The HHS Office for Civil Rights has accused the University of Vermont Medical Center of violating federal conscience protection law by requiring a nurse to participate in an elective abortion.
Roger Severino, the office's director, said Wednesday that UVMC scheduled the nurse to participate in the procedure even though she previously had stated her religious or moral objection to participating. He declined to discuss the specifics of the patient's situation, such as the fetus' condition and gestation age.
OCR has given UVMC 30 days to bring its conscience protection and staffing policies into compliance with the federal Church Amendments, or face loss of federal funding from the Health Resources and Services Administration. Severino did not mention any potential Medicare or Medicaid payment cutoff.
He said UVMC was not cooperative with OCR's investigation and has not clearly indicated that it will voluntarily participate in changing its policies.
UVMC disputed the allegations, which it said were based on a complaint from a former employee.
"We flatly deny that we schedule any employees to participate in procedures they register objections to," UVMC spokeswoman Annie Mackin said. "We promptly and thoroughly investigated (the allegations) and determined that they were not supported by the facts."
She added her facility was not informed by OCR that the notice of violation would be announced Wednesday.
This is the first conscience protection case involving an allegation that a medical staffer was forced to participate against her or his will in an abortion since HHS established a new Conscience and Religious Freedom Division last year within OCR.
Severino said two previous enforcement actions were filed against California and Hawaii for allegedly requiring crisis pregnancy centers, which counsel women against abortion, to give women information about abortion options.
He said that since the new conscience office was launched, the number of complaints OCR has received regarding violations of conscience protection rules has risen from about one a year to hundreds per year. He declined to discuss what percentage involve forced participation in abortions.
"We don't want a society where on the issue of life and death, people are forced to violate their beliefs, especially when abortion and medical professionals are involved," he said. "These people are trained to save lives, not take them.
"How could that happen in America today?" he added. "It will continue unless there is vigorous enforcement."
He said the action against UVMC relied on existing federal statute, not on a new conscience protection rule issued by the Trump administration that takes effect Nov. 22.
In 2013, OCR handled a complaint by a nurse, Cathy Cenzon-DeCarlo, alleging that Mount Sinai Hospital in New York forced her to assist in a second-term abortion in 2009 against her objections or else face disciplinary action. OCR got the hospital to change its policies and procedures.
Severino rebuffed questions about whether there were complicating factors in the UVMC patient's pregnancy that were involved in the decision to perform an abortion. He said any such factors were not relevant in OCR's decision to sanction UVMC.
"The Church Amendments provide (conscience) protection for people," he said. "It says abortion, it doesn't make distinctions … The line drawn by the law is abortion, period."
UVMC's Mackin said her organization "has robust, formal protections that safeguard both our employees' religious, ethical and cultural beliefs, and our patients' rights to access safe and legal abortion. We do not discriminate against any employees for exercising their rights to opt out of procedures to which they object."
She added that UVMC is willing to work cooperatively with OCR to identify ways to further support employees' conscience and religious rights, consistent with legal and ethical obligations to patients.
Nicole Huberfeld, a professor of health law and ethics at Boston University, said healthcare organizations have been aware of conscience protection rules for a long time, and there historically have been few complaints.
"The Office of Conscience and Religious Freedom appears to be a solution in search of a problem," she said. "It seems to me that it is publicizing this notice of violation in order to prove it exists for a reason. I just don't believe there is a sudden uptick in conscience violations."
