HHS Proposal Needs Input

NASW Executive Director Elizabeth J. Clark wrote a letter to the Department of Health and Human Services (HHS) to voice concerns about a proposed "provider conscience regulation" that would allow a health care provider to refuse to provide certain medical services on the basis of his or her religious or moral beliefs.

Speaking on behalf of the association's 150,000 members, Clark stated that the proposed regulation lacks involvement from stakeholders, is unclear in its definition and is too broad in scope.

Clark stated NASW requests a 90-day comment period and hearings on newly proposed regulations prior to implementation. She also noted a 2006 policy drafted by NASW that addresses family planning and choice.

It states, "The social work profession's position concerning abortion, family planning, and other reproductive health services is based in the principle of self-determination: Every individual (within the context of her or his value system) must be free to participate in abortion, family planning, and other reproductive health services. NASW believes that client self-determination and access to a full range of safe and legal reproductive health care services without discrimination will contribute to an enhancement of the individual and collective quality of life, strong family relationships, and population stability."

Clark stated in the letter that the proposed regulation could mean a patient's health care needs may be disregarded because of the religious or moral objectives of the health care providers.

The executive director noted that when institutions and individuals opposed to abortion, family planning, and other reproductive health services do not refer patients to other providers or even provide them with information about legal options or where they can obtain such information, they deny women access to appropriate health care services - particularly women who are poor, uninsured or underinsured, or who live in rural areas or other areas with limited resources.

Clark went on to state that the proposed regulation may result in abrupt or sudden individual health care providers' withdrawal from service delivery, which would likely result in disruption of services for women.

Existing guidelines and state laws in some areas have provided a functional balance between a patient's rights and the health care provider's rights, Clark said. "The proposed regulation would undermine these local institutional guidelines and laws," she stated.

In November, the Congressional Quarterly (CQ) noted the proposed regulation faced more opposition, this time from Henry A. Waxman (D-Calif.), chairman of the U.S. House Oversight and Government Reform Committee.

CQ stated that Waxman sent a letter to HHS Secretary Michael O. Leavitt to express concern that the proposed rule is duplicative of a provision in the Civil Rights Act of 1964, which prohibits employment discrimination against applicants and employees based on religion.

The letter stated that since the HHS proposal deals with rights of health care employees to make certain refusals on the basis of religious or moral beliefs, there is "clear and substantial overlap between its scope and that of the Equal Employment Opportunity Commission (EEOC)'s religious discrimination work."

Waxman noted in the letter that it was apparent HHS officials did not seek consultation with the EEOC in drafting the proposal and thus may have violated an executive order by allegedly failing to coordinate with other agencies in issuing a proposed regulation on physicians' conscience rights.