New data published today to LawAtlas.org explore the complexities of state laws that protect health care providers who refuse to provide reproductive health services, including abortion, sterilization, contraception, and emergency contraception, because the service goes against their conscientious beliefs. This release is an update to an existing dataset that previously tracked these laws through December 2018, and shows very few changes in the law in the past year.
Between December 2018 and December 2019, only one state, Vermont, adopted a new reproductive health conscience law. Vermont’s law protects health care providers who choose to participate in abortion from government interference, but it does not establish protections for providers who refuse to participate in abortion.
Seven other states passed minor changes to their conscience statutes, but these changes had limited or no substantive impact on providers’ or patients’ rights.
While conscience protections exist for reproductive services nationwide, they are far more prevalent for abortion: 47 states now have conscience laws establishing protections for health care providers in the context of abortion, according to the data released today; of these, 46 protect providers who refuse to participate.
The research by Nadia N. Sawicki, Georgia Reithal Professor of Law and Co-Director of the Beazley Institute for Health Law & Policy at Loyola University Chicago, focuses specifically on the legal protections granted to those who decline to provide medical services that violate their deeply-held conscientious beliefs or whose conscientious beliefs otherwise impact their provision of care.
The data also explore protections in the law for patients — particularly for those facing a provider’s refusal during a medical emergency, or in other contexts where refusal to participate in abortion might constitute medical malpractice. It also reviews protections related to a patients’ rights to informed consent regarding legal and medically appropriate procedures that individual providers may not be willing to offer.
Protections for patients are generally more limited than those for providers: 13 states limit providers’ conscience rights if they refuse to participate in abortion when the patient is seeking emergency care or her life is in danger.
Illinois is the only state with abortion-specific conscience laws that explicitly require a refusing provider to inform their patient that abortion may be a medically appropriate treatment option. In most states, a patient who is injured as a result of a provider’s refusal is prohibited from suing for malpractice to recover damages.
“There were very few substantive changes to states’ reproductive health conscience laws in 2019. However, the fact that eight states’ legislatures passed amendments to these laws in the past year suggests that there is ample opportunity for reproductive health advocates to petition for changes that would protect the most vulnerable patients.”
Sawicki also published a research letter in Journal of the American Medical Association that analyzes the data.
Sawicki partnered with the Temple University Center for Public Health Law Research Policy Surveillance Program to develop the legal data. This dataset joins a suite of more than 15 reproductive health-focused legal maps on LawAtlas.org.