President Trump has been in the news promoting his promise to take steps to protect conscience and religious liberty of individuals and health care entities. He signed an executive order to this effect in May 2017, and 2017 the Department of Justice directed the U.S. Department of Health and Human Services (HHS) to implement religious freedom laws. Recently, the HHS Office for Civil Rights (OCR) issued a final version of their conscience rule to protect both individuals and institutions from discrimination when exercising their conscience in HHS-funded programs. This comes after reviewing over two hundred thousand public comments on the proposed rule before issuing a final conscience rule.

Specific Conscience Protections

HHS aims to provide a set of tools to protect healthcare providers, entities, and individuals from having to “provide, participate in, pay for, provide coverage of, or refer for, services such as abortion, sterilization, or assisted suicide.” It also includes conscience protections with respect to advance directives, according to the May 2nd press release from HHS. The rule, which is over 400 pages in length, also provides guidance for covered entities on how to comply and provide a certificate of compliance. This includes cooperating with OCR investigations, maintaining appropriate records and reporting procedures, and non-retaliation requirements.

The rule lists a series of conscience protections afforded to the different covered entities under the new ruling. These include everything from sections of the Affordable Care Act regarding abortions and suicide to the Church Amendment that protects providers from having to provide sterilization treatments. It also includes protections for nonmedical healthcare institutions and nonmedical care.

Who is Covered by This Rule?

Protected entities include health care entities and employers such as hospitals, doctors’ offices, insurance providers, and others. The rule also covers health care professionals who decline to receive training regarding abortions, sterilization, and physician-assisted suicide. It also covers individuals who do research funded by HHS.

The rule protects patients who object to certain procedures from a sincere moral or religious conviction. These procedures include health screenings and mental health treatments of the patient or his or her children. Therefore, even if the patient goes to a facility that does not have a reason to limit its providers and does provide certain services, the patient still has a right to opt out of these procedures on behalf of themselves or their dependents.