Health Care Provider Refusals to Treat, Prescribe, Refer or Inform: Professionalism and Conscience

R. Alta Charo
Publication Date: 
February 7, 2007

In this Issue Brief, Professor of Law & Bioethics R. Alta Charo of the University of Wisconsin Law School examines the debates surrounding health care provider refusals to provide health care services - such as pharmacists refusing to dispense emergency contraception and physicians refusing fertility services to a gay patient or refusing to forward medical records for a patient who has had an abortion. She describes the early laws allowing some providers to refuse to offer abortion services and more recent efforts to expand these laws to allow more kinds of providers to refuse to perform more kinds of services, as well as recent regulatory efforts to push back and limit such refusals. She analyzes the ethical arguments that have been offered in support of provider refusals and gives rejoinders to them. The paper then discusses in more detail the duty of professionals to provide services, based on the prevailing medical ethic of universal care, the principle of non-discrimination, and other considerations. Finally, several policy options are suggested, such as treating heath care providers as public accommodations that may not discriminate based on sex, and requiring refusing providers to facilitate the referral of patients to other providers to ensure that every member of the public has access to needed health care services.