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HHS announces Conscience and Religious Freedom Division

Office of Civil Rights will return to era of upholding, rather than treating with hostility, claims of conscience in healthcare, says director.

Susan Morse, Executive Editor

Roger Severino speaking during an interview as a staff member from the Heritage Foundation in 2015.

The Department of Health and Human Services on Thursday announced the formation of a new Conscience and Religious Freedom Division in the HHS Office for Civil Rights. 

The division has been established to enforce federal laws already on the books to protect the rights of conscience and religious freedom, according to a released statement from the Office of Civil Rights. OCR said it prohibits coercion on issues such as abortion and assisted suicide.

The OCR is run by newly-appointed director Roger Severino and the office is at the center of the healthcare debate on abortion, contraception and LGBT rights.

"For too long, governments big and small have treated conscience claims with hostility instead of protection, but change is coming and it begins here and now," Severino said by statement.

How or if the new division affects healthcare providers and hospital operations is not yet known.

During a news conference Tuesday, speakers said the federal government had been "trying to strongarm nuns."

The case is that of the Little Sisters of the Poor, an order of Roman Catholic nuns who in 2016 won their case in the Supreme Court against an Affordable Care Act regulation to provide free contraceptive services to employees or face an annual fine reportedly to be in the millions. 

In May 2017, President Donald Trump issued an executive order directing HHS to protect the Little Sisters of the Poor and similar ministries from the mandate.

Several speakers spoke of a new era under President Trump without government interference, as opposed to President Barack Obama and the ACA requirement that most employers cover birth control in their health insurance plans.

Under the Obama administration, OCR was tasked with investigating claims of discrimination against transgender people or based on gender identity.

"For too long healthcare practitioners have been bullied. State and federal (authorities) have hounded religious hospitals," acting HHS Secretary Eric Hargan said during the press conference. "We have strong laws. Now they will be enforced by the OCR."

Everett Piper, MD, President of Oklahoma Wesleyan University said founding father Thomas Jefferson was against government intrusion and had a wall protecting church and state. The OCR's new division will help make that vision a reality, he said.

"This division creates an opportunity for protection for religious minorities and those who hold unpopular beliefs," said Montse Alvarado, executive director of the Becket Fund for Religious Liberty. It is a return to a country, "free from government intrusion," she said.

But Vanita Gupta, president and CEO of The Leadership Conference on Civil and Human Rights, said the OCR's stance will allow healthcare providers to discriminate against patients.

"This proposed rule would allow providers to ignore their medical training and guidelines, and instead allow their personal religious beliefs to determine how a patient should be treated," Gupta said. "The new division is unneeded. These changes will unnecessarily put lives at risk, especially harming women and the LGBTQ community."

Pamela F. Cipriano, president of the American Nurses Association, said, "The American Nurses Association Code of Ethics for Nurses with Interpretive Statements states that a nurse has a duty to care. It also states a nurse is justified in refusing to participate in a particular decision or action that is morally objectionable, so long as it is a conscience-based objection and not one based on personal preference, prejudice, bias, convenience, or arbitrariness. Nurses are obliged to provide for patient safety, to avoid patient abandonment, and to withdraw only when assured that nursing care is available to the patient. 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."

Nurses should not be discriminated against by employers for exercising a conscience based refusal, she said.

"However, we must take care to balance health care professionals' rights to exercise their conscience with patients' rights to access a full range of healthcare services. 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."

Twitter: @SusanJMorse
Email the writer: susan.morse@himssmedia.com