From Disability Scoop:
“Disability Advocates Worry
‘Conscience Rule’ Could Spell Trouble”
A new Trump administration rule
granting health care providers greater latitude to decline care they disagree
with could have serious ramifications for people with disabilities, advocates
say. Earlier this month, the U.S. Department of Health and Human Services
finalized an updated “conscience rule” that protects medical staff and health
care entities from having to provide, refer to, or pay for services such as
abortion, sterilization or assisted suicide. But advocates say the implications
are much broader because the rule says that an individual can’t be required to
“perform or assist” in any part of a “health service program” if contrary to
the person’s religious beliefs or moral convictions. For instance, they say, a
doctor could deny hormones to a transgender person or a sign language
interpreter might refuse to communicate information about birth control. People with disabilities could also feel the
effects in their own homes if they receive federally-funded services. Samantha Crane, legal director and director of
public policy for the Autistic Self Advocacy Network, said group homes and
agencies that provide personal care attendants are often faith-based. She said
their employees are considered health care workers. “This rule could mean if someone is living in
a group home, the group home can refuse to allow overnight visitation by their
same sex partner,” Crane said. “It could mean the person charged with helping a
person bathe, dress and groom themselves, could refuse to help them dress in
clothing that reflects their gender if they’re transgender.” According to HHS,
the religious liberty protection extends to “individuals and entities”
receiving federal dollars through Medicare, Medicaid and the Affordable Care
Act, among other programs. In releasing the rule, Roger Severino, director of
HHS’s Office for Civil Rights, said it would ensure that providers “won’t be
bullied out of the health care field because they decline to participate in
actions that violate their conscience, including the taking of human life.” The
rule applies not only to physicians and nurses but ambulance drivers and staff
who make schedules or prepare rooms for procedures, HHS documents say. “This is
really a huge impediment for people with disabilities to get the access to care
they need,” said David Machledt, senior policy analyst at the National Health
Law Program. “If it applies to an ambulance driver, why wouldn’t it apply to
someone providing a non-emergency transport to a medical appointment? You might
have someone who is refusing to help you take a contraceptive pill.” HHS
officials declined to answer questions about application of the rule to
personal care attendants and staff in residential settings such as group homes.
A spokeswoman referred questions to a fact sheet and the 440-page final rule. The
new rule has already been met with legal opposition. Last week, California
filed a lawsuit while another suit was filed by New York on behalf of itself
and 18 other states. The city of San Francisco was the first to sue, saying the
rule would lead to discrimination. “If an individual were to believe that
transgender people should not transition, it would empower them to refuse to
provide any health-related service to a transgender patient, such as medical
bill processing or scheduling an X-ray for a broken leg,” the San Francisco
suit says. Crane said people with disabilities who live in states with
self-directed Medicaid services will have the option of interviewing and
selecting their own personal care attendants who are willing to provide the
care they need, while individuals relying on an agency may have less control
over who assists them and could run into issues. Nonetheless, she said that even
with the expansion of conscience protections, that doesn’t supersede the civil
rights of people with disabilities. “I personally think this religious refusal
rule is going to make it tremendously hard for people in group homes, many of
which are faith-based, to enforce their rights that we fought for,” she said.
^ I do not believe anyone in the
medical profession should be required to perform an abortion, assisted suicide
or anything like that if it is against their moral beliefs. I do believe, however,
that everyone in the medical profession should be required to give a person
(disabled or not) all of their options whether they are going to perform the
procedure or not. I also do not believe that it should be extended to ambulance
drivers, caregivers, drivers of disability service vans/buses, etc. – anyone who is support staff for the
disabled, but is not directly expected to perform any of these medical
procedures. ^
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