ѻý

HHS Launches Religious Freedom Division

<ѻý class="mpt-content-deck">— Will enforce laws allowing providers to object to certain procedures
MedpageToday

WASHINGTON -- The Department of Health and Human Services (HHS) is launching a new division within its Office for Civil Rights (OCR) to protect the rights of healthcare providers who have conscientious or religious objections to providing certain services.

"The new division will make sure we don't repeat the mistakes of past, that we will focus on enforcement, outreach and policymaking," OCR director Roger Severino said at a Thursday press conference. "Since 2008 until the election in 2016, we received 10 conscience complaints ... Since the election, we've received 34 and they are growing."

"With the rise of complaints ... we need to have an institutional force to address them," he continued. Severino mentioned several laws already on the books -- the , which says that the federal government and state governments can't discriminate against entities that refuse to undergo training in how to perform abortions, or to provide such training; and the , which prohibits the federal government from discriminating in grants or loans on the basis of whether the entity is willing to perform sterilizations or abortions.

"Whatever your thoughts about the legality of abortion ... presidents have spoken year after year ... that people's rights must be [respected] in matters of life and death," including assisted suicide, Severino said.

"Often government would treat [religious freedom] as something to be overcome; often there was outright hostility," he said. "Often HHS was not the best [with this]. But the times they are a-changing."

"For too long, [healthcare providers] have been discriminated against because of their religious beliefs and moral convictions," said HHS Acting Secretary Eric Hargan. "The federal government and state governments have hounded religious hospitals, forcing them to provide services [they object to] or refer for them, when they only wish to serve based on their religious beliefs."

"Medical students too can have their beliefs threatened when they are forced to do procedures that violate their consciences," Hargan continued. The good news is that we already have laws [to protect them] and now they will be vigorously enforced by OCR."

The press conference included remarks by Sara Hellwege, a midwife who said she was refused employment by a federally qualified health center because of her anti-abortion beliefs. "I never dreamed that my commitment to serving women and their children would [prevent my getting a job]," she said. "We are called to serve others and do no harm, as the Hippocratic Oath I took states."

Reaction to the new division was mixed. "The American Association of Pro-Life Obstetricians and Gynecologists (AAPLOG) applauds the creation of this department dedicated to actually enforcing our American right[s] to speak and act according to our conscience, a right on which this country was founded, but which was trampled on by the previous administration," AAPLOG executive director Donna Harrison, MD, said in a statement.

"AAPLOG members now have someone to turn to when pressured to kill human beings or else be forced out of medical practice. We will be encouraging OCR to follow through on this beginning."

The Heritage Foundation, a right-leaning think tank here, also praised the move. "When conscience violations and discrimination occur, it is critical that the administration responds with robust enforcement of federal law," Melanie Israel, a research associate at the foundation, said in a statement. "This new HHS division will help ensure that healthcare professionals enjoy the same rights they have had for decades -- to not face coercion or discriminatory actions if they decide not to participate in certain procedures because of moral or religious objections."

But Physicians for Reproductive Health, a pro-abortion rights organization, disagreed. "As a physician, my most important concern is that people can get the timely, high-quality healthcare they need without stigma or obstacles," said Lealah Pollock, MD, a family physician and fellow at the organization.

"I think patient care should come first. I respect individuals' religious beliefs, and as a physician I want to make sure patients are treated with the compassion and professionalism they deserve. I don't think [those are] at odds with each other, but I do worry that privileging providers' religious beliefs over the healthcare needs of patients could result in a delay in care and denials of care."

Examples of this might include a pharmacist who refuses to dispense a birth control prescription, or pediatricians who refuse to treat children because their parents are lesbian, gay, or transgender. "I've also heard stories of nurses refusing to place IVs of patients in the hospital for an abortion," she said.

"At least in my circles and experience, this isn't a need that healthcare providers have felt like they had ... I've heard far more stories about people being denied jobs because they also work as abortion provider at another facility ... rather than being denied jobs because of religious or moral beliefs."

Americans United for Separation of Church and State, an organization dedicated to church-state separation, that the new division "will enforce a still unreleased rule that will allow healthcare workers to use religion as a reason to deny services to patients."

"Americans United is already suing the Trump administration over its policies restricting women's access to birth control and banning Muslims from entering the country. Once released, this new rule will likely spark litigation as well," the organization said.