The Denial of Care Rule, the Equality Act, and Nursing Ethics

The U.S. Department of Health and Human Services (HHS) Office of Civil Rights has released what they are referring to as “the final conscience rule protecting health care entities and individuals.” This rule is more broadly being referred to as the Denial of Care Rule, as it prohibits the government from penalizing practitioners or organizations for refusing to provide health care based upon religious conscience.

The president of GLMA, Gal Mayer, MD, has spoken out against this rule in no uncertain terms. In particular, he noted that, “The Denial of Care rule also stands in direct conflict with the Joint Commission and the major medical and health professional associations representing physicians, nurses, nurse practitioners, physician assistants, psychologists, social workers and other healthcare providers that have adopted standards to ensure all patients, including LGBTQ patients, are treated with respect and without bias and discrimination in all healthcare settings.”

The GLMA Nursing Section is in full agreement with President Mayer’s statement. It is absolutely unacceptable that HHS, whose mission is “to enhance and protect the health and well-being of all Americans” would issue a rule that facilitates denial of care for, among others, LGBTQ people.

The Code of Ethics for Nurses states in its first provision that “[t]he nurse practices with compassion and respect for the inherent dignity, worth, and unique attributes of every person.” It also states in provisions two and three that nurses prioritize the health and safety of the patient, both in terms of promoting health and safety and advocating for patients. Provision eight speaks to nurses’ obligation to protect human rights and reduce health disparities, and provision nine speaks to the importance of integrating social justice into both nursing and health policy.

In short, the American Nurses Association has made clear in over half the provisions of the Code that it is the responsibility of nurses to not only provide care to their patients based on their unique needs, but also to advocate for policies that ensure patients’ health and safety are protected. The Denial of Care rule, as Dr. Mayer stated in more general terms, is in direct conflict with the Code of Ethics for Nurses, and, in fact, requires nurses to speak out against this rule.

So, what can nurses do?  Plenty, at many different levels.  Talk about this rule with policy-makers in your workplace.  Bring it up with any of your professional organizations.  And most importantly, call your representative and ask them to support the Equality Act (HR 5/S 788).

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