Everyone should have access to quality health care and accurate medical information when they need it. But refusal laws (sometimes called “conscience” laws) let some people refuse to provide care to patients.
These laws allow individuals and institutions to refuse to provide or pay for medical treatments they find objectionable—or even counsel or refer patients for those treatments.
This means doctors, hospitals, pharmacists, businesses and insurance companies could withhold the health care you are seeking and refuse to provide complete information about your medical options.
These laws can affect a broad range of reproductive and sexual health services, including:
- Genetic counseling
- Infertility treatment
- Treatment for survivors of sexual assault
- STD and HIV testing
- LGBTQ-specialized care
- Abortion care, including information and referrals
After Roe v. Wade, there was a concerted effort by anti-choice forces in Congress, in state legislatures and in the courts to enact refusal laws. In North Carolina, physicians and nurses were allowed to refuse to participate in any procedure that results in an abortion once abortion was legalized in 1973. In 2013, that protection was extended to any health care provider in North Carolina. This type of situation may occur in an emergency, when a patient needing an emergency termination may come into a hospital for treatment (for instance). It is critical institutions have policies in place to provide quality care as required for the safety of the patient, while protecting the religious beliefs of employees.
Over the years, these laws have expanded to include individual health-care professionals as well as hospitals, employers, health insurers and pharmacies. A federal refusal law even allows institutions to refuse to provide referrals for abortion care.
In some states, that means your local pharmacy could refuse to fill your prescription for birth control. And it means a Catholic hospital could refuse to provide abortion care for a woman whose health is at risk.
In 2018, a new office of civil rights was established in the federal Department of Health and Human Services to further protect health care workers who have “moral” objections to any type of treatment.
Refusal laws disproportionately affect low-income people and rural residents. Difficulty obtaining time off from work, finding transportation and making child care arrangements increase the burden of seeking medical care from an alternate provider. People who live far from large cities also may face challenges if the provider or institution closest to them refuses to provide care. In some rural areas, the next-closest provider may be more than 100 miles away.
Refusal laws limit access to complete information and the full range of medical care while making it nearly impossible for some people to access abortion services. Others have difficulty accessing the full range of reproductive-health care they may need to choose how to raise their families.
Health-care institutions have a duty to make sure patients receive accurate information and appropriate care. Failure to provide this care is wrong and puts Americans’ health in jeopardy.