How President Trump’s decision puts women’s health at risk
Dr. M. was treating a pregnant woman at a Catholic hospital and discovered that she had cancer. The woman needed aggressive surgery and chemo, meaning she would have to terminate her wanted pregnancy. Once she accepted that painful outcome, Dr. M. asked the hospital’s ethics committee for permission to terminate her pregnancy in order to save her life. He was denied and told she would have to find somewhere else to get an abortion. He recalled telling the committee, “This poor woman is suffering. She’s got a malignancy, she doesn’t want to terminate, she realizes she has to and you’re going to make her go to a clinic?”
This devastating scenario where women are turned away at the most vulnerable time of their lives despite their doctor’s wishes could become more common thanks to the Trump administration’s Department of Health and Human Services. This month, it announced the intention to create a new “conscience and religious freedom” division that introduces sweeping interpretations of so-called conscience protection laws covering medical providers, backed by aggressive enforcement. This new initiative could embolden institutions and individuals to refuse to provide health care, with dangerous consequences for patients.
Research shows that physicians at Catholic hospitals, like Dr. M., regularly find themselves in conflict with religious directives that undermine the standard of care. They are forced to wait for signs of infection that could damage women’s health and fertility before treating a miscarriage. They sometimes have to bend the truth to get the approvals they need from hospital religious authorities to move forward with medically necessary treatment. In some cases they must send away pregnant women with time-sensitive, complicated conditions to get an abortion elsewhere. In rural and underserved areas, the closest alternative place to obtain care could be hours away. Tying the hands of medical professionals creates unnecessary distress for them and their patients, and could carry grave medical risks.
Our research also shows that most people will have no idea that their hospital has these kinds of restrictions on reproductive health care until they find themselves face-to-face with a denial. When we surveyed women, we found that the vast majority want to know about religious restrictions on reproductive care before deciding where to seek it. Like most states, California has no laws that require hospitals to provide this information ahead of time, never mind actually provide the care. Rather than encouraging transparency and medical best practices, this new rule will put the force of the federal government firmly behind institutions and individuals that block access to care.
Don’t expect the new HHS division to bend over backward to protect doctors whose conscience compels them to provide the best possible health care if it is restricted by the hospital’s religion. The administration’s crusade is selective. The word abortion comes up 155 times in the proposed HHS rule. This dangerous move is yet another attack on women’s health in the guise of religious liberty.
The administration’s gift to opponents of contraception and abortion could have even more dire consequences, with hospitals, doctors, nurses, pharmacists and even support staff such as medical interpreters emboldened to stand in the way of reproductive health care.
There are already effective models to accommodate providers’ moral and religious beliefs in training and practice, while striking a crucial balance with delivering evidence-based, patient-centered care. This proposal skews that balance, lowers the bar for care and exposes women who seek reproductive health care to discrimination and dangerous delays. It’s time the administration stops politicizing medicine and interfering in the judgment of medical professionals.