Social justice of conscience clauses: Balancing the needs of all patients with the beliefs of some providers

As many in the public health sector have been striving to increase access to essential services and preventive practices, those opposed to reproductive freedom have become more creative in placing hurdles in front of women seeking safe and legal reproductive health services. Over the last few years one recent tactic involves significantly expanding the concept of refusal clauses. These provisos (also known as exemption clauses or conscience clauses) purport to protect the religious and moral beliefs of healthcare providers but in effect, act as a means to refuse some treatments and medications to all comers. Under the guise of protecting religious freedom, anti-choice activists—with the backing of some members of the Catholic hierarchy—have aggressively used the political process to allow healthcare professionals, including doctors, nurses and pharmacists, to opt out of providing essential reproductive healthcare services and medications. Across the country, the Catholic hierarchy has worked in collaboration with some anti-choice organizations both to suggest that the consciences of medical professionals are routinely violated and to expand the number of services considered to be subject to such an exemption. This session will discuss the history of these clauses and how they may be formulated to balance the needs of patients with the beliefs of providers. The session will be useful for those who have an interest in health-care ethics, those who may be negotiating conscience clauses in their own institutions and states, and for health professionals who may be considering their own positions on conscience clauses.