that may refuse to provide services. If implemented as drafted, the proposed regulation would significantly expand the ability of healthcare providers to withhold treatment, counseling or medical information based on their religious or moral beliefs—without regard for the needs of patients.

The guise of religious freedom should not be used to create unreasonable barriers for women and men to access sexual and reproductive healthcare. Regardless of what allowances may be made for the individual conscience of a medical professional, individuals and institutions should not seek to impose ideology and should instead defer to the individual conscience of the patient by respecting her or his right to necessary comprehensive healthcare. By the estimates of HHS, the proposed regulation will impact 584,294 healthcare entities, including hospitals, private physician offices and health centers. This proposed regulation could have a debilitating effect on these healthcare entities and on the millions of individuals and families who rely on them for healthcare.

To read the full letter submitted to the Department of Health and Human Services by Catholics for Choice opposing the proposed “Provider Conscience Regulation,” click here.

Read the November 2016 message from Jon O'Brien:
Pope Francis’ Announcement on Abortion Is About Bridging the Deep Chasm Between the Church Hierarchy and the Reality of Everyday Catholics