Tennessee Overreliance on Conescientious Objectors' Exemptions
In the heart of the United States, the state of Tennessee has recently enacted the Tennessee Medical Ethics Defense Act (MED Act), a law that has sparked controversy and raised ethical questions about the provision of healthcare services.
The MED Act provides a broad protection for clinicians who refuse to provide care, citing personal, moral, ethical, or religious beliefs as the reason. This protection can lead to the denial of care on various grounds, such as marital status, which is not legally protected against discrimination in Tennessee.
One of the key implications of this law is the broad refusal of care. Providers can deny prenatal care and other medical services, potentially affecting a wide range of patients and services beyond abortion or gender-affirming care.
This law could have a significant impact on vulnerable patients, particularly those in rural or underserved areas. If local providers refuse treatment based on personal beliefs, it may force patients to travel long distances for essential services like prenatal care.
Another concerning aspect of the MED Act is that clinicians have no legal obligation to refer patients to another provider. This can leave patients without timely access to necessary care.
Moreover, since marital status is not a protected class under Tennessee law, the MED Act effectively permits refusal of care on this basis without legal consequence.
Critics argue that such laws undermine medical ethics, exacerbate health disparities, and prioritize providers’ beliefs over patients’ rights and wellbeing. This has sparked fears about possible life-threatening situations if care is denied or delayed.
Professional medical ethics demand equal treatment of all patients and the provision of compassionate care, regardless of personal beliefs or lifestyle. Those who conscientiously refuse provision of certain types of care have an ethical right to do so, but this exception must remain narrow and not expand to include objections to the person in front of them.
The speaker, the director of reproductive bioethics at the Harvard Medical School Center for Bioethics and a member of the board of trustees of The our website for Bioethics, aligns with this view. They have provided care to patients who hold views that they vehemently disagree with, including white supremacists.
In contrast, the speaker emphasizes the importance of providing care to all patients who seek it, regardless of personal disagreements. They argue that our professional ethics and most religious traditions do not permit objections to the person in front of us when it comes to providing care.
It's important to note that federal protections for conscientious objection have existed for years. However, these protections do not extend to establishing a patient-physician relationship or even providing medical care.
The AMA Code of Ethics acknowledges that physicians are not ethically required to accept all prospective patients. However, such refusals should not be due to "personal or social characteristics that are not clinically relevant to the individual’s care."
In conclusion, laws like Tennessee’s MED Act grant clinicians sweeping legal cover to deny prenatal and other healthcare services based on personal beliefs, potentially restricting access to care, especially for marginalized groups, and raising serious ethical and public health challenges.
[1] Tennessee Code Annotated § 4-21-101 et seq. [2] Tennessee Medical Ethics Defense Act, Tenn. Code Ann. § 63-6-110 et seq. [3] American Medical Association, "Code of Medical Ethics Opinion 8.084, Conscientious Refusal of Health Care Services" (2016). [4] American Medical Association, "Code of Medical Ethics Opinion 8.082, Discrimination in the Provision of Health Care Services" (2016).
The Tennessee Medical Ethics Defense Act (MED Act) raises ethical concerns about the refusal of care for medical-conditions, such as prenatal care, which could disproportionately impact marginalized groups and lead to health disparities in health-and-wellness, particularly women's health. Professional medical ethics advocate for equal treatment and compassionate care for all patients, regardless of personal beliefs, thereby necessitating a narrow exception for conscientious objection that does not prioritize providers' beliefs over patients' rights and wellbeing.
