Executive SummaryThis paper discusses how health care refusals or "conscience" clauses undermine medical standards of care and pose a risk to women's health.
Health care refusals and denials of care, sometimes referred to as “conscience” clauses, are proliferating in the United States based on ideological and political justifications that have no basis in medical standards of care. “Standards of care” are medical practices that are medically appropriate, and the services that any health care practitioner under the circumstances should be expected to render. Denials of care violate the essential principles of modern health care delivery: evidence-based practice, patient centeredness, and prevention. A recent report from the National Health Law Program (“NHeLP”), Health Care Refusals: Undermining Quality Care for Women, provides an extensive analysis of the adverse health care consequences for women when medicine is based on ideological beliefs instead of medical standards of care. NHeLP’s report investigates and documents the extent to which these denials of care conflict with professionally developed and accepted medical standards of care for women’s health, and analyzes the potential health consequences for patients. The report concludes that refusal clauses and denials of medical care undermine standards of care by allowing or requiring health care professionals to abrogate their responsibility to deliver services and information that would otherwise be required by generally accepted practice guidelines and laws.