Healthcare providers urge SC governor to veto bill letting them refuse ‘unconscionable’ procedures

Published: May. 20, 2022 at 7:22 PM EDT|Updated: May. 20, 2022 at 9:35 PM EDT
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CHARLESTON, S.C. (WCSC) - Healthcare providers in South Carolina may soon be able to refuse to perform procedures that they say violate their morals, ethics, or religious beliefs.

These “medical rights of conscience” would protect practitioners, including doctors, nurses, and medical students, from being fired or punished for opting out. Healthcare institutions and payers would also be afforded legal protections from the state for refusing these procedures on moral grounds.

This week, a group of 50 medical students, doctors, and nurses sent a letter to Republican Gov. Henry McMaster, urging him to veto the bill, H.4776, once it reaches his desk.

“With doctors and medical students specifically, we each take an oath to uphold scientific knowledge, to treat our patients to the best of our abilities, and to do no harm. Bills like H.4776 completely wipe away all accountability for any physician or provider who would not uphold their oath to protect their patients and to treat them to the best of their abilities,” Thomas Agostini, a medical student in South Carolina who signed the letter, said.

Agostini and others argued this bill becoming law could lead to a denial of care for services like gender-affirming care, life-saving medications to prevent and treat HIV, and family planning services.

Opponents at the State House contended this could especially hurt South Carolinians in areas where doctors are already hard to come by.

“What are we doing here?” Rep. Roger Kirby, D - Florence, asked one of the bill’s sponsors, Rep. John McCravy, R – Greenwood, during debate in the House of Representatives on March 30.

“All this bill does is allow a medical care provider or somebody that works with them to opt out of controversial procedures, and it’s really not about the procedure, it’s about their conscience. So if it violates your conscience to do an abortion, then you can opt out of that,” McCravy responded.

South Carolina law already protects doctors, nurses, and technicians who refuse to perform abortions because they find them objectionable, but this bill would add medical student, who are not covered under the current law, to that list.

Agostini said he and others share those same concerns as the bill’s opponents in the General Assembly about more barriers being imposed on care, especially in rural areas, citing South Carolina’s failure to expand Medicaid.

While practitioners could recommend others who may perform procedures that they refuse, the bill would not require or recommend they do so.

“It’s not necessarily that people have a bunch of doctors or a bunch of practitioners that they can choose from if one denies them care,” Agostini said. “A lot of times, people can only have options based on their geographic location, their insurance status, their mobility.”

But backers of the legislation argue this bill could do the opposite and keep more medical professionals on the job because they would not need to balance their morals against fears of being fired.

“Care providers are reluctant to speak out on many of these bioethical issues for fear of being fired or muzzled or having their admitting privileges restricted,” Dr. Richard McCain, an orthopedic surgeon in Columbia, said.

The bill explicitly forbids refusal of service based on race, and it would not apply to emergency procedures, as federal law requires those services be rendered.

But Dr. McCain believes the right to refuse non-emergency procedures they find unconscionable is one healthcare providers should have legally protected.

“A physician still has to treat each patient with care and compassion and concern and competency,” he said.

This bill passed both the House of Representatives and Senate, largely along party lines, before the legislative session ended last week.

But the chambers passed different versions of it, so a smaller group of Senate and House members will next need to work out a compromise bill to send to the governor.

The Trump administration did put a medical rights of conscience rule on the books at the national level.

But that rule never fully went into effect after it was blocked in federal court and reportedly may soon be formally repealed by the Biden administration.

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