Resources Available on Physician Refusals to Provide Reproductive Health Care
ACS is pleased to distribute a discussion by University of Wisconsin Professor of Law and Bioethics R. Alta Charo entitled, "Health Care Provider Refusals to Treat, Prescribe, Refer or Inform: Professionalism and Conscience." The phenomenon of doctors imposing their moral choices on patients is the subject of mounting controversy, as reflected in an article in this morning's Washington Post which quotes Professor Charo as an authority on the subject.
In this issue brief, Professor Charo examines the debates surrounding health care provider refusals to provide health care services - such as pharmacists refusing to dispense emergency contraception and physicians refusing fertility services to a gay patient or refusing to forward medical records for a patient who has had an abortion. She describes the early laws allowing some providers to refuse to offer abortion services and more recent efforts to expand these laws to allow more kinds of providers to refuse to perform more kinds of services, as well as recent regulatory efforts to push back and limit such refusals. She analyzes the ethical arguments that have been offered in support of provider refusals and gives rejoinders to them. The paper then discusses in more detail the duty of professionals to provide services, based on the prevailing medical ethic of universal care, the principle of non-discrimination, and other considerations. Finally, several policy options are suggested, such as treating heath care providers as public accommodations that may not discriminate based on sex, and requiring refusing providers to facilitate the referral of patients to other providers to ensure that every member of the public has access to needed health care services.
The National Women's Law Center has also assembled an extensive list of resources on this topic, including a legal guide to refusal clauses which protect health care providers who deny services to their patients.
A recent study published in the New England Journal of Medicine found that 8 percent of doctors believe they have no obligation to present all options to patients, and 18 percent believe they do not have to tell patients about other physicians who provide care that they object to.
In this issue brief, Professor Charo examines the debates surrounding health care provider refusals to provide health care services - such as pharmacists refusing to dispense emergency contraception and physicians refusing fertility services to a gay patient or refusing to forward medical records for a patient who has had an abortion. She describes the early laws allowing some providers to refuse to offer abortion services and more recent efforts to expand these laws to allow more kinds of providers to refuse to perform more kinds of services, as well as recent regulatory efforts to push back and limit such refusals. She analyzes the ethical arguments that have been offered in support of provider refusals and gives rejoinders to them. The paper then discusses in more detail the duty of professionals to provide services, based on the prevailing medical ethic of universal care, the principle of non-discrimination, and other considerations. Finally, several policy options are suggested, such as treating heath care providers as public accommodations that may not discriminate based on sex, and requiring refusing providers to facilitate the referral of patients to other providers to ensure that every member of the public has access to needed health care services.
The National Women's Law Center has also assembled an extensive list of resources on this topic, including a legal guide to refusal clauses which protect health care providers who deny services to their patients.
A recent study published in the New England Journal of Medicine found that 8 percent of doctors believe they have no obligation to present all options to patients, and 18 percent believe they do not have to tell patients about other physicians who provide care that they object to.
Written By:Chris Bell On February 15, 2007 5:21 PM
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See the district court testimony in the Supreme Court case of Gonzales v. Planned Parenthood.
Several doctors testified that they always used the induction method for 2nd-trimester abortions, even though it has been shown to be less safe than several partial-birth variants. Some doctors also said they wouldn't refer a patient to a doctor who would perform the procedure, nor would they inform the patient that a safer procedure even existed.