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President Trump announced Thursday an expanded "rule of conscience" to protect health care workers who oppose abortion, sterilization, assisted suicide and other medical procedures for religious or moral reasons.
The rule establishes guidelines to punish health facilities for losing federal funds if they do not respect the rights of these workers.
"Today, we have finalized new conscientious right protections for doctors, pharmacists, nurses, teachers, students and faith-based charities," Trump said at a news conference. demonstration at the Rose Garden on the occasion of the National Day of Prayer. "They want to do this for a long time."
After the publication of the 440-page rule, some groups expressed concern that the provisions were too broad and compromised the treatment of patients seeking reproductive health care. They also said that this could lead to discrimination against homosexual or transgender patients and their children and weaken public health efforts to develop child immunization.
"The rule allows a very large number of people – from the receptionist to hospital management boards, through all the people to each other – to deny medical care to a patient if his or her personal convictions embarrassment, "said Fatima Goss Graves, National President. Women's Law Center. Ms. Fatima described the rule not only as a strengthening of civil rights enforcement but also a shift in the balance of rights between patients and their clinicians.
The rule was issued by the Civil Rights Bureau of the Department of Health and Human Services, which was significantly expanded under President Trump. The administration created a division of conscience and freedom of religion in the office, and the president's budget sought to increase funding.
The president prefigured the new rule early in his term by signing a decree "freedom of expression and religious freedom".
"People and organizations should not give up their religious beliefs just to help others in the field of health care," said Roger Severino, director of the H.H.S. Civil Rights Office. During a teleconference with journalists, he spoke about a series of existing laws designed to protect people opposed to certain forms of care. "We bring these laws to life with this regulation."
Several conservative and religious groups have applauded the new standards that they believe would protect health care providers from the obligation to provide services contrary to their beliefs.
"Frankly, it's horrible and horrible, whatever your personal beliefs about abortions, that a nurse like Cathy DeCarlo was forced to participate in such treatment, even if she is pro-life" Mélanie Israel, research associate at the Heritage Foundation. She was referring to a complaint that a nurse successfully filed against a hospital in New York in 2013. Mr. Severino mentioned the same case in his remarks on Thursday.
Ms. Israel stated that the Trump administration's actions on the exemption of religion and conscience had been important, not only to strengthen law enforcement, but also to attract Attention to this problem.
Severino said complaints to his office had increased sharply. The Obama administration averages a little over a year a year. On the other hand, the office received 343 complaints in the last fiscal year, Severino said.
A series of civil rights laws have long protected health care workers from certain types of care that are incompatible with their religious beliefs. But the new regulation brings together 25 separate laws – some only pertain to abortion services, some advance directives and others that have generally not been overseen by the Department's Civil Rights Bureau – within a general framework. It also protects workers who refuse not only to provide care, but also to refer patients to someone who will provide them.
"The purpose of the proposed rule was to broaden the universe of individuals and behaviors that would be protected under the laws of the provider's conscience, and to establish a wider range of services." Application tools and formal requirements ", said Jocelyn Samuels, who was director of the Civil Rights Bureau for part of the Obama administration and who is now executive director of the Williams Institute of the University of California at Los Angeles. She was concerned that this rule could affect women's access to reproductive health care and the care of L.G.B.T. patients more generally.
The laws written in the 1970s to protect workers who opposed sterilization procedures, for example, are cited in the rule. The old laws were evoked following recent cases involving health personnel with religious objections to treating transgender patients.
"This is a completely false application of the statues and a huge leap from anything planned," said Jamie Gliksberg, a lawyer at Lambda Legal, who supports L.G.B.T. people. "They take this out of context and taking advantage of the transgender community."
The rule can be challenged in the courts. California Attorney General Xavier Becerra, who has already adopted a number of Trump administration policies, suggested that he could fight it.
Once the rule comes into force, in about two months, the administration could begin to flex new muscles. California, for example, has a law requiring all health insurers to cover abortions, and Severino has officially criticized the Obama administration's handling of the law.
"They give themselves the power to apply all this," said Katie Keith, a research professor at Georgetown University. "What they'll do next is going to really test things."
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