Conscience clauses are legal clauses attached to laws in some parts of the United States and other countries which permit pharmacists, physicians, and/or other providers of health care not to provide certain medical services for reasons of religion or conscience. It can also involve parents withholding consenting for particular treatments for their children.
In many cases, the clauses also permit health care providers to refuse to refer patients to unopposed providers. Those who choose not to refer or provide services may not be disciplined or discriminated against. The provision is most frequently enacted in connection with issues relating to reproduction, such as abortion (see conscientious objection to abortion), sterilization, contraception, and stem cell based treatments, but may include any phase of patient care.
The earliest national conscience clause law in the United States, which was enacted immediately following the Supreme Court's decision in Roe v. Wade , applied only to abortion and sterilization. It was sponsored by Senator Frank Church of Idaho.The Church Amendment of 1973, passed by the Senate on a vote of 92-1, exempted private hospitals receiving federal funds under the Hill-Burton Act, Medicare and Medicaid from any requirement to provide abortions or sterilizations when they objected on “the basis of religious beliefs or moral convictions.” Nearly every state enacted similar legislation by the end of the decade—often with the support of legislators who otherwise supported abortion rights. Supreme Court Justice Harry Blackmun, the author of the Roe v. Wade majority opinion, endorsed such clauses “appropriate protection” for individual physicians and denominational hospitals.
According to Nancy Berlinger, of the bioethics research institute The Hastings Center, "...Conscientious objection in health care always has a social dimension and ...Laws and professional guidelines on conscientious objection in health care must balance the respect for an individual’s beliefs against the well-being of the general public."
Conscience clauses have been adopted by a number of U.S. states. including Arkansas, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Mississippi, Pennsylvania, and South Dakota. There are some recent comprehensive reviews of federal and state conscience clause laws across the United States and in select other countries.
Some clauses address local concerns: Oregon, recognizes a physician's right to refuse to participate in physician-assisted suicide, although it is legal in that state.
An informed consent clause, although allowing medical professionals not to perform procedures against their conscience, does not allow professionals to give fraudulent information to deter a patient from obtaining such a procedure (such as lying about the risks involved in an abortion to deter one from obtaining one) in order to impose one's belief using deception. These principles were reaffirmed in the Utah Supreme Court's decision in Wood v. University of Utah Medical Center (2002).Commenting on the case, bioethicist Jacob Appel of New York University wrote that "if only a small number of physicians intentionally or negligently withhold information from their patients significant damage is done to the medical profession as a whole" because "pregnant women will no longer know whether to trust their doctors."
The Right of Conscience Rule was a set of protections for healthcare workers enacted by President George W. Bush on December 18, 2008, allowing healthcare workers to refuse care based on their personal beliefs.Specifically, the rule denied federal funding to institutions that did not allow workers to refuse care that went against their beliefs. In February 2011, President Barack Obama rescinded the Right of Conscience Rule.
States have historically provided a conscience clause right allowing pharmacists to refrain from participating in abortions.In April 2005, Governor Rod Blagojevich by emergency executive order required all pharmacists to provide Plan B levonorgestrel. In September 2012, the Illinois Appellate Court found the Governor's order violated Illinois law.
In June 2006, the Pharmacy Board of the Washington State Department of Health rejected a draft rule proposed by Governor Christine Gregoire to require all pharmacies to begin carrying Plan B.Governor Gregoire responded by releasing a public statement warning the Board members to reconsider or they could be removed. In July 2006, the Washington State Human Rights Commission warned the Board members that they would be personally liable for illegally discriminating against women if they did not pass the Governor's Plan B rule. In April 2007, the Board approved a final rule prohibiting pharmacies from not stocking Plan B for religious reasons but allowing exemptions for “good faith” business reasons.
When Ralph's Thriftway, a grocery store in Olympia, Washington, refused for religious reasons to carry Plan B, it was widely boycotted, leading Gregoire to cancel the grocer's longstanding account with the Washington Governor's Mansion.The only complaints for violating the Plan B rule were filed against the grocer. Half of Washington's hospitals are Catholic. The grocer sued but, instead of alleging violations of the broader Constitution of Washington, its attorneys at the Alliance Defending Freedom and the Becket Fund for Religious Liberty only filed under the Free Exercise Clause of the United States Constitution. The case is known as Stormans, Inc. v. Wiesman.
On November 8, 2007, U.S. District Judge Ronald B. Leighton granted the grocer a preliminary injunction blocking the rule.On May 1, 2008, United States Court of Appeals for the Ninth Circuit Judges Thomas G. Nelson and Jay Bybee denied the state a stay of the injunction pending appeal, over a dissent by Judge A. Wallace Tashima. However, on July 8, 2009, Circuit Judge Kim McLane Wardlaw, joined by Richard Clifton and N. Randy Smith reversed the preliminary injunction.
On February 22, 2012, after four years of discovery and a twelve-day bench trial, Judge Leighton issued a permanent injunction blocking the Plan B rule as unconstitutional.On July 23, 2015, Circuit Judge Susan P. Graber, joined by Judges Mary H. Murguia and Richard Clifton reversed. The grocer's petition for certiorari from the Supreme Court of the United States was denied on June 28, 2016. Justice Samuel Alito, joined by Chief Justice John Roberts and Justice Clarence Thomas, dissented, writing that “the rules challenged here reflect antipathy towards religious beliefs that do not accord with the views of those holding the levers of government power.”
In 2014and 2016, Senator Cory Booker introduced the “Access to Birth Control Act” bill, which would require all pharmacists in the United States to provide emergency contraception.
Health care providers opposed to abortion or contraception support the clauses because they believe that disciplinary or legal action for refusing to perform services obliges providers to supply services which their moral or religious principles forbid.
Reproductive rights organizations, such as Planned Parenthood and NARAL Pro-Choice America, oppose the provision because they maintain that pharmacists, doctors, and hospitals have a professional duty to fulfill patients' legal medical needs, regardless of their own ethical stances. Opponents see conscience clauses as an attempt to limit reproductive rights in lieu of bans struck down by Supreme Court rulings such as Roe v. Wade .
As a result, the term "conscience clause" is controversial and primarily used by those who support these provisions. Those who oppose them often prefer to use the term "refusal clause," implying that those who exercise the clauses are refusing to treat a patient.
The conscience clause is widely invoked in Catholic universities, hospitals, and agencies because the Catholic Church opposes abortion, contraceptives, sterilization, and embryonic stem cell treatments. Opponents of related FOCA legislation have interpreted the possible end of the conscience clause as a demand to either "do abortions or close."Timothy Dolan has said, "“In effect, the president is saying we have a year to figure out how to violate our consciences." However, conscience clauses are sometimes interpreted differently and their use will often depend on the given context.
Public health specialists[ who? ] have questioned whether "conscience clauses" are ethical, observing in an article on the danger to miscarrying patients created by hospital anti-abortion policies that "in some Catholic-owned hospitals, the private patient–physician relationship, patient safety, and patient comfort are compromised by religious mandates that require physicians to act contrary to the current standard of care in miscarriage management."
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Christine "Chris" O'Grady Gregoire is an American politician and lawyer who served as the 22nd Governor of the state of Washington from 2005 to 2013. A member of the Democratic Party, Gregoire defeated Republican candidate Dino Rossi in 2004 and again in 2008. She is the second female governor of Washington. She was the National Governors Association Chair for the 2010–11 term.
The terms medical record, health record, and medical chart are used somewhat interchangeably to describe the systematic documentation of a single patient's medical history and care across time within one particular health care provider's jurisdiction. The medical record includes a variety of types of "notes" entered over time by health care professionals, recording observations and administration of drugs and therapies, orders for the administration of drugs and therapies, test results, x-rays, reports, etc. The maintenance of complete and accurate medical records is a requirement of health care providers and is generally enforced as a licensing or certification prerequisite.
The Freedom of Access to Clinic Entrances Act is a United States law that was signed by President Bill Clinton in May 1994, which prohibits the following three things: (1) the use of physical force, threat of physical force, or physical obstruction to intentionally injure, intimidate, interfere with or attempt to injure, intimidate or interfere with any person who is obtaining reproductive health services or providing reproductive health services, (2) the use of physical force, threat of physical force, or physical obstruction to intentionally injure, intimidate, interfere with or attempt to injure, intimidate or interfere with any person who is exercising or trying to exercise their First Amendment right of religious freedom at a place of religious worship, (3) the intentional damage or destruction of a reproductive health care facility or a place of worship.
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Timeline of reproductive rights legislation, a chronological list of laws and legal decisions affecting human reproductive rights. Reproductive rights are a sub-set of human rights pertaining to issues of reproduction and reproductive health. These rights may include some or all of the following: the right to legal or safe abortion, the right to birth control, the right to access quality reproductive healthcare, and the right to education and access in order to make reproductive choices free from coercion, discrimination, and violence. Reproductive rights may also include the right to receive education about contraception and sexually transmitted infections, and freedom from coerced sterilization, abortion, and contraception, and protection from gender-based practices such as female genital cutting (FGC) and male genital mutilation (MGM).
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The Abortion Law Reform Act 2008 is an abortion law reform passed by the Victorian Parliament in the Australian state of Victoria in 2008. The reform bill sought to amend section 65 of the Victorian Crimes Act 1958, which had codified the common law offences relating to abortion. The reform also repealed section 10 of the Crimes Act dealing with a separate offence of child destruction.
A contraceptive mandate is a government regulation or law that requires health insurers, or employers that provide their employees with health insurance, to cover some contraceptive costs in their health insurance plans.
Abortion restrictions in the United States are laws intended or resulting in restricting the availability or practice of abortions in the United States. Though the Supreme Court in Roe v. Wade recognized a legal right for a woman in the United States to get an abortion, and Planned Parenthood v. Casey invalidated certain restrictions that create an undue burden on women seeking abortions, these cases permit states to make certain restrictions in the guise of regulation of the practice, but which they argue do not create an “undue burden”. Some state laws that impact on the availability of abortions have been upheld. Regulations imposed by individual states that have impacted on the availability of abortions, particularly in the 2010s, include requiring a woman seeking an abortion to view an ultrasound, requiring abortion providers to have admitting privileges at nearby hospitals, and long waiting periods after the first consultation with the abortion provider.
The Washington State Department of Health is a state agency of Washington. It is headquartered in Olympia, Washington.
The history of African American women and their participation in the birth control movement reflects a very conflicted set of ideals regarding African American women, the use of contraceptive practices and abortion. Prominent historical figures debated whether African American communities would benefit from birth control or if birth control was another methodical scheme put in place to suppress the African American community.
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National Institute of Family and Life Advocates v. Becerra, 585 U.S. ___ (2018), was a case before the Supreme Court of the United States addressing the constitutionality of California's FACT Act, which mandated that crisis pregnancy centers provide certain disclosures about state services. The law required that licensed centers post visible notices that other options for pregnancy, including abortion, are available from state-sponsored clinics. It also mandated that unlicensed centers post notice of their unlicensed status. The centers, typically run by Christian non-profit groups, challenged the act on the basis that it violated their free speech. After prior reviews in lower courts, the case was brought to the Supreme Court, asking "Whether the disclosures required by the California Reproductive FACT Act violate the protections set forth in the free speech clause of the First Amendment, applicable to the states through the Fourteenth Amendment."
Conscientious objection to abortion is the right of medical staff to refuse participation in abortion for personal belief.
Box v. Planned Parenthood of Indiana and Kentucky, Inc., No. 18-483, 587 U.S. ___, 139 S.Ct. 1780 (2019), was a United States Supreme Court case dealing with the constitutionality of a 2016 anti-abortion law passed in the state of Indiana. Indiana's law sought to ban abortions performed solely on the basis of the fetus' gender, race, ethnicity, or disabilities. Lower courts had blocked enforcement of the law for violating a woman's right to abortion under privacy concerns within the Fourteenth Amendment, as previously found in the landmark cases Roe v. Wade and Planned Parenthood v. Casey. The lower courts also blocked enforcement of another portion of the law that required the disposal of aborted fetuses through burial or cremation. The per curiam decision by the Supreme Court overturned the injunction on the fetal disposal portion of the law, but otherwise did not challenge or confirm the lower courts' ruling on the non-discrimination clauses, leaving these in place.