US: Rescind Regulation Jeopardizing Women’s Health

‘Provider Conscience Rule’ Ignores Impact on Those Needing Services
April 8, 2009

Freedom of conscience is a fundamental right. But it should not be used to trample on others’ rights to life, health, and freedom from discrimination. (Meghan Rhoad, US Researcher for the Women’s Rights Division)

(New York) – The Obama administration should rescind the Bush-era regulation that allows healthcare workers to deny women essential health information and services, Human Rights Watch said today. April 9, 2009, is the final day for public comment on a proposal to rescind the regulation, the “provider conscience rule.”

The regulation, issued by the US Department of Health and Human Services at the end of the Bush administration, permits healthcare workers at hundreds of thousands of federally funded clinics to refuse to provide health information and services related to abortion and other procedures they find objectionable. But it has no provision for considering and addressing the impact of such refusals on patients. Most important, it does not require the clinics to ensure that women receive essential health information and care, despite any individual worker’s refusal to participate.

“Just as it would be unacceptable for clinics to withhold information about medical procedures to treat cancer, heart disease, or broken bones, it is unconscionable to do so when it comes to women’s health,” said Meghan Rhoad, researcher in the Women’s Rights Division of Human Rights Watch. “Freedom of conscience is a fundamental right. But it should not be used to trample on others’ rights to life, health, and freedom from discrimination.”

Under the regulation, healthcare providers receiving federal funding must allow workers the option of refusing tasks they find objectionable. For example, an emergency room doctor at a federally funded hospital could claim the right to refuse rape victims information about emergency contraception, if doing so would offend the doctor’s beliefs.

Refusals must be accommodated even when the employee is not directly involved in the procedure. There is no provision, though, for exceptions to the rule or other alternatives in the case of a need for lifesaving procedures or other emergencies, and the regulation does not require a referral to another employee who does not object and can carry out the procedure.

“This regulation threatens women’s health, and in some cases their lives,” said Rhoad. “The rule poses a particular threat to low-income women and women of color, who are more likely to rely on publicly funded healthcare services.”

Human Rights Watch said that women’s health has been compromised in other nations with similar laws. In those countries Human Rights Watch has found that it is often women with limited resources and access to care who are refused services by conscientiously objecting providers.

The Bush administration first proposed the regulation in August 2008. More than 200,000 individuals and groups, including the American Medical Association and the American College of Obstetricians and Gynecologists, formally opposed the rule, but it was finalized in December 2008. (