The Ohio Academy of Family Physicians (OAFP) released a statement on July 16, expressing concern with the recently enacted Medical Practitioners Conscience Clause. The statement released is attributed to OAFP President Mike Sevilla, MD, and OAFP Public Policy Committee Chair Sarah Sams, MD.
Ohio has long balanced protection of the rights of medical practitioners to express conscience objections with the need for clinicians to fulfill their obligations to patients and care for them to the best of their ability. The Medical Practitioners Conscience Clause, recently enacted by the Ohio General Assembly, upsets this balance and compromises the care of the citizens of Ohio.
This clause now allows health care practitioners, health care facilities, and insurance providers to refuse to provide or pay for a medical service based upon conscience or moral belief. Essentially making discrimination against patients legal, these provisions could have an immense impact on the health and safety of Ohioans. For example, LGBTQ patients may find it more difficult to access the medical care they need and desire.
The enacted language imposes an obligation to transfer the care of a patient to another willing provider only when “possible” and when the objecting provider is “willing.” The words “possible” and “willing” are key and have the potential to create a scenario where patients could be without necessary care of any practitioner due to the objection of the original practitioner.
Further, these provisions would allow insurance companies to render reimbursement decisions related to procedures after a procedure has been completed. A patient could have a procedure recommended by their doctor anticipating that it is covered under their insurance plan; only to, after the fact, discover their insurance company has declined coverage due to “moral objection.”
Not only is the clause unacceptable, the process in which the clause was adopted is objectionable. While there are no budget implications to the clause, the Medical Practitioners Conscience Clause was inserted into the state budget bill at the eleventh hour without the opportunity for any public input through the committee hearing process.
The OAFP wants all patients to know that everyone is welcome in our practices, we want all patients to have access to appropriate care, and we will advocate for all patients so that they have that access.
It is apparent that the OAFP has joined the other organizations in endorsing the concept that physicians must treat and or participate in treating conditions or requests of patients that would be contrary or against the providers personal ethics or beliefs. It is said to see you endorse ones beliefs or life style overriding the physicians as not worthy.
Federal law already allows a provider to decline to provide a medical service due to objections of conscience, but compels doctors to find another physician to perform the service. This provision removes that requirement, and prevents a practitioner, institution or insurance company from facing any liability for declining to do so.
The provision casts a wide net. Doctors and nurses can decline to perform necessary procedures, lab techs can refuse to analyze test results or perform screening procedures, insurance companies can refuse to cover a procedure already performed by a doctor, a pharmacist can refuse to dispense birth control even if a patient has a valid prescription, and more.
Many have expressed concern that this provision would legalize discrimination against LGBTQ patients, minorities, marginalized groups such as those with substance use disorders or a sexually transmitted disease and could prevent women from accessing birth control and other family planning and reproductive health care services.