Iowa bill would let patients, providers opt out of care on grounds of conscience

DES MOINES — Medical practitioners, health care institutions and patients would be given broader allowance for conscientiously objecting to receiving or administering certain forms of medical care under proposed legislation in the Iowa Legislature.

The Senate Judiciary Subcommittee voted to advance two bills Tuesday, including one that would give medical practitioners the right to not perform a medical service if it violates their conscience.

The bill provides an exception for emergency medical services.

  Buy Photo

Sen. Jeff Taylor, R-Sioux Center, the sponsor of Senate File 220, said the legislation is not designed to deny patients medical treatment, but rather to allow medical providers to perform their jobs while not going against their consciences.

“In terms of the idea of pitting the conscience of the health care provider against the best interests of the patient, some have made it sound as though it's really like you're pursuing your own self-interest, and it's sort of a selfish thing,” Taylor said. “But I think that's a false dichotomy, because the health care provider has not only his or her own conscience in mind, but they're wanting to abstain from a certain procedure or treatment because they don't believe that it is going to be helpful to the patient.”

There are federal protections in place for health care professionals who refuse to participate in abortion if they find it morally objectionable or if they believe that it is not in the best interest of their patient.

Connie Ryan, representing Interfaith Alliance of Iowa Action Fund, said the legislation would allow medical providers to discriminate against patients.

“This legislation would allow medical providers, institutions and payers to insert their own personal religious beliefs into the medical care of others ...,” Ryan said. “It creates a health care system where the health of patients becomes second to health care providers' personal beliefs.”

Sen. Matt Blake, D-Urbandale, said the bill’s language is too broad, adding he believes “there's no check” on what the legislation constitutes as a medial provider's conscience.

“It is such a subjective standard and there are so many ways that this could be abused and mischaracterized that I think it will ultimately harm patients,” Blake said.

Patient protections

Senate File 180 would provide protections to individuals who refuse to receive medical services for reasons of conscience — including religion — during public health emergencies.

Under the legislation, certain actions taken by entities including employers, businesses and health care providers in response to an individual objecting to receiving a medical treatment would be prohibited, including terminating their employment, denying them access to commerce or public service, or penalizing them financially.

Sen. Kevin Alons, R-Salix, who introduced the bill, said he believes these protections are necessary after the COVID-19 pandemic, when some employers required employees to be vaccinated.

Lena Tucker Reinders, representing the Iowa Public Health Association, said medical providers need to be able to follow proper public health protocol when responding to public health emergencies.

“While the rights of the individual are always important to consider during medical procedures, we also have to think about the risk of the public and emergency preparedness protocols need to be adhered to to protect the public during outbreaks,” Tucker Reinders said.

Gabby Fistler, representing Informed Choice Iowa, said current vaccine requirement exemptions don't go far enough to protect individuals who object to receiving vaccinations.

"Exemptions can be applied subjectively and may not be considered equal for each person," Fistler said. "Seeking an exemption requires an individual to take actions others would not be required to take, and this alone is discrimination. Even with exemptions in place, people with them could continue to be segregated, put on unpaid leave, fired or treated differently because of their status."

  Buy Photo

Blake said the broadness of the bill would take away the rights of those whose health is impacted by people not getting the vaccine.

“If you're trying to do this balance of individual right versus the others, we are completely forgetting about the rights of the sick that would be potentially impacted by this,” Blake said. “This bill as written, I think, completely moves the pendulum to one side and completely leaves out the individuals that will be impacted, for those that are refusing to take these vaccines.”

The three-person subcommittee voted to advance both bills with Blake declining to sign on.