The lawsuit states the moral objections rule limits patient access to healthcare.
A coalition of 23 state and local governments have filed a joint lawsuit against the Department of Health & Human Services, claiming that a recent rule regarding providers’ moral objections to certain medical care in fact infringes upon citizens’ rights to access healthcare.
The lawsuit, which was filed in the Southern District of New York, specifically addresses the religious freedom and conscience rights rule finalized by HHS in early May, 2019. The rule states that providers, medical professionals, or other individuals involved in patient care do not have to provide, participate in, pay for, or provide coverage for a medical procedure that goes against their moral or religious views.
The rule also includes protections for articles listed in an advance directive.
The rule applies to federally funded healthcare clinics.
“Finally, laws prohibiting government funded discrimination against conscience and religious freedom will be enforced like every other civil rights law.” said Roger Severino, the director of the HHS Office for Civil Rights. “This rule ensures that healthcare entities and professionals won’t be bullied out of the health care field because they decline to participate in actions that violate their conscience, including the taking of human life. Protecting conscience and religious freedom not only fosters greater diversity in healthcare, it’s the law,” Severino concluded.
But the final rule does not take into account all civil rights, the lawsuit alleges, specifically individual rights to access medically necessary healthcare. This rule essentially allows medical providers to deny healthcare on the basis of their own moral convictions, which in turn denies patients their own rights to health, said Massachusetts Attorney General Maura Healey, one of the lawyers on the lawsuit.
“Access to medically accurate and necessary health care is a basic civil right,” Healey said in a statement. “Providers should not be able to use their personal beliefs as an excuse to deny needed care. We are suing to protect the lives and health of our residents.”
The lawsuit specifically states that the rule will violate the federal Administrative Procedure Act and the Spending Clause. Additionally, the lawsuit states that the rule violates the separation of powers principles in the US Constitution.
The rule will expand the pool of providers who are allowed to deny patient care, the lawsuit says. Under the rule, providers ranging from ambulance drivers to emergency department doctors to receptionists may deny patients their services based on religious beliefs.
The rule gets in the way of states’ own authority, the attorneys general added. State laws that may be infringed upon include:
- Emergency department access regulations
- Rules about abandoning patients
- Requirements about answering patient questions and referring them to relevant or necessary care
- Requirements for access to prescriptions
- Requirements for access to comprehensive reproductive care
- Rules about payer coverage for reproductive health services such as contraception
The rule also limits hospitals’ abilities to do what the attorneys general say would be appropriate screening of job applicants. For example, a hospital may not ask a prospective nurse hire about potential objections to administering the measles vaccine or other tasks that would be central to the nurse job description.
The HHS rule’s proponents say it protects medical professionals from undue discrimination should they choose not to deliver a certain medical service. This will protect individuals’ rights to their religious or moral beliefs, a principle held steadfast in the current Administration.
But this rule goes beyond the traditional use of a conscience clause, according to the Massachusetts Medical Society (MMS), which spoke out in support of its attorney general’s participation in the lawsuit.
“The rule opens the door for a physician and other practitioners to bring his or her bias into a patient encounter and justify denial of care based on the patient’s racial identification, national or ethnic origin, sexual orientation, gender identity, religious affiliation, disability, immigration status, or economic status,” said Maryanne C. Bombaugh, MD, president of MMS. “While the MMS supports the traditional definition of the conscience clause, the new rule expands the longstanding definition of the clause and threatens access to care and the lives of our patients.”
National medical industry leaders likewise spoke out against the rule. The American Medical Association (AMA) stated that the rule could amount to legal discrimination against certain patients in the healthcare setting.
“The AMA believes the Proposed Rule would undermine patients’ access to medical care and information, impose barriers to physicians’ and health care institutions’ ability to provide treatment, impede advances in biomedical research, and create confusion and uncertainty among physicians, other health care professionals, and health care institutions about their legal and ethical obligations to treat patients,” AMA stated following the January 2018 rule proposal. “We are very concerned that the Proposed Rule would legitimize discrimination against vulnerable patients and in fact create a right to refuse to provide certain treatments or services.”
At this time, Massachusetts is joined by 18 other states in this lawsuit, including New York, Colorado, Connecticut, Delaware, Hawaii, Illinois, Maryland, Michigan, Minnesota, Nevada, New Jersey, New Mexico, Oregon, Pennsylvania, Rhode Island, Vermont, Virginia, and Wisconsin.
The cities of Chicago, New York, and Cook County, Illinois, as well as the District of Columbia, have also joined the lawsuit.
Date: May 29, 2019