Fast Moving Missouri Bill Expands the “Right to Deny” Care


Overreaching “conscience clauses” are all the rage in the 2013 legislative session, as politicians demand that “religious liberty” be protected at all costs. Arkansas and Alabama are both “defending the freedoms” of employers and others by introducing bills that can block access to birth control either by allowing a pharmacist to refuse to fill a prescription or by allowing an employer to deny coverage in employee health plans.

Missouri is following in Arkansas’s shoes. Like their neighbor to the south, the state has introduced HB 457, a new bill that will shore up conscience clauses in the state to provide more opportunity for medical practitioners of every kind to refuse to offer medications or do procedures they find “morally objectionable.” Missouri’s proposed law would allow medical providers to refuse not just care, but even referrals to someone else who can offer that care instead. So while an Arkansas nurse in a hospital allegedly should at least try to find another person to administer emergency contraception to a rape victim, in Missouri no replacement needs to be offered.

From the bill:

 (4) “Participate in specified medical procedures or research”, to provide, perform, assist in or refer for specified medical procedures or research; and

            (5) “Specified medical procedures or research”, abortion, abortion-inducing drugs, contraception, sterilization which is not medically necessary, assisted reproduction, human cloning, human embryonic stem-cell research, human somatic cell nuclear transfer, fetal tissue research, and nontherapeutic fetal experimentation.

            191.1153. 1. A medical professional has the right not to participate, and no medical professional shall be required to participate in specified medical procedures or research that violate his or her conscience.

The scenario isn’t just one that harms rape victims going to hospitals for care, but those who need to access emergency contraception on their own. Pamela Sumners, executive director of NARAL Pro-Choice Missouri told the Riverfront Times. “Maybe you got raped and you live in Randolph County and nobody there is dispensing emergency contraception to you or even offering it. You’ve got to go fifty miles away and what if your car is broken down? Here you are and you don’t even have a referral to a pharmacy that dispenses emergency contraception.”

It’s harmful to victims of rape, but just as harmful to those who simply want to access contraception itself, especially in more rural areas where there aren’t a variety of pharmacies to choose from. In fact, although they will claim that the real issue is to stop physicians as well as pharmacists from participating unwillingly in abortions, the arguments behind conscience clause bills don’t add up. From their 2011 model legislation guide, Americans United for Life writes:

in the past few years, abortion advocates and their allies have honed in on pharmacists. Their goal is to require pharmacists to dispense contraceptives, including “emergency contraceptives,” forcing them to choose between their livelihood and their moral, ethical, or religious beliefs. Although the U.S. Constitution protects the free exercise of religion, allowing one to follow what his or her conscience dictates, the abortion lobby is turning the debate into a referendum on alleged “refusals” to provide women with constitutionally-protected reproductive health services.

The abortion lobby and their allies recognize that if they can establish legal precedent to coerce someone to violate their conscience regarding contraceptives, they can then easily extend that legal precedent to coerce pharmacists to dispense RU-486 (the so-called “abortion pill”), to coerce medical students to participate in abortion training, and to coerce doctors to participate in surgical and medical abortions.

The whole effort is entirely disingenuous. Even if anti-choice legislators had not been working tirelessly to introduce and pass bills regulating how RU-486 can be distributed, the medication has never been stocked in a pharmacy and pharmacists have never been in a situation where they would have to “violate their consciences” to fill a prescription for it.

Planned Parenthood Advocates of Missouri have come out strongly against HB 457, which has already passed the House vote and moved on to the senate.

”This bill expands our current refusal clause and allows health care providers to put their religious beliefs over the needs and well-being of their patients,” Michelle Trupiano, Statewide Manager of Government Affairs for Planned Parenthood Affiliates in Missouri told RH Reality Check. “This bill only deals with women’s reproductive health care and allows providers to refuse to treat rape survivors with emergency contraception. This bill goes to far.”

Like this story? Your $10 tax-deductible contribution helps support our research, reporting, and analysis.

Follow Robin Marty on twitter: @robinmarty

  • 0ldman

    There needs to be a “keep your religion off my body” clause !

  • OGalaxy

    I think medical schools and boards of certification should have the right to deny PhDs and licenses to medical providers who refuse to provide patients the health care they want and need! If you don’t intend on providing the full scope of care, then don’t become a doctor or nurse! Become a priest or a nun, for God’s sake. I’d LOVE to see the boards revoke their licenses.

  • http://www.facebook.com/olivia.e.engel Olivia Engel

    Yes OGalaxy, if they want that kind of thing then they should stop pretending to be medical practitioners and join a missionary hospital. This kind of legislation has no place in a secular democracy (which is what the USA is supposed to be).

    Is there a petition or grassroots organization we can get in touch with that is combating this particular bill? If someone knows one please post for us!