Proposed refusal clause bills threaten health care access

By |2018-01-16T06:45:10-05:00October 31st, 2017|Uncategorized|

By Dawn Wolfe Gutterman

LANSING – Imagine this: you get to the pharmacy just before they close to fill your prescription for gender dysphoria-related hormones or birth control pills. But the pharmacist refuses to give you your medicine because it’s against his or her religion to do so. And the nearest open pharmacy – which may or may not honor your prescription – is across town. Or, if you’re in a rural area, that pharmacy is in the next town, thirty or more miles away.
Or perhaps you’ve carefully drawn up a living will specifying that you don’t want extraordinary means used to keep you alive. But after a car accident in which you suffer irreparable brain damage, you’re taken to a Catholic hospital. They refuse to honor your living will, and hook you to a feeding tube.
These are examples of situations Michigan citizens could be faced with under a package of bills recently introduced in the state legislature.
Known as the “conscientious objector accommodation act,” House Bill 4741 would “protect and accommodate the right of conscience of health care providers who conscientiously object to providing or participating in certain health care services under certain circumstances.” House Bills 4775, 4745 and 4746 would offer the same protections to pharmacies, health care corporations, and insurance companies.
The bills’ opponents claim the bills would affect access to health care ranging from basic birth control to enforcement of living wills and medical powers of attorney.
“I fundamentally think that [the bills] turn the whole doctor-patient relationship upside down,” said Representative Chris Kolb. “Instead of the patients’ needs being the prime driving force … the health care providers’ beliefs become the prime driving force, and it’s wrong.”
“When you go to the doctor, you go there to receive their medical advice, you don’t go there to have that filtered through their moral values,” Kolb added.
The bills forbid discrimination against gays and lesbians but they do not provide protection to transgender individuals. Nor do the bills, all of which are sponsored by Republican legislators, require practitioners, pharmacies or medical corporations to give public notice about what services they will or will not provide. Referrals are not required.
“I think that those bills are unconscionable and that they violate the Hippocratic Oath,” said Representative Paul Condino. “I question whether patient advocates and living wills would necessarily be enforced at certain institutions.”
Rebekah Warren, executive director of the Michigan Abortion Rights Action League, called the bills, “a little bit less horrible than the ones they’ve proposed in the past.”
According to Warren, Michigan already has statutes protecting doctors who refuse to provide abortions on moral or religious grounds.
“This new provision to allow pharmacists to refuse … to provide treatment is a serious concern to us,” she said.
“We’re a large state geographically – in a lot of towns there may only be one pharmacy,” Warren added. “And if your pharmacist chooses not to prescribe basic birth control pills, women could end up driving 20 or 30 miles – and that’s a real hardship.”
Under the bills, “They don’t have to refer you, they don’t have to tell you if there’s someone else who will – and in some states [with similar laws], providers are holding the prescription and refusing to give it back to the patient,” Warren said.
“These bills say that the health care provider’s or insurance company’s issues and ethics are more important than the patient,” she said.
Triangle Foundation Director of Policy Sean Kosofsky explained that his organization is against the bills, and encouraged the entire LGBT community to voice opposition.
“Triangle Foundation remains opposed to any bill that would allow discrimination in the delivery of health care,” said Kosofsky. “The proponents of this legislation may state they’ve neutralized gay opposition to these bills [by including sexual orientation protection], but they’re mistaken. Our opposition to these bills will be stepped up.”
“The transgender community is just one of many, including women, who should be outraged by any posture of our legislature to violate the Hippocratic Oath to do no harm,” Kosofsky added. “We should stop calling them conscientious objector bills. They are refusal clauses, and we should not give them the dignity of calling them conscientious objector bills.”

Speak OUT!

Contact your state Representative and let her or him know how you feel about allowing health care providers’ religious or moral beliefs to affect access to health care. To find contact information for your Representative call the Michigan State House Clerk’s office at 517-373-0135 or visit

About the Author:

BTL Staff
Between The Lines has been publishing LGBTQ-related content in Southeast Michigan since the early '90s. This year marks the publication's 27th anniversary.