ANA releases statement on the HHS’ new Conscience and Religious Freedom Division

Nurse Leader Insider, January 25, 2018

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Lawmakers and faith leaders joined Health and Human Services officials Thursday morning to launch a new HHS division that aims to protect healthcare organizations and their employees from discrimination on the basis of religion.

The Conscience and Religious Freedom Division, within the HHS Office of Civil Rights (OCR), will ramp up enforcement of legal protections that went neglected under the Obama administration, proponents said. They cited cases in which healthcare workers were penalized for their objection to abortion.

“No nurse or doctor should lose her job, her livelihood, or her profession because of her faith,” Rep. Vicky Hartzler (R-Mo.), chair of the House Values Action Team, said during a series of speeches at HHS headquarters with fellow backers of the initiative.

The division’s work will be authorized by several existing statutes that make it illegal to discriminate against healthcare workers who refuse to participate in abortions, sterilization, or assisted suicide. These are included in the Church Amendments, the Public Health Service Act, the Weldon Amendment, and the Affordable Care Act.

The American Civil Liberties Union and other critics worry, that this shift could open the door to more discrimination against women and LGBTQ people in need of medical care.

American College of Physicians President Jack Ende, MD, MACP, said his organization will evaluate the new HHS division as it begins operating, measuring its actions against ACP's ethics manual and public policy positions.

Harper Jean Tobin, director of policy for the National Center for Transgender Equality, released a statement saying HHS “appears ready to create sweeping, dangerous exemptions to patient protections that would encourage doctors, hospitals, paramedics and other medical providers to pick and choose which patients they will and won’t treat, and who does and doesn’t get life-saving medical care.”

Shortly after the announcement last week, American Nurses Association (ANA) president Pamela F. Cipriano, PhD, RN, NEA-BC, FAAN, released the following response to the HHS’ new division:

“The American Nurses Association Code of Ethics for Nurses with Interpretive Statements states that a nurse has a duty to care. It also states a nurse is justified in refusing to participate in a particular decision or action that is morally objectionable, so long as it is a conscience-based objection and not one based on personal preference, prejudice, bias, convenience, or arbitrariness. Nurses are obliged to provide for patient safety, to avoid patient abandonment, and to withdraw only when assured that nursing care is available to the patient. Nurses who decide not to participate on the grounds of conscientious objection must communicate this decision in a timely and appropriate manner, in advance and in time for alternate arrangements to be made for patient care. Nurses should not be discriminated against by employers for exercising a conscience based refusal.

However, we must take care to balance health care professionals’ rights to exercise their conscience with patients’ rights to access a full range of health care services. Discrimination in health care settings remains a grave and widespread problem for many vulnerable populations and contributes to a wide range of health disparities. All patients deserve universal access to high quality care and we must guard against erosion of any civil rights protections in health care that would lead to denied or delayed care.”

Steven Porter of HealthLeaders Media contributed to this article.

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