Conscience clause in medicine in the United States

[2] The earliest national conscience clause law in the United States, which was enacted immediately following the Supreme Court's decision in Roe v. Wade, applied only to abortion and sterilization.

Supreme Court Justice Harry Blackmun, the author of the Roe v. Wade majority opinion, endorsed such clauses “appropriate protection” for individual physicians and denominational hospitals.

including Arkansas, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Mississippi, Pennsylvania, and South Dakota.

[6] Commenting on the case, bioethicist Jacob Appel of New York University wrote that "if only a small number of physicians intentionally or negligently withhold information from their patients significant damage is done to the medical profession as a whole" because "pregnant women will no longer know whether to trust their doctors.

[13] In July 2006, the Washington State Human Rights Commission warned the board members that they would be personally liable for illegally discriminating against women if they did not pass the Governor's Plan B rule.

[19][16] On February 22, 2012, after four years of discovery and a twelve-day bench trial, Judge Leighton issued a permanent injunction blocking the Plan B rule as unconstitutional.

Reproductive rights organizations, such as Planned Parenthood and NARAL Pro-Choice America, oppose the provision because they maintain that pharmacists, doctors, and hospitals have a professional duty to fulfill patients' legal medical needs, regardless of their own ethical stances.

Opponents see conscience clauses as an attempt to limit reproductive rights in lieu of bans struck down by Supreme Court rulings such as Roe v.

In 2018, Roger Severino, the then-Director of the Office for Civil Rights at the United States Department of Health and Human Services, criticized those who oppose conscience clauses, saying “[t]here’s a movement that tries to squelch dissent on the question of abortion so that those that stand up for life are being systematically driven out of the medical profession.” He also stated that “[n]obody should be fired from their position as a medical professional because they refuse to participate in the taking of a human life in abortion.

[33] Three members of the Department of Obstetrics, Gynecology and Reproductive Sciences and the Bixby Center for Global Reproductive Health at UCSF have questioned whether "conscience clauses" are ethical, writing in a journal article that "in some Catholic-owned hospitals, the private patient–physician relationship, patient safety, and patient comfort are compromised by religious mandates that require physicians to act contrary to the current standard of care in miscarriage management.