People Who Are Refused Reproductive Health Care Can’t Always “Just Go Someplace Else”!


The National Women’s Law Center is committed to removing all barriers to reproductive health care access. One major barrier that’s been getting lots of attention lately is religious refusals, imposed by institutions and individuals who claim that their beliefs justify denying patients access to services, information and referrals. Much attention has been drawn to the issue with the 11th hour promulgation of the Bush Administration’s HHS Refusal Rule. Currently the Obama Administration has proposed rescinding the rule. In the meantime, the debate rages on, with those who support refusals often claiming that providers’ “conscience” should trump patients’ right to health care, because patients who are refused can “just go someplace else.” Not only is this presumption flatly wrong, but it fails to recognize the full scope of physical, emotional and economic harms that can result from provider refusals.

For example:

  • Some providers have asserted a right to refuse medical care even in emergency situations. There are documented cases of providers withholding treatment to women having miscarriages, because any (potentially life-saving) intervention while there was still a fetal heartbeat amounted to an “abortion” in their opinion.
  • Some providers insist on the right to deny patients information about treatment options, even when patients are depending on doctors to give them all of the facts they need to make important decisions about their health and lives. A cancer patient could choose a less effective treatment that spares her fertility over one that has better odds but would render her infertile because her doctor withheld information about the option of freezing her fertilized eggs.
  • Some providers assert a right to withhold referrals to another healthcare provider for services to which they object, even when their failure to do so may prevent a patient from timely access to time-sensitive treatment, such as emergency contraception.
  • A doctor may claim that a woman needs birth control pills for a medical reason, such as endometriosis, so that her Catholic employer will allow the company’s insurance plan to cover them. If she ever loses her employer based health insurance, she could find herself unable to get individual insurance coverage because her medical records indicate that she has a preexisting condition.

We have more examples in our new paper, When health care providers refuse: The impact on patients of providers’ religious and moral objections to give medical care, information or referrals. It is not just a matter of patients “going someplace else.” Real people can suffer real harms as a result of religious refusals. Next time someone asks the question “What’s the big deal?” — make sure you are prepared to tell them.

For more information on religious restrictions in reproductive health care, please visit the National Women’s Law Center’s Health Care Religious Restrictions Project website.

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To schedule an interview with Jill Morrison please contact Communications Director Rachel Perrone at rachel@rhrealitycheck.org.

  • http://blog.crisswrites.com invalid-0

    Thank you for writing this!

    I cannot wrap my head around the idea that a medical professional would deny someone care or services based on his personal beliefs. If your beliefs are that strong, that they prohibit you from DOING YOUR JOB, then you need to go into a different line of work.

    I teach public school. I, like most teachers, am strongly against standardized testing. It essentially goes against everything we teachers stand and strive for. Yet, allowing my students to be pulled from my class to go to tutoring and administering the test are part of my job requirements. If I do not comply with the state’s mandates, I can lose my job, lose my certification, and even go to jail. (And my refusal to administer the dumb test would not affect anyone’s physical or mental health in any way; it wouldn’t even prevent the dumb test from being administered, as someone else would be called in to take my place. The students would merely get a few minutes of down time.)

    No law would protect a doctor who refused to treat someone because that person was Muslim or Jewish or followed any faith that was different from the doctor’s. No law would protect a doctor who refused to treat a patient because of the patient’s race. Why are we allowing doctors to refuse to treat women based on the same (faulty) logic?

  • progo35

    Would you please provide links to the stories of people who chose certain cancer treatments or don’t get miscarriage treatment because of their doctor’s religious beliefs?

    "Well behaved women seldom make history."-Laurel Thatcher Ulrich

  • invalid-0

    I do not understand why religion and religious fanatics keep interfering in other peoples lives. This infuriates me. Nothing is getting done fast enough in congress because of this religious belief stuff. Enough of this already! I agree with Criss on this. If you can’t follow the rules get out! Maybe these so called doctors should be ministers and that goes for all the congress and senators that are using religion to stop peoples freedoms. We have to put an end to this. Keep your religion to yourself and help the people who voted for you. Amen!

    • invalid-0

      At people different games: at adult uncles – games in war, at women – games in “jealousy and struggle for men”, at politicians for the power, at religious fanatics – game in “who is guilty also whose religion is not right?”, at lazy Russian – game in “in all Jews are guilty”, at Jews – game in “a world gain”, at Americans – game in “the world power”… And only at Japanese of any games – one continuous economy. The rising sun country – the hi-tech future already today!

  • progo35

    Anon-this IS separation of church and state, because the people involved are enjoying their constitutionally protected rights of conscience. If the state stepped in and forced doctors, pharmacists, and others to participate in actions that they believe take a human life, that would violate separation of church and state.
    "Well behaved women seldom make history."-Laurel Thatcher Ulrich

  • invalid-0

    If the state stepped in and forced doctors, pharmacists, and others to participate in actions that they believe take a human life, that would violate separation of church and state.

    “Sir, I am a member of the First Aryan Church of Christ. We hold that God created the White Man in His image, and that Satan created the Black Man in his own. This business establishment does not serve the spawn of Satan. So I’m going to have to ask you to take your nigger-ass out of here.”

    So, what about his constitutionally-protected right of conscience?

  • jill-morrison

    There is a recent article in the Journal of the American Public Health Association on religious objections to treating miscarriages. You can find an abstract of it here http://www.ncbi.nlm.nih.gov/pubmed/18703442. There are also numerous articles published on why oncologists and other providers withhold information about fertility preservation from patients who will become infertile as a result of treatment.  Some providers cite their moral objections to such treatments, including their belief that male patients under 18 shouldn’t be allowed to look at pornography when producing semen to freeze.  In these cases, patients are making crucial treatment decisions without having full and accurate information on their choices. 

  • invalid-0

    They must treat criminals, murderers, rapists. I believe you are wrong about this. Consciences? Then they have no right being doctors. Like I said they should be ministers if they want to preach and tell people what to do!! People that want to listen anyway. I for one am sick of hearing about someone elses beliefs and that we should do what they say. We might as well be living in the middle east where religion controls everything that everyone does and says.

  • progo35

    Okay, stop using the Aryan nation CRAP to distort the issue. Treat people like they are intelligent. No one should be so blind as to think that that is what the conscience clause is for. Wake up.

    Ok"Well behaved women seldom make history."-Laurel Thatcher Ulrich

  • progo35

    I think that a lot of people here HATE pro lifers. Weould you like to articulate why this is not true?

    "Well behaved women seldom make history."-Laurel Thatcher Ulrich

    • invalid-0

      No, I don’t hate pro-lifers, and neither do most pro-choicers. We just think some of the views held by pro-lifers are hypocritical, and disagree with them.

      Here’s the thing about the conscience objections; if a person feels that their beliefs get in the way of performing their job, they shouldn’t have taken that job. Like Quakers wouldn’t join the army, vegetarians wouldn’t work at a meat-packing plant, Hindus wouldn’t work with beef, etc. Women don’t always have someplace close by and accessible to get reproductive health care, so denying them their prescriptions or certain medical options because of the beliefs of the medical/pharmaceutical provider isn’t just an inconvenience. Sometimes it’s a serious health issue.

  • progo35

    Thank you, Jill. I will certainly take a look at that. It’s very important for people to be informed.

    "Well behaved women seldom make history."-Laurel Thatcher Ulrich

  • invalid-0

    Reproductive Health ?

    There is NO legislation PREVENTING reproduction
    so LETS stop mis framing the debate.

    *

    The REAL debate stems over women’s presumptuous “rights”
    to sexual narcissism VOID of natural biological
    consequences.

    So PLEASE stop calling it “reproductive freedom” as
    reproductive RIGHTS have never been obstructed here
    in the USA.

  • invalid-0

    Okay, stop using the Aryan nation CRAP to distort the issue. Treat people like they are intelligent. No one should be so blind as to think that that is what the conscience clause is for.

    I never said nor implied that the purpose of the conscience clause was to enable racial discrimination. It was to present a direct counterexample to your “If the state stepped in … that would violate separation of church and state” statement. (If the “take a human life” bit is important to you, then let’s have Mr. White Power add, “I believe that every time you give comfort to a nigger, a White baby is miscarried.”)

    The example is ridiculous, sure. But then, so is the idea that a doctor or pharmacist would (or could be allowed to) abrogate their professional code of conduct to pass judgment on a customer/patient, and potentially deny her vital medical supplies and information.

    I mean, consider that in itself. Doesn’t it strike you as ludicrous? It’s only because the rights of women—which few people have true respect for—are at stake, that no one gets just how Bizarro-world this whole thing is.

    • What if your father had emphysema, and went to get a prescription, and the pharmacist said, “I’m sorry sir, but you smoked when you knew that smoking was dangerous. You have to accept responsibility for that decision, and I can’t let you have this medication to allow you to escape that responsibility.”
    • What if you had an obese friend, and his/her doctor says, “I’m afraid I won’t refer you to a nutrition specialist. If you’re not going to have the self-discipline to eat less, then you’re just wasting everybody’s time.”
    • What if you went to get a prescription ointment for a mild STD (dog forbid), and the pharmacist said, “I’m sorry, but the itching is God’s way of telling you that you should have waited until marriage to have sex. No, I’m not giving you your prescription slip back.”

    Pretty crazy, right? And yet, when we’re talking about womens’ reproductive health, somehow this becomes okay. People stop condemning the self-righteous, meddlesome doctor or pharmacist, and start clamoring for laws that explicit protect this insanity!

    It’s one thing to have a conscience clause that allows anyone who doesn’t want to have a direct hand in abortion to abstain without penalty. No one is arguing that a medical worker with a moral aversion to that must (or even should) be forced to take part. But contraceptives? Referrals? The only sane answer to that is, “Dude, just do your job, or get the f*** out of here.”

  • progo35

    Like I said, that example is bogus and so are the other ones you are giving, because they HAVEN’T happened,they’re as-if scenarios to make your point, and the conscience clause only applies to procedures that take human life. It does not apply to any of the hypothetical situations that you have brought up. There is no way that the conscience clause would protect a health care provider if he or she did what is described in those situations. It is unfair to the general population for you to misrepresent what the conscience clause refers to.

    "Well behaved women seldom make history."-Laurel Thatcher Ulrich

  • invalid-0

    attempt to chip away at a law that is Roe vs. wade. You know we were not born yesterday. Mr. W. Bush was sneaky and manipulative he did this in his last days in office. You had mentioned that “some of us women hate pro-life people” I can not speak for anyone but myself, I do not hate anyone. I do not like people inflicting their beliefs in something that should remain incredibly personal as one relationship with a higher being. It has nothing to do with hate. It has to do with individuality. I do not like church or churches because they are all patriarchal and biased against women but that does not mean that I do not believe in a higher being.

    Something that I really resent is people commenting that women want abortion and contraceptives so they can be permiscuous! Try again. What about married women who do not want 10 kids that they can not afford. or a single women who is only being paid 78 cents to a mans dollar still after 45 years!!!! When the equal pay act was signed into law. A lot of good that does.
    Stop accusing women of being sluts when half the time it is the men who are very forceful and demanding sex all the time. Men start learning to control yourselves first before you condemn someone else. I am not saying all men are like this or that all women aaren’t I just am sick and tired of women being blamed for every living thing on earth!!!!!!!!!

  • colleen

    and the conscience clause only applies to procedures that take human life

    No they don’t and particularly when you’re talking about the ‘consciences’ of pharmacists who refuse to fill legal prescriptions and sometimes pocket the prescription. Taking birth control or, for that matter, having a tubal ligation do not “take a human life” but forcing women to submit to a standard of healthcare approved by the Vatican sure can.

    Did you read the cite provided by the writer of this excellent diary. Because it says:

    Catholic-owned hospital ethics committees denied approval of uterine evacuation while fetal heart tones were still present, forcing physicians to delay care or transport miscarrying patients to non-Catholic-owned facilities. Some physicians intentionally violated protocol because they felt patient safety was compromised

    Are the physicians who intentionally violated protocol entitled to a conscience? Or is a conscience without consequence a luxury only the religious right is entitled to…

  • invalid-0

    President Obama will overturn this last ditch effort from Bush to screw with women’s reproductive healthcare. Too bad for you anti-choicers, you LOSE again!! Maybe you should get it through your THICK heads that we women will not tolerate your trying to control our bodies, sex lives, and lives in general. If an anti-choicer is in a healthcare position, and interferes with women and their God and constitutional right to control their own reproduction, then they BETTER get a job somewhere else as they are just trying to obstruct women from getting the care that they need, and can be taken to court. So remember this, any woman who is denied a perscription being filled, or a referral, or whatever, take the person to court! If this is done enough, you can put them out of business, or at the very least, get publicity so that women do not go to them anymore. ( or protest their store, or boycott their places!) Whatever it takes! We will not put up with this CRAP!!

  • http://blog.amyadoptee.com invalid-0

    Something to thing about. My sister went to the hospital to have her child. The doctor ordered her prepped for delivery. The nurse refused. What these rules are doing are letting folks in the medical field not do their jobs. They can turn around and claim it as religious preference. It has happened. If they had not gotten a neonatal pediatrician in to look at the baby. Her child,my niece, could have died.

    At the same time, my mother left the hospital because the ER doctor refused to listen to her when she said that she just had a heart attack previously. This stuff happens. People are using this “choice thing” to extremes. They are claiming it violates their rights to perform the required service for the woman.

  • invalid-0

    Then they should go into another line of work. They have no right to practice medicine, it is a privilege. If, in their supreme arrogance, they are not going to give their patient what they need or want, especially when it is legal, then they should not be working in the medical field at all. There is a separation of church and state, which means that your beliefs should not infringe upon my or other women’s health care. If people’s religious beliefs get in the way of their ability to care for their patients, then they are not doing their job correctly, and should be fired or get another job. Period.

  • invalid-0

    At least from some previous articles I have read dealing with rapists, murderers and criminals and religion, destroying a fetus is worse than murdering a woman and worse than raping a child. Was it a couple of months ago that a medical staff and most of a girl’s family was excomunicated from the Catholic Church for aiding in her abortion that was result of being raped by her step-father? If I remember correctly, the stepfather wasn’t excommunicated. Sad and sick.

  • progo35

    On what ground did the nurse make this refusal?

    "Well behaved women seldom make history."-Laurel Thatcher Ulrich

  • progo35

    Also, of course doctors are entitled to their conscience even if they have to violate protocol if a patient’s life is in jeopardy. I’d also like to know more about what procedure is being discussed in regard to the miscarriage situation, as I don’t see how that could be related to a fetal heartbeat, because miscarriage results in the fetus dying. If the fetus was still alive, what kind of miscarriage are we talking about, and what procedure is being refused?

    "Well behaved women seldom make history."-Laurel Thatcher Ulrich

  • progo35

    Having read the link that Jill provided, I am still unclear as to what is going on in those situations. Are these women miscarrying wanted pregnancies? If so, why doesn’t the physician try to save them? Why was a uterine evacuation, ie a dialation and evaculation procedure, necessary to treat the miscarriage? Any doctors out there? "Well behaved women seldom make history."-Laurel Thatcher Ulrich

  • invalid-0

    In other words, the obligatory conclusion of women having sexual pleasure, even within monogamous/married relationships, is compulsory reproduction?

  • jill-morrison

    These are cases where the woman is in the process of miscarrying, nothing can be done to save the pregnancy, and the medical intervention needed to save the woman’s life results in the termination of the pregnancy slightly earlier than it would have ended on its own. Uterine evacuation, according to the doctors, is necessary to stop potentially life-threatening bleeding and/or infection.

  • invalid-0

    My sister in-law miscarried, the dead fetus was still in her uterus, but because of the medieval attitude of the medical community where she lived she had to go to the next state to have the procedure performed to remove the dead fetus before the rotting corpse inside her killed her. It would have been what the anti-choicers call a “partial birth” (or medically accurate “late term”) abortion. Leave medical decisions to the doctors & the patients – keep government out of the doctor’s offices and our bedrooms and put them in the boardrooms where they belong.

  • jill-morrison

    This is something else that has come to our attention: even when the fetus has already died, there are some hospitals and providers that will not remove the fetus, despite the fact that a woman could die from an infection if she is not treated promptly.  The only apparent justification is that the treatment bears a remote resemblance to an abortion. 

    I’m am so sorry to hear this Walt, but thank you for affirming that it really happens. We are working to address this. If your sister-in-law would be willing to speak with me, please have her contact me at info@nwlc.org.

     

     

    Jill Morrison is a Senior Counsel for Health and Reproductive Rights at the National Women’s Law Center.

  • invalid-0

    Scottidee said: “…presumptuous “rights” to sexual narcissism VOID of natural biological consequences.”

    Soo… you’re also against people getting plastic surgery for their visual narcissism void of natural biological consequences of having been around long enough to start aging…?

    You could carry that to its logical end and be against people who had natural biological consequences from venturing into the woods and being mauled by a bear. Should we allow doctors to refuse to treat them?

    Silly humans, going around LIVING and stuff. Having stuff happen to them.

    Oh but you probably only want to hold WOMEN accountable for existing and needing reproductive health care.

    And yes, it IS reproductive health and freedom. It concerns the reproductive system, and women have the right to decide for themselves whether and when and how they will reproduce, or not reproduce. And frankly, their sex lives are none of your business, busybody. But I bet you never thought it through enough to realize that married women also terminate pregnancies. Sometimes even pregnancies they wanted. Things happen. Think harder and butt out.