The Bush administration announced its "conscience protection" rule for the health care industry yesterday, giving everyone including doctors, hospitals, receptionists and volunteers in medical experiments the right to refuse to participate in medical care they find morally objectionable.
"This rule protects the right of medical providers to care for their patients in accord with their conscience," outgoing Health and Human Services Secretary Mike Leavitt said.
The right-to-refuse rule includes abortion, but Leavitt's office said it extends to other aspects of health care where moral concerns could arise, including birth control, emergency contraception, in vitro fertilization, stem cell research or assisted suicide.
The rule will take effect the day before President George W. Bush leaves office.
It also sets the stage for an early conflict in the Obama administration over abortion. In August, Sen. Barack Obama criticized the rule when it was proposed and said he was "committed to ensuring that the health and reproductive rights of women are protected."
The rule reaches nearly all providers of health care, including hospitals, clinics, universities, doctor's offices and pharmacies, and says they can be charged with discrimination if an employee is pressured to participate in care that is "contrary to their religious beliefs or moral convictions." Violators would lose their federal funds.
Critics of the rule said it was too broad and threatened the rights of patients. They said they were worried that patients would not be given full and complete information about their medical options.
"This gives an open invitation to any doctor, nurse, receptionist, insurance plan or even hospital to refuse to provide information about birth control on the grounds that they believe contraception amounts to abortion," lawyers for the National Women's Law Center said.
They also pointed to the last-minute nature of the change. "We are shocked that the Bush administration chose to finalize its midnight regulation and to take this parting shot at women's health and ignore patients' rights to receive critical health care services and information they deserve," said Cecile Richards, president of the Planned Parenthood Federation of America.
Asked about the rule yesterday, a spokesman for Obama's transition team said the new president "will review all 11th-hour regulations and will address them once he is president."
After Jan. 20, the Obama administration could begin the process of adopting a revised ruled, but that would likely take many months. Instead, Congress could adopt a resolution that rejects the late rules adopted by the Bush administration.
Shortly after the Supreme Court in 1973 ruled that pregnant women had a right to abortion, Congress adopted laws to make clear that no one was required to perform an abortion. Later laws went further and said "no individual shall be required to perform or assist" in any research or health care procedure that "would be contrary to his religious beliefs or moral convictions." Leavitt said the new right-to-refuse rule was needed to enforce these laws.
He agreed the "doctor-patient relationship requires a balancing of interests," but added doctors have a duty only "to provide care that they are comfortable providing."