A new Trump administration office charged with protecting medical providers and staff that refuse to participate in abortion, assisted suicide or other procedures because of moral or religious objections quickly drew fire from Democrats and civil libertarians. They claimed the “conscience protections” enforced by the new Conscience and Religious Freedom Division at the Department of Health and Human Services could be used to deny medical treatment to gay, lesbian and transgender patients or parents.
While Sister Carol Keehan, D.C., president and chief executive officer of the Catholic Health Association, welcomed the new office as a mechanism to ensure that existing federal conscience protections are respected, she was eager to allay some of the concerns raised by the administration’s renewed attention to the subject.
“Yes, conscience is important,” she told America. “Everyone’s conscience is important; there are services that [C.H.A. members] will not offer because of our conscience, but any services that we do offer are available to everybody.”
Sister Keehan said that the new office would have no impact on the way transgender and same-sex couples and their children would be treated by Catholic health care providers. “Transgender patients have heart attacks,” she said, “transgender patients have gallbladder surgery, and transgender patients can have bad infections that need our attention just like the rest of us. And they need to know they are welcome and they will not be looked down upon” if they come to Catholic institutions seeking help.
Sister Keehan said that the new guidelines would have no impact on the way transgender and same-sex couples and their children would be treated by Catholic health care providers.
She does not believe any C.H.A. member-institution would use the Trump administration’s new emphasis on conscience as an excuse to avoid providing services to anyone. It is already the practice that Catholic health institutions do not provide abortion, sterilization or gender-reassignment services, but all other medical services will continue to be provided to all patients, she said. “We have delivered many a lesbian couple’s baby and many a gay couple’s baby. It’s not that we’re endorsing this, it’s just that this is a human being, made in the likeness of God,” she said.
“If you say we’re the healing ministry of Christ, then we need to be the healing ministry of Christ for all Christ’s people,” Sister Keehan said. “I don’t know of any doors in Catholic health care that would have been closed before this office was established or any that will be closed after.”
The administration’s new conscience division will be part of the Health and Human Services department’s civil rights office. H.H.S. officials emphasized that the division will focus on upholding conscience protections that are already part of federal law and that its opening did not suggest a new effort to expand such protections. Conscience protections for medical providers and staff, specifically governing abortion and euthanasia, among other procedures, are already deeply embedded in federal law, including the Church and Weldon amendments, the Public Health Service Act of 1996 and the Obama administration’s Affordable Care Act.
Cardinal Timothy M. Dolan of New York, chair of the U.S. Conference of Catholic Bishops’ Committee on Pro-Life Activities, and Archbishop Joseph E. Kurtz of Louisville, chair of the U.S.C.C.B.’s Committee for Religious Liberty, released a statement on Jan. 19 applauding the H.H.S. move as a significant action to protect conscience rights and religious freedom.
“We are grateful,” they wrote, “that H.H.S. is taking seriously its charge to protect these fundamental civil rights…. For too long, we have seen medical professionals, including pro-life nurses like Cathy DeCarlo, who have been coerced by their employers into participating in abortion. And we have seen states like California, New York, and Oregon demand that even religious organizations cover elective abortions in their health plans. These violations of federal law require a remedy from H.H.S.”
The bishops still seek a long-term fix to threats to conscience rights of medical professionals. “Conscience protection should not be subject to political whims,” they said. “Permanent legislative relief is essential. We urge Congress to pass the Conscience Protection Act in order to give victims of discrimination the ability to defend their rights in court. No one should be forced to violate their deeply held convictions about the sanctity of human life.”
“I don’t know of any doors in Catholic health care that would have been closed before this office was established or any that will be closed after.”
Introducing the new division, H.H.S. Office of Civil Rights Director Roger Severino said, “Laws protecting religious freedom and conscience rights are just empty words on paper if they aren’t enforced. No one should be forced to choose between helping sick people [or] living by one’s deepest moral or religious convictions, and the new division will help guarantee that victims of unlawful discrimination find justice.” The H.H.S. announcement came a day ahead of the annual March for Life in Washington.
In a statement critical of the new division, Louise Melling, deputy legal director at the American Civil Liberties Union, said: “Religious liberty doesn’t include a right to be exempt from laws protecting our health or barring discrimination. It doesn’t mean a right to refuse to transport a patient in need because she had an abortion. It doesn’t mean refusing care to a patient because she is transgender.
“Medical standards,” Ms. Melling said, “not religious belief, should guide medical care. Denying patients health care is not liberty. Choosing your patients based on their gender or gender expression is not freedom. Should the administration choose to move forward to implement a discriminatory policy, we will see them in court.”
But in a statement released by the C.H.A. on Jan. 18, Sister Keehan denied that the new division would have the effect of curtailing treatment for transgender or other patients at Catholic institutions. Noting that the new division should “bring awareness of the importance of conscience protections in health care,” she said, “H.H.S. and its divisions carry the primary responsibility for promoting the health of everyone in our nation. They have a special role in promoting and protecting caregivers as well.
“Catholic health care has always treasured the opportunity to care for everyone, not only those of other religious beliefs, races and backgrounds but even in conflict situations such as in wars and situations where there is a profound difference of opinions,” Sister Keehan said.
“Our deeply held religious and moral convictions are the source of both the work we do and the limits on what we will do. The conscience of Catholic health care does not allow us to participate in certain procedures we feel are an assault on the dignity of human life, such as abortion and euthanasia. That same conscience compels us to love and respect others who feel differently.
“This is a moment where the decency and integrity of the American people should frame the discussion,” she added in the C.H.A. statement. “One more polarized and politicized argument is not going to serve the people of this nation well.”
Regarding some of the concerns raised by the H.H.S. announcement, she told America on Jan. 19, “If this becomes an opportunity for us to have an adult conversation in this pluralistic country about the importance of respect for everybody’s conscience and the importance of not only passing laws that protect conscience but enforcing them, that would be very helpful.”
“Conscience is important,” said Sister Keehan, “but...since [the Trump administration] started undermining [the Affordable Care Act], three million people have lost their insurance; nine million children will lose insurance if we lose [the Children’s Health Insurance Program]; we have several hundred thousand people threatened with being removed from the country they grew up in if we don’t fix DACA; and an absolutely vital program to help hospitals that take care of the poor buy drugs at a discount, the 340B drug program, is about to go down the drain.”
Sister Keehan suggests these vital issues, in addition to conscience, need to be part of the nation’s ongoing conversation about health care.
Updated (Jan. 19, 2018, 5:45 p.m., ET) to include a statement from the U.S. Conference of Catholic Bishops.