Speaking of Women's Rights: #NotMyConscience: The Ever-Growing Prioritization of Religion Over Patients' Needs

Friday, July 29, 2016

#NotMyConscience: The Ever-Growing Prioritization of Religion Over Patients' Needs

By Rachel Kuenzi

“The consciences we should protect belong to women who should choose their own reproductive destiny.”
–Rep. Lois Frankel

On July 13, 2016, the House passed the Conscience Protection Act. Based on the title, this bill is agreeable and has nothing to do with my uterus, right? Wrong.

This bill would considerably expand and make permanent the Weldon Amendment, an annual appropriations rider that restricts funding to abortion care. The Conscience Protection Act would allow any “health care entity” to refuse to “facilitate,” “make arrangements for,” or “otherwise participate in” abortion care in order to safeguard the “conscience” of religious employees and institutions. Under this bill, a hospital could refuse to serve a woman in need of medical care and refuse to inform her of her potential treatment options.

This bill is part of a growing trend of “right of conscience” legislation and policies that allow prioritization of religious freedom over medically appropriate standards of care. For instance, Catholic hospitals are guided by the Ethical and Religious Directives (ERD), a set of regulatory guidelines outlining religious healthcare, which mandate that Catholic hospitals cannot provide sterilization procedures, end-of-life procedures, gender transition procedures, contraceptives, abortion, or fertility treatments. Conscience protection laws permit Catholic hospitals to employ the ERDs, ensuring that physicians have no obligation to provide or even inform a patient of her full treatment options if the procedure conflicts with the institution’s “conscience.”

For example, if a woman is suffering from an extra-uterine ectopic pregnancy (that will likely kill her without medical treatment) and is rushed to a Catholic hospital for assistance, the hospital can refuse to treat her because of the ERD and her physician has no obligation to inform her of another institution that could assist her. Such delays in treatment are extremely dangerous and can be life threatening. Further, ERDs routinely prevent physicians from providing treatment they wish to prescribe. In fact, one in five physicians report a conflict between ERDs and their desired recommended treatment.

This growing trend towards prioritizing provider’s “conscience” is particularly concerning given the prevalence of Catholic hospitals and the increase of hospital mergers. Republicans in the House posit the myth that a patient can simply choose another hospital if she does not want her care directed by Catholic beliefs. However, in Washington State, where Catholic institutions own more than 40% of hospital beds in the state, this claim is highly unrealistic. Traveling to non-Catholic hospitals can take hours of driving, substantial amounts of money, and may not be covered by insurance, posing substantial burdens on access to needed health care. What’s more, while there are efforts underway to improve hospital policy transparency, patients often do not realize that their local hospital operates under the ERDs or other restrictive policies and will not provide the services they need.

Instead of prioritizing the hospital’s conscience, shouldn’t we be prioritizing the “conscience” of the patients seeking accurate and legal health care options? What about the “conscience” of the physicians attempting to provide medically appropriate services? Our health system should aim to endorse medically based treatments, use best health care practices, and fully inform patients of all treatment options.

The Obama administration stated that the President would veto the Conscience Protection Act if it arrives on his desk, acknowledging that it would “limit women’s health care choices.” However, with the upcoming election and with “conscience” laws rapidly becoming an expanding frontier for preventing access to reproductive health care, we should be concerned about the passage of the Conscience Protection Act and the ever-growing prioritization of religion over health care needs. This bill is #NotMyConscience!

Rachel Kuenzi is a legal intern at Legal Voice and a rising second-year student at Georgetown University Law Center. She is a Public Interest Fellow dedicated to alleviating intimate partner violence and day dreams about founding a domestic violence advocacy theater troupe that includes pro-bono legal services for victims.

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