HHS Announces Final Conscience Rule Protecting Health Care Entities and Individuals

News Release
For immediate release

US Department of Health and Human Services

The U.S. Department of Health and Human Services (HHS) Office for Civil Rights (OCR) announced today the issuance of the final conscience rule that protects individuals and health care entities from discrimination on the basis of their exercise of conscience in HHS-funded programs. Just as OCR enforces other civil rights, the rule implements full and robust enforcement of approximately 25 provisions passed by Congress protecting longstanding conscience rights in healthcare.  

The final rule fulfills President Trump’s promise to promote and protect the fundamental and unalienable rights of conscience and religious liberty, a promise he made when he signed an executive order in May 2017 protecting religious liberty.  In October 2017, the Department of Justice issued guidance encouraging other Departments, including HHS, to implement and enforce all relevant religious freedom laws.  

As a result, in January 2018, following the launch of its new Conscience and Religious Freedom Division, HHS announced the proposed conscience rule.  OCR received over 242,000 public comments, and analyzed and carefully considered all comments submitted from the public on the proposed conscience regulation before finalizing it.

This final rule replaces a 2011 rule that has proven inadequate, and ensures that HHS implements the full set of tools appropriate for enforcing the conscience protections passed by Congress.  These federal laws protect providers, individuals, and other health care entities from having to provide, participate in, pay for, provide coverage of, or refer for, services such as abortion, sterilization, or assisted suicide.  It also includes conscience protections with respect to advance directives.

The final rule clarifies what covered entities need to do to comply with applicable conscience provisions and requires applicants for HHS federal financial assistance to provide assurances and certifications of compliance. The rule also specifies compliance obligations for covered entities, including cooperation with OCR, maintenance of records, reporting, and non-retaliation requirements.

“Finally, laws prohibiting government funded discrimination against conscience and religious freedom will be enforced like every other civil rights law.” said OCR Director Roger Severino. “This rule ensures that healthcare entities and professionals won’t be bullied out of the health care field because they decline to participate in actions that violate their conscience, including the taking of human life. Protecting conscience and religious freedom not only fosters greater diversity in healthcare, it’s the law,” Severino concluded.

Click here to read the Final Conscience Rule.

Click here – PDF to read the Final Conscience Rule Factsheet.

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*This HHS-approved document is being submitted to the Office of the Federal Register (OFR) for publication and has not yet been placed on public display or published in the Federal Register.  This document may vary slightly from the published document if minor editorial changes are made during the OFR review process.  The document published in the Federal Register is the official HHS-approved document. 

*People using assistive technology may not be able to fully access information in these files.  For assistance, please email OCR at OCRMail@hhs.gov or contact the OCR Call Center at (800) 368-1019.

Contact: HHS Press Office 202-690-6343 media@hhs.gov

Canadian protection of conscience bill progresses

David Anderson, M.P.

Two years ago, taking a patient’s life was culpable homicide. Although the law now permits physician assisted suicide, many doctors’ consciences will not. The Supreme Court of Canada has explicitly said that the legalization of euthanasia did not entail a duty of physicians to provide it.

However, regional associations have introduced regulations compelling conscientiously objecting physicians to provide effective referrals for physician assisted suicide, contravening this assurance. This happens, without any penalty.

I believe it’s time to stand up for doctors and health care providers who aren’t willing to leave their core ethics behind when they’re at a patient’s bedside. The protection of conscience rights for medical professionals is part of protecting the fundamental freedom of conscience and religion guaranteed to all Canadians in the Charter of Rights and Freedoms.

Bill C-418 amends the Criminal Code to make it an offence to intimidate a medical practitioner, nurse practitioner, pharmacist or any other health care professional for compelling them to take part, directly or indirectly, in the provision of medical assistance in dying.

It also makes it an offence to dismiss from employment or to refuse to employ a medical practitioner, nurse practitioner, pharmacist or any other health care professional for the reason only that they refuse to take part, directly or indirectly, in the provision of medical assistance in dying.

I expect Bill C-418 will be debated on May 29, 2019.

Click below to view and download materials to spread the word about C-418 and build support for this important legislation:


Click here to download a copy of C-418 (EN/FR)

Click here to download an informational graphic on C-418 with tear-away letter to the Minister of Justice | Français

Click here to download a letter on C-418 which can be sent to your local Member of Parliament | Français

Click here to download a petition on C-418 | Français


Protection of conscience bill passes in Indiana

Sean Murphy*

Indiana Senate Bill 201, proposed by Senator Liz Brown, passed the Indian Senate by a vote of 38-8 and will be sent to Goveror Eric Holcomb for signature. Existing Indiana law protects freedom of conscience for physicians, nurses and institutional employees in relation to surgical abortion. Bill 201 amends the statute to include medical abortion and extends protection to physician assistants and pharmacists.

Catholic hospital group sued for refusing transgender hysterectomy

Cathoic News Agency

San Francisco, Calif., Mar 25, 2019 / 02:00 pm (CNA).- A group of five Catholic hospitals in California is being sued by a woman who identifies as a transgender man after one of its locations, St. Joseph Hospital, Eureka, refused to perform a hysterectomy.

Oliver Knight is suing St. Joseph Health of Northern California, alleging that she was refused the surgery because of her “gender orientation.”

The suit was filed in the Humboldt County Superior Court on Thursday, March 21. In the lawsuit, Knight says that workers at the hospital canceled the surgery because she identifies as transgender. . . [Full text]

Doctors to fight new abortion law

Hawthorn Caller

Mike Billings

A group of doctors opposed to abortion say they will fight any moves in looming reforms to erode their rights to refuse to deal with patients wanting abortions. The issue of referring patients seeking abortions to another doctor has drawn opposition from the group.

Justice Minister Andrew Little says he agrees with a Law Commission proposal for doctors who are “conscientious objectors” to abortion to be made to directly refer a patient on to another doctor who they know will provide the service.

Currently, such doctors only have to advise the patient they can get the service elsewhere without specifying where. . . [Full text]