- HHS on Thursday announced the formation of a Conscience and Religious Freedom Division, to be housed in the Office for Civil Rights.
- OCR Director Roger Severino said, "No one should be forced to choose between helping sick people and living by one’s deepest moral or religious convictions, and the new division will help guarantee that victims of unlawful discrimination find justice.”
- Reactions were swift with some critics worried the unit will give clinicians cover to refuse to provide abortions, for example, on moral or religious grounds.
The Trump administration posits the move will allow for greater religious freedom but some providers are skeptical and worried the move will block care services to vulnerable populations.
The division will "provide HHS with the focus it needs to more vigorously and effectively enforce existing laws protecting the rights of conscience and religious freedom, the first freedom protected in the Bill of Rights," the agency announced.
The announcement follows an executive order signed by President Donald Trump last May, dictating the executive branch will "vigorously enforce federal law's robust protections for religious freedoms."
The executive order calls on HHS to consider amended regulations to address conscience-based objectives.
The division's establishment is a reversal of a policy from former President Barack Obama's administration, which prohibits healthcare workers from refusing to perform "medically necessary" services on transgender individuals. The measure, implementing Section 1557 of the Affordable Care Act, also prohibits refusal to care for those who had or are seeking an abortion.
Section 1557 was challenged in court by the Franciscan Alliance, a religious hospital system. At the end of 2016, the U.S. District Court for the Northern District of Texas issued an opinion in the case, placing an injunction on the enforcement on the regulation implementing Section 1557 regulation’s prohibitions against discrimination on the basis of gender identity and termination of pregnancy on a nationwide basis while the injunction remains in place.
OCR continues to enforce protections against discrimination on the basis of race, color, national origin, age or disability.
The latest move is likely to be challenged in court as well.
American Nurses Association President Pamela Cipriano in response noted nurses have a duty to care but also are justified in deciding to refuse in morally objectionable actions, as long as the decision is consciously-grounded and not stemming from a personal preference or prejudice.
"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," Cipriano wrote. "Nurses should not be discriminated against by employers for exercising a conscience based refusal."
She added discrimination in healthcare 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.”
Many are outright worried the new division will give physicians cover to refuse to perform services such as abortion or sex reassignment surgeries.
“This is the latest example of this administration’s efforts to block women, transgender people, and other marginalized communities from accessing healthcare," Dana Singiser, VP of public policy and government relations at Planned Parenthood, said. "No patient should have to fear that their very identity could prevent them from getting the healthcare they need."