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HHS Final “Conscience” Ruling

Started by Michelle_P, May 02, 2019, 01:33:53 PM

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Michelle_P

HHS Final "Conscience" Ruling

https://www.hhs.gov/sites/default/files/final-conscience-rule.pdf

AGENCY:   Office   for   Civil   Rights   (OCR),   Office   of   the   Secretary,   HHS.   

"prohibits discrimination by such entity against physicians or other health care personnel ... declining to perform or assist in any such service or activity based on religious beliefs or moral convictions, or the individual's religious beliefs or moral convictions respecting such services or activities more generally."

Trans?  Gay?  Queer?  You can be declined care by any provider based on their religious or moral objections.

HHS has essentially handwaved away the complaints that prioritizing religious freedom over patient care could impact care for marginalized groups, LGBTQ+ folks in particular.

"The report provides anecdotal accounts of discrimination from LGBT residents of those states. However, the report does not attempt to determine if the laws passed by those states played any causal role in the discrimination experienced by the respondents, e.g., via comparison to LGBT individuals' experiences in states where no such laws had been passed.
Multiple comments provided lists of various incidents in which providers declined to participate in a service or procedure to which they had a religious or moral objection. Such lists offer no suitable data for estimating the impact of this rule."

AIDS Care

"The Department administers certain programs under the President's Emergency Plan for AIDS Relief (PEPFAR), to which additional conscience protections apply.
...
cannot be required, as a condition of receiving such funds, (1) to "endorse or utilize a multisectoral or comprehensive approach to combating HIV/AIDS," or (2) to "endorse, utilize, make a referral to, become integrated with, or otherwise participate in any program or activity to which the organization has a religious or moral objection."

So, it's OK to receive federal founds for AIDS relief and then proceed to push an 'abstinence only' treatment plan. 

General Care by Organizations Receiving Federal Funds - 42 U.S.C. 300a‐7(c)(2)

"This subparagraph prohibits discrimination by such entity against physicians or other health care personnel in employment, promotion, or termination of employment, as well as discrimination in the extension of staff or other privileges, because of an individual's performance or assistance in any lawful health service or research activity, declining to perform or assist in any such service or activity based on religious beliefs or moral convictions, or the individual's religious beliefs or moral convictions respecting such services or activities more generally."
Earth my body, water my blood, air my breath and fire my spirit.

My personal transition path included medical changes.  The path others take may require no medical intervention, or different care.  We each find our own path. I provide these dates for the curious.
Electrolysis - Hours in The Chair: 238 (8.5 were preparing for GCS, five clearings); On estradiol patch June 2016; Full-time Oct 22, 2016; GCS Oct 20, 2017; FFS Aug 28, 2018; Stage 2 labiaplasty revision and BA Feb 26, 2019
Michelle's personal blog and biography
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GingerVicki

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Bea1968

I would take that as meaning no retaliation or cause of action against a health professional that chose not to take part in HRT, Ffs, GRS or other medical procedures that conflict with their religious beliefs.  I am ok with that.

I do not want someone monitoring my health or engaged in a procedure on me who does not believe that I have rights or should be respected.  I would not force people to do something that they believe is wrong.  I may disagree with them and they may disagree with me BUT, flip this around.

Do you think we should be compelled to live or act in a way that is inconsistent with our beliefs!?

Why then should we expect that others not be treated the same?

I know, my opinion is likely to not be popular here but if I am to be fighting to be free to live as I believe why would I accept less for others?
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Michelle_P

Quote from: Bea1968 on May 02, 2019, 02:10:24 PM
I would take that as meaning no retaliation or cause of action against a health professional that chose not to take part in HRT, Ffs, GRS or other medical procedures that conflict with their religious beliefs.  I am ok with that.

As am I.  Unfortunately, the legal interpretation of this is far, far broader than that.

An emergency medical service can decline to treat a transgender person injured in an automobile accident, or in diabetic shock.  While ethically they should still required to stabilize an individual before declining to provide further care, that will not be absolutely determined legally until after a case is brought and litigated to determine the proper course of action in case law, as we currently have a conflict in the rules.

There is already a long history of care being declined for persons presenting for medical care while transgender.  The HHS rules enshrine the rationale for declining care, shielding medical providers from litigation.

Dead from diabetic shock after EMS refused treatment:
https://bklyner.com/ems-denied-transgender-patient-care-causing-her-death-alleges-sheepshead-bay-lawyer-sheepshead-bay/

Dead when EMS and ER providers realized the accident victim was trans, and therefor not worth saving:
https://en.m.wikipedia.org/wiki/Tyra_Hunter

Naturally, transition-related care is also impacted, even if the doctors and insurers approve, but a third party decides to intervene:
https://lostcoastoutpost.com/2019/mar/21/aclu-sues-st-joseph-health-discrimination-against/

The new HHS rules grant permission to deny care with no recourse at the federal level.  It remains to be seen if state law will be able to withstand this effort.
Earth my body, water my blood, air my breath and fire my spirit.

My personal transition path included medical changes.  The path others take may require no medical intervention, or different care.  We each find our own path. I provide these dates for the curious.
Electrolysis - Hours in The Chair: 238 (8.5 were preparing for GCS, five clearings); On estradiol patch June 2016; Full-time Oct 22, 2016; GCS Oct 20, 2017; FFS Aug 28, 2018; Stage 2 labiaplasty revision and BA Feb 26, 2019
Michelle's personal blog and biography
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Bea1968

Some rare cases that will happen.  I am sure there are many more cases of black man dying because he was not worth the effort/ expense or homeless person or old patient......

I believe that largely, your fears are unfounded.  I believe most life saving care will not be withheld to transgender patients.  I believe health care professionals are above considerations of race, gender, sexual orientation or whatever when it comes to life saving care.  I believe that professionals have a right to decline participating in things for which they do not believe.  Be it medical, spiritual, artistic or whatever.  No one should be compelled to do work that they believe is wrong.  No one should be compelled to live a life they feel is wrong.
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Michelle_P

Tell it to Tyra Hunter.


Sent from my iPhone using Tapatalk
Earth my body, water my blood, air my breath and fire my spirit.

My personal transition path included medical changes.  The path others take may require no medical intervention, or different care.  We each find our own path. I provide these dates for the curious.
Electrolysis - Hours in The Chair: 238 (8.5 were preparing for GCS, five clearings); On estradiol patch June 2016; Full-time Oct 22, 2016; GCS Oct 20, 2017; FFS Aug 28, 2018; Stage 2 labiaplasty revision and BA Feb 26, 2019
Michelle's personal blog and biography
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Iztaccihuatl

I wonder if the LGBT community should take this to the insurers, i.e. convince them that it is a good business policy for them to drop any healthcare provider from their network if they discriminate against LGBT persons. Kind of if a healthcare provider is not providing services to all insured clients of the insurance, they cant do business with them. Just a thought...


Sent from my iPad using Tapatalk
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Faith

I didn't take any kind of oath to be trans or be myself. They take an oath to provide care for people, there is not a provision for 'unless I don't want to' or 'I don't agree'  If you don't wish to treat all to equal health-care, change professions.
I left the door open, only a few came through. such is my life.
Bluesky:@faithnd.bsky.social

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GingerVicki

Quote from: Bea1968 on May 02, 2019, 02:10:24 PM
I would take that as meaning no retaliation or cause of action against a health professional that chose not to take part in HRT, Ffs, GRS or other medical procedures that conflict with their religious beliefs.  I am ok with that.

I do not want someone monitoring my health or engaged in a procedure on me who does not believe that I have rights or should be respected.  I would not force people to do something that they believe is wrong.  I may disagree with them and they may disagree with me BUT, flip this around.

Do you think we should be compelled to live or act in a way that is inconsistent with our beliefs!?

Why then should we expect that others not be treated the same?

I know, my opinion is likely to not be popular here but if I am to be fighting to be free to live as I believe why would I accept less for others?

I would agree but the Catholic church is buying all of the hospitals. This means that I may end up self-medicating because no doctor will see me. This is not ok!

They are gonna shove us underground and make many of us use the black market. Suicide rate may increase because of lack of care. To some, this administration is a death sentence and I hope that people realize that this is done in the name of religion.

Let that set in.
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tgchar21

Quote from: Iztaccihuatl on May 02, 2019, 04:49:45 PM
I wonder if the LGBT community should take this to the insurers, i.e. convince them that it is a good business policy for them to drop any healthcare provider from their network if they discriminate against LGBT persons. Kind of if a healthcare provider is not providing services to all insured clients of the insurance, they cant do business with them. Just a thought...


Sent from my iPad using Tapatalk

A boycott like that would then mean that anyone trying to get services at said provider with said insurance - trans or cis - would be denied treatment (just shifting the denial of services and possibly the loss of life from one group to another).
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Iztaccihuatl

Quote from: tgchar21 on May 03, 2019, 07:39:26 AM
A boycott like that would then mean that anyone trying to get services at said provider with said insurance - trans or cis - would be denied treatment (just shifting the denial of services and possibly the loss of life from one group to another).

Not necessarily. It would just be out of network, but non-LGBT folks could still get service there. It would simply be more expensive and drive folks away from that service provider for non-emergency services.
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Devlyn

Massachusetts requires all insurers to provide coverage to transgender people. You need to take it to your legislators, not the insurance companies.
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tgchar21

Quote from: Iztaccihuatl on May 03, 2019, 07:44:08 AM
Not necessarily. It would just be out of network, but non-LGBT folks could still get service there. It would simply be more expensive and drive folks away from that service provider for non-emergency services.

Only if the boycott applies strictly to NON-EMERGENCY services. No one should be forced to pay more for urgent and life-saving treatment purely out of principle for another issue.
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Linde

Quote from: Bea1968 on May 02, 2019, 04:18:42 PM
Some rare cases that will happen.  I am sure there are many more cases of black man dying because he was not worth the effort/ expense or homeless person or old patient......

I believe that largely, your fears are unfounded.  I believe most life saving care will not be withheld to transgender patients.  I believe health care professionals are above considerations of race, gender, sexual orientation or whatever when it comes to life saving care.  I believe that professionals have a right to decline participating in things for which they do not believe.  Be it medical, spiritual, artistic or whatever.  No one should be compelled to do work that they believe is wrong.  No one should be compelled to live a life they feel is wrong.
As a health care professional, I wonder when we started to weight one life against another?  Do you rally feel that the life saving of a transgender person is of no value as long as we don't save lives of black, yellow or whatever color person?  Each death of each person, no matter which skin color or orientation this person has, is tragic!

And no, not all health care professionals are above considerations of race, gender, etc.  Us health care professionals are human being like anybody else, with all failures and shortcomings.  I met some really racist health care professionals before!
If I want to be treated by such a person is another questions, but sometimes my wants are not in the foreground if I need to be stabilized to stay alive!
02/22/2019 bi-lateral orchiectomy






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