Ungodly Patients? Florida Bill Would Create Right to Withhold Medical Care on Religious, Moral Grounds (UPDATED)

Update published 5/13/2023 2:20 p.m.: Governor Ron DeSantis signed SB 1580 into law, giving Florida healthcare providers and insurers the right to deny treatment to patients on the basis of moral, religious, and ethical beliefs.

DeSantis signed the bill during a ceremony dubbed "Prescribe Freedom" in Destin on May 11, flanked by Florida Surgeon General Joseph Ladapo and the bill's sponsor, Florida Sen. Jay Trumbull.

"It's a very simple thing. The bill says that if I'm a physician and have a conscience-based objection, a moral objection to something, I should be able to say 'no,'" Trumbull said.

DeSantis claimed the bill protects physicians' freedom of speech and will shield healthcare providers from retaliation if they take unpopular stances on treatment protocols for COVID-19.

ACLU of Florida senior policy counsel Kara Gross called the bill "a state-sanctioned license to discriminate" in the provision of medical services.

"The potential public health and private sector consequences of such a bill are wide-ranging and detrimental," Gross said in a statement ahead of the bill's signing. "Medical standards — not ethical, moral, or religious beliefs — should guide medical treatment and healthcare services."

DeSantis signed three other healthcare bills during the ceremony, including SB 252, which prohibits businesses, schools, and government entities from requiring people to wear masks or show COVID-19 vaccine documentation. The governor's office claimed the laws will protect Floridians from the "Biomedical Security State."

The original story follows below.

It's been a busy legislative session chock-full of culture-war-driven bills seeking to overhaul Florida schools, healthcare, and even public toilets. There have been so many politically charged proposals that legislation with profound implications for Floridians seems to be slipping through the cracks of our collective consciousness.

That's all to say you'd be forgiven if you aren't yet familiar with Senate Bill 1580.

Making its way through the Florida legislature, SB 1580 AKA "Protections of Medical Conscience" is seeking to give healthcare providers and insurers the right to deny medical services to patients on the basis of moral, religious, and ethical beliefs.

The bill was deemed favorable by the Health Policy Committee and last week passed through the Senate Rules Committee, paving the way for a floor vote before the session ends on May 5. Senator Jay Trumbull, who represents Panama City and several counties in the Panhandle, sponsored the bill.

If the legislation passes, then medical offices, doctors, nurses, pharmacies, hospitals, clinical lab personnel, and even acupuncturists, among others, would have a right to deny healthcare services to a patient on the basis of a "conscience-based objection" stemming from a "sincerely held" personal belief.

That includes the right to deny surgery, medication, counseling, and countless other services (acupuncture presumably included) in the event the service conflicts with a healthcare provider's beliefs.

Per the bill, employers would be prohibited from punishing healthcare workers who cite a "conscience-based objection" in refusing to treat a patient. The law would be enforced by the Florida Attorney General's office, which could fine violators and seek injunctions to demand compliance. 

The ACLU of Florida has described the measure as "shocking in its breadth, vagueness, and government overreach into the private sector and regulated businesses."

The group's senior policy counsel, Kara Gross, tells New Times it is "a brazen attempt to make it easier to discriminate against people" over the treatment they need. She warns that the bill would entitle employees across the healthcare spectrum to refuse to provide everything from medical billing to therapy to record-keeping.

"Who is to determine whether something is a sincere ethical belief?" Gross asks. "This opens up the door to tremendous discretionary refusals of healthcare and to discrimination in healthcare... and would be a public health disaster."

Gross envisions a cascading set of scenarios in which the bill's language could be used to deny essential medical services. She warns that it will disproportionately affect LGBTQ people, minorities, and other marginalized communities who could be denied service on a whim.

"So what if there's a healthcare provider that thinks that it's unethical to bring a child into the world given overpopulation and climate change? Can that healthcare provider refuse to provide prenatal care to the pregnant person? Under this bill, yes, they can. Can they refuse to assist in labor and delivery? Apparently, under this bill, they can if they have a moral or ethical opposition to it," Gross says.

Gross says the bill has gone largely unnoticed by Florida residents owing to the deluge of sweeping legislation pushed through the statehouse by Republican legislators supporting Gov. Ron DeSantis' agenda, such as the six-week abortion ban and expansion of bans on sexual-orientation lessons in school.

"It's been under the radar because there's been so many other attacks on our civil liberties and civil rights. Frankly, I just don't think that people had time to even notice this one," Gross says.

Trumbull has maintained that Mississippi, Arkansas, Ohio, and South Carolina have similar laws on the books and "there have been zero unintended consequences or harms to patients in those states."

"This does not disadvantage a single person based on race, color, creed, religion or sexual orientation," Trumbull said before the rules committee on April 19. "It only affects the practice itself. There's a longstanding track record that conscience laws work without harming patients."

Trumbull claimed a provision is included to ensure the law will not be used to deny emergency medical services. The bill's supporters insist it will protect medical workers who want to opt out of participating in abortions or transgender care.

"There are specific guardrails," Trumbull said.

To prevent misuse of the "conscience-based objection," an amendment was added stating that a healthcare provider or payer cannot deny service on the basis of a patient’s race, color, religion, sex, or national origin.

A retired physician from the Florida Department of Health, who spoke out against the bill during the rules committee hearing, maintained that the measure invites discrimination, violates professional standards, and further exemplifies the legislature's attack on the LGBTQ community.

"This conversation should be about patient rights to treatment, not trying to establish doctors' and insurance companies' right to withhold treatment," he said. "This bill represents legislative overreach in violation of long-established professional standards... It validates prejudice," the doctor said.

A related bill in the Florida House of Representatives, HB 1403, is scheduled for a second reading on the floor next week after making it through a healthcare regulation subcommittee and health-and-human-services committee.

The vast majority of states have some protections in place for healthcare workers who don't want to perform abortions. As of April 1, however, only eight states had so-called "open-ended" medical conscience laws (akin to Florida's SB 1580) that allow refusal of any treatment on moral or religious grounds, according to data from the Guttmacher Institute and a report from Religious Liberty in the States.

Attempts by Republican state legislators across the country to institute open-ended medical conscience laws have ramped up since 2021. In the past two years, Arkansas, Ohio, and South Carolina each enacted broad medical-treatment-refusal rights in the vein of SB 1580.

A complex patchwork of federal and state regulations has been in place for decades on the issue of healthcare providers' rights to deny treatment. Modern regulations date back to the 1973 Church Amendments, which made it illegal to make federal funding to healthcare providers contingent upon their agreeing to perform abortions or sterilization procedures. The amendments also prohibited entities that receive federal funding from taking adverse employment action against workers because of their refusal to participate in those medical procedures.
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