NC House leaders back bill allowing healthcare workers to turn away patients for 'moral' reasons

Should you be turned away from medical care because a provider has a moral or ethical objection to something about you? You could be — under a bill that is likely headed for the House floor next week.

House Bill 819, which sponsors call the Medical Ethics Defense Act, would allow any healthcare provider, hospital or institution, or insurer or other payer to refuse to provide care or service to any person if the provider has a "religious, moral or ethical" objection to doing so. The GOP-backed measure passed the House Health committee Thursday.

The bill reiterates a decade-old state law that allows any healthcare provider to object to performing abortions on religious grounds. However, H819 goes far beyond abortion to allow the refusal of any type of care to any person. That could include refusal of care to patients based on sexual orientation, gender identity, or even political opinions or marital status, opponents say.

During a committee hearing Thursday, sponsor Rep. Donna White, R-Johnston, told a story about nearly being fired from her job as a public health nurse when she conscientiously objected to a procedure she described as a "tool." She never stated what the "tool" was, only that she and her employer had come up with a workaround in which someone else would explain it to her patients. "I have a right to say that I'm not the one to take that tool out of the box," White said.

Opponents worry that the bill would lead to regular refusal of care for people who need it. "It's worded so that if I encountered somebody, and I was a health professional, and in my ethics I'm not aligned, I can make that decision," added Rep. Maria Cervania, D-Wake.

The bill's use of amorphous words such as "moral" and "ethical" came under scrutiny during a committee hearing Wednesday. When pressed for her definition, White said, "'Ethical means' a compilation of a lot of your personal beliefs, your personal practices."

"Ethical can certainly have a different definition for what's ethical to you and what is ethical to me," she added.

Liz Barber, a policy analyst at the American Civil Liberties Union of North Carolina, cautioned that the bill casts a much wider net than just doctors and nurses. She said schedulers, surgery prep staff, and even insurance claims processors could refuse to participate in care at any time, and their employers would be barred from reassigning or disciplining them. Barber said similar bills have been filed across the country, aimed at the LGBTQ+ community, but cautioned that they will "sweep up everyone."

"Anti-trans bills are a trend that we're seeing, and I think that this is just one play out of that playbook. It’s giving medical professionals a license to discriminate against trans people, and really, anyone.," Barber said.

During the committee hearing, three public speakers on each side of the debate were allowed two minutes each to weigh in on the bill.

Those in support of the bill included former Wake County school board candidate Michele Morrow, a former nurse who opposed COVID-19 vaccine requirements, and Susan Banes, a practicing OB/GYN doctor. Both cited the looming shortage of medical care providers as a reason to do more to protect providers' freedom of conscience.

"No medical professional should be forced to violate his or her oath — 'first do no harm'," Banes said. "In health care, we should never refuse a person. We may sometimes refuse a practice."

NC Values Coalition director Tami Fitzgerald also spoke in favor of the bill, telling lawmakers that five other states have already enacted similar laws, including South Carolina and Arkansas. "We have realized in recent years that healthcare providers and pharmacists have been asked, and in some cases forced, to provide drugs and services which run counter to their deeply-held religious beliefs."

Transgender-rights supporter Rae Bandy spoke against the bill while administering their own topical hormone treatment at the podium, treatment they credited with saving their life.

"This bill could take away the medicine that saves lives of transgender people across our state," Bandy told lawmakers. "If you pass this bill, you will have blood on your hands."

Lawmakers also heard from Kristen Castle, the mother of transgender teen whose insurer rejected their hormone treatment on religious grounds, and from Elizabeth Campbell, an oncologist who warned the bill was being misrepresented and would harm health care.

"I've seen people denied the right to die who wanted to die because they were done with cancer," Campbell said. "Their families wanted them to be able to be released. But then somebody in billing decided that was unethical, interfering with the doctor-patient relationship and making them die in pain. This is the threshold of the same kind of action."

White had asked to remove the bill from the agenda for more work, but ultimately agreed to allow a vote. It passed committee on a voice vote along party lines. But White said she would make changes to it before its next appearance in the House Judiciary committee.