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The core mission of the United States Department of Health and Human Services (DHHS) is "to enhance and protect the health and well-being of all Americans." The Trump administration recently announced the creation of the Conscience and Religious Freedom Division (CRFD) of the DHHS Office for Civil Rights to accept complaints by health care providers who feel that they have had to participate in medical procedures counter to their religious values. The CRFD directly contradicts the DHHS mission as well as standards of medical ethics.
JEOPARDIZING CARE
The proposed CRFD rules1 outline a wide-ranging plan that allows members of the health care workforce to avoid providing any health-related services, programs, research activities, or insurance coverage that conflict with their religious beliefs. The rules apply to all health care professionals, ranging from doctors and nurses to front desk staff and insurance administrators. Hospitals or clinics that do not allow their care providers to refuse patients for religious reasons face repercussions that could include a loss of federal funding.
Under the proposed CRFD rules, health care providers are encouraged to prioritize their religious beliefs above the welfare of their patients. The 95% of Americans who report having sex before marriage2 may risk their health care provider denying them care or contraceptive counseling if they disclose their sexual behavior. In the midst of an opioid epidemic, the 25 million Americans who report using illicit drugs3 risk being turned away from care if they disclose their drug use. With some providers, the 52% of Americans who drink alcohol3 may risk being turned away as well.
DISCOURAGING DISCLOSURES
The proposed CRFD rules would make each provider an unknown, unwritten law unto her- or himself. Patients could reasonably be concerned about disclosing stigmatized characteristics or behaviors to any provider, given that the information might be entered into electronic medical records that other providers would see. The rules would permit...