A conscience clause is a legal clause in the United States that was implemented by George W. Bush that protects the right for pharmacists, physicians, and other health care providers from providing certain medical services due to the individual or group's religion or conscience (Nelson & Dark, 2003). A clause is usually used for situations like abortion and contraception. Unfortunately, when the roles of professionals in the medical world intertwine with personal belief systems, there will be a clash of values, opinions, and beliefs and the end result won't benefit anyone. A majority of the states follow conscience clauses. Most of the state laws were put into place after the passage of Roe vs. Wade in 1973 which permitted physicians to opt out of performing or participating in legalized abortions. Also, some students in medical school opt out of learning how to perform an abortion and they are fine to do so under the American Medical Association's code of ethics (Berlinger, 2008). The biggest question is whether conscience clauses are something that we need to be concerned about or leave it as it is.
There are many criticisms about this clause because clauses also determine whether a patient lives or dies. There are two facts about the conscience clause and one of them being that the federal government will not force hospitals or medical professionals to provide abortion care against their will. This means if you or a loved one need a prescription filled or an emergency surgery or procedure done, the surgeon can refuse because of his or her beliefs. A woman who may think she is pregnant can have Plan B denied if it goes against the pharmacist's religious beliefs. Second, the public definitely is against the Federal Refusal Clause and for great reasons. One of the reasons why the public is against it is because they believe that if hospitals receive funds from the government, then they should be able to provide proper medical services, regardless of their religious beliefs. Contraception use is one of the biggest issues in public health. There is evidence that pregnancies that aren't planned may cause serious risks to a woman's health and economic security and that is why access to birth control and other forms of contraceptives have greatly increased throughout the years, because when spend most of their years trying not to get pregnant (Ward & Brusky, 2013).
There are forty-five (45) states that allow some health care providers to decline abortion services and all of those states permit health care providers to refuse to provide abortion services, twelve (12) states allow some health care providers to decline services related to contraception including six states that explicitly allow pharmacists to turn down the use of contraceptives, and eighteen (18) states allow some health care providers to decline the use of sterilization services (“Guttmacher Institute” 2016). This means that women who have fear of being pregnant or women who have emergencies aren’t granted access to the necessary medications that can prevent an even bigger problem.
If I were to use the clause, it would be in the case of abortion for a pregnancy that was not necessarily accidental. There are many women that aren't being careful with who they are involving themselves with and not using the proper protection and they try to use abortion as a form of birth control. That is completely wrong and inhumane and if I were a doctor, I personally wouldn't perform a procedure on a woman who believes that she can simply go to the doctor’s office and get rid of a fetus that she could have easily avoided getting.
Nelson, W. A., & Dark, C. K. (2003). Evaluating claims of conscience. Healthcare
Executive, 18(2), 54-55.
Fast Factions about the Federal Refusal Clause [PDF Document]. Retrieved from
Vansickle-Ward, R. & Hollis-Brusky, A. (2013). An (un)clear conscience clause: the causes and
consequences of statutory ambiguity in state contraceptive mandates. Journal Of Health Politics, 38(4), 683-708.
Berlinger, N. (2008). Conscience clauses, health care providers, and parents. Bioethics Briefing
Refusing to Provide Health Services [PDF Document]. Retrieved from