New HHS Conscience and Religious Freedom Division Must Not Undermine Physician’s Obligations to Treat All Types of Patients

Statement attributable to:
Jack Ende, MD, MACP
President, American College of Physicians

Washington, DC (January 18, 2018) — The American College of Physicians (ACP) cautions that the creation of a new Health and Human Services (HHS) division—the conscience and religious freedom division— tasked with enforcing conscience laws must not lead to discrimination against any category or class of patients, as guided by the medical profession’s ethical obligations and consistent with ACP policies.  ACP would be particularly concerned if the new HHS division takes any actions that would result in denial of access to appropriate health care based on gender, gender identity, sexual orientation, race, ethnicity, or other personal characteristics.

ACP will evaluate the newly formed division as it begins operating, informed by our ethics and public policy positions.  Those state that physicians have a professional obligation to not discriminate against any class of patients, but also that a physician may have a conscience objection to providing a specific medical service to a patient. 

ACP’s Ethics Manual states “Although the physician must address the patient's concerns, he or she is not required to violate fundamental personal values, standards of medical care or ethical practice, or the law. . . If the physician cannot carry out the patient's wishes after seriously attempting to resolve differences, the physician should discuss with the patient his or her option to seek care from another physician.”

The manual goes on to detail the physician’s the professional obligation to provide care, “By history, tradition, and professional oath, physicians have a moral obligation to provide care for ill persons.  Although this obligation is collective, each individual physician is obliged to do his or her fair share to ensure that all ill persons receive appropriate treatment. A physician may not discriminate against a class or category of patients.” [Emphasis added in bold]

In ACP’s paper, Lesbian, Gay, Bisexual, and Transgender Health Disparities, evidence showed that “individuals with gender identity variants face increased discrimination, threats of violence, and stigma.”  ACP recommends that, “To reduce the potential for discrimination, harassment, and physical and emotional harm toward persons who are not covered by current protections, the medical community should include both sexual orientation and gender identity as part of any comprehensive nondiscrimination or anti-harassment policy.”

ACP strongly opposes any policies that increase discrimination and have the potential to harm patients especially the most vulnerable populations based on their personal characteristics.  Instead, we urge our government to establish policies that are based on inclusion and support.


About the American College of Physicians
The American College of Physicians is the largest medical specialty organization in the United States with members in more than 145 countries worldwide. ACP membership includes 152,000 internal medicine physicians (internists), related subspecialists, and medical students. Internal medicine physicians are specialists who apply scientific knowledge and clinical expertise to the diagnosis, treatment, and compassionate care of adults across the spectrum from health to complex illness. Follow ACP on Twitter and Facebook.

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