WASHINGTON – More than a dozen states are considering new laws to protect health workers who do not want to provide care that conflicts with their personal beliefs, a surge of legislation that reflects the intensifying tension between asserting individual religious values and defending patients’ rights.
At least 18 states are already considering 36 bills; about half the proposals would shield pharmacists who refuse to fill prescriptions for birth control and morning-after pills because they believe the drugs cause abortions. But many are far broader measures that would shelter any doctor, nurse, aide, technician or other employee who objects to any therapy. That might include in-vitro fertilization, physician-assisted suicide, embryonic stem cells and perhaps even providing treatment to gays and lesbians.
The flurry of political activity is being welcomed by conservative groups that consider it crucial to prevent health workers from being coerced into participating in care they find morally repugnant – protecting their “right of conscience” or “right of refusal.”
“This goes to the core of what it means to be an American,” said David Stevens, executive director of the Christian Medical &Dental Associations. “Conscience is the most sacred of all property. Doctors, dentists, nurses and other health care workers should not be forced to violate their consciences.”
The swell of propositions is raising alarm among advocates for abortion rights, family planning, AIDS prevention, gays and lesbians, the right to die and others who see the push as the latest manifestation of the growing political power of social conservatives.
“This a very significant threat to patients’ rights in the United States,” said Lois Uttley of the MergerWatch project, who is helping organize a conference in New York to plot a counter strategy. “We need to protect the patients’ right to use their own religious or ethical values to make medical decisions.”
Most states have long had laws to protect doctors and nurses from being fired, disciplined, sued or facing other legal action if they do not want to perform abortions. Conflicts over other health care workers emerged after the morning-after pill was approved and pharmacists began refusing to fill prescriptions for it, with the result that some lost their jobs, were reprimanded or were sanctioned by state licensing boards. That prompted a number of states last year to consider new laws that would either protect pharmacists or, alternately, require them to fill such prescriptions.
At least seven states are considering laws that would specifically protect pharmacists or pharmacies.
“Every other day I hear from pharmacists who are being threatened or told they have to sign something that says they are willing to go along with government mandates,” said Francis Manion of the American Center for Law &Justice, which is fighting an Illinois regulation requiring pharmacies to fill all prescriptions.
Opponents argue that such laws endanger patients by denying them access to legal drugs, particularly morning-after pills that must be taken quickly.
“Women all over the country are being turned away from obtaining valid and legal prescriptions,” said Jackie Payne of the Planned Parenthood Federation of America. “These kinds of laws would only make the situation worse. It’s shameful.”
At least nine states are considering “right of refusal” bills that are far broader. Some would protect virtually any worker involved in health care, while others would also extend protection to hospitals, clinics and other health care facilities.
At least five of the broad bills would even allow insurance companies to opt out of covering services they find objectionable for religious reasons. A sixth state, Pennsylvania, is considering a bill designed specifically for insurers.
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