HHS move protects health workers who refuse care based on conscience

The Trump administration on Thursday announced a new federal health division designed to protect doctors, nurses and others who object to providing medical care such as abortions and sex-change operations, prompting intense reactions among Georgia activists, health care providers and patients.

All of them, even organizations for medical providers, were still trying to digest the news Thursday afternoon and understand what exactly it would mean. But activists on behalf of conservative religious groups rejoiced at the message it sent, even as those on behalf of people seeking such services voiced fear for what the patients would now encounter.

Cole Muzio, the president of the Family Policy Alliance of Georgia, hadn’t heard about Thursday’s announcement but had heard rumors it was coming.

“It’s about time somebody looked out for religious freedom,” Muzio said. “I’m excited that the Trump administration is taking the concerns of people of faith seriously. And that they’re willing to take active steps.”

While it was unclear Thursday what the impact on the ground would be, advocates on all sides said they expected patients and caregivers to start testing the new lines and find out.

One trainer to caregivers on transgender and gay health care issues said they already can deny care if it’s not life-threatening. A spokeswoman for Planned Parenthood Southeast suggested that the government would explicitly protect caregivers for denying a referral to services the patient seeks, and that it would randomly send auditors to health facilities to ensure policies were in place to protect the caregivers.

“They’re proactively going in to make sure there are mechanisms where people can discriminate, as opposed to protecting against discrimination — which is what they’re supposed to do,” said Barbara Ann Luttrell, the Planned Parenthood spokeswoman.

Luttrell called the lack of obligation to refer a patient to the correct provider dangerous. “And we think it’s unethical. … It’s devastating but not surprising,” she said.

The new organization will be called the Conscience and Religious Freedom Division, and it will be placed in the existing Civil Rights Office of the U.S. Department of Health and Human Services.

The civil rights workers traditionally have enforced civil rights laws as they apply to ensuring health care and the privacy protections patients have under federal health privacy laws. The change was announced Thursday morning at a press conference in Washington attended by conservative lawmakers including U.S. House Majority Leader Kevin McCarthy. The event took place the day before anti-abortion groups plan to hold marches and rallies both in Washington and in cities including Atlanta.

“For too long, too many of these health care workers have been bullied and discriminated against,” Eric Hargan, the acting secretary of the health department, said at the news event.

The civil rights office’s leader, Roger Severino, said in a statement that “the new division will help guarantee that victims of unlawful discrimination find justice.”

“For too long, governments big and small have treated conscience claims with hostility instead of protection,” he said, “but change is coming and it begins here and now.”

Organizations representing some of Georgia’s care providers were scrambling to understand the new developments, all while attempting to respect the views of their members from urban to rural and conservative to liberal.

The Georgia Hospital Association wasn’t taking a position on the new office, per se, said Ethan James, the executive vice president of external relations there.

“Many hospitals already do have those protocols in place to accommodate reasonable requests,” which would include religious ones, James said. “However, we also believe that no treatment or care for a patient should be compromised or interrupted at any time.”

The statewide organization for doctors, the Medical Association of Georgia, “doesn’t have specific policy,” spokesman Tom Kornegay said. It does support the American Medical Association’s policy that “the relationship between a patient and a physician is based on trust, which gives rise to physicians’ ethical responsibility to place patients’ welfare above the physician’s own self-interest or obligations to others, to use sound medical judgment on patients’ behalf, and to advocate for their patients’ welfare.”

Tanya Ditty, the state director of the conservative Concerned Women for America of Georgia, said there are so many providers of different opinions that people shouldn’t worry that medical care will suffer, even for procedures her members oppose.

“To say you are limiting medical availability simply because someone won’t do a referral, I just don’t buy that argument,” Ditty said.

Genevieve Wilson, a spokeswoman for Georgia Right to Life, was glad to hear the news Thursday as she prepared for the anti-abortion march. Up to now the country has been “ignoring the Constitution, which is our foundational rights,” she said.

She added, “Our constitutionally held rights trump medical care.”

Muzio said “the First Amendment applies to everybody.”

“It says we have a right to exercise our religion,” he said. “That doesn’t end when we leave the home and go to our workplace.”

Chanel Haley, a gender inclusion organizer for the group Georgia Equality, fears the new directive will hurt medical care because the lack of a referral to a new provider puts the burden on the patient to find the right provider.

Haley is transgender, and she has given training lectures to hospital workers and others on caring for groups including transgender patients. As for her own care, she needs drugs for both diabetes and hormone replacement therapy, and she said there are very few endocrinologists who will do both. Whether or not legal restrictions on providers change, she said, behavior likely will.

“I think it’s just more putting discrimination and hate to the forefront,” Haley said. “It will probably be more widespread now.”

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