A new South Carolina law that allows physicians, medical students and nurses to refrain from doing procedures that violate their conscience has prompted concern that the measure will restrict healthcare options for the state's LGBTQ population.
Signed into law by Republican Gov. Henry McMaster on June 17, the “Medical Ethics and Diversity Act” gives medical practitioners, health care institutions and health care payers protection for objecting to performing a procedure that goes against their moral, ethical or religious views. The law does not apply to emergency procedures where such life-saving services must be provided per federal regulation. Physicians are also not required to make a referral should they deny care.
The bill allows doctors to do their job “in a way that doesn't contradict with their best medical judgement or their moral and religious beliefs,” Brandon Charochak, the governor's deputy communications director, said in an email. "It’s important that South Carolinians receive the best care possible from providers who fully believe in the work they’re doing.
South Carolina joins several other states that have moved recently to protect “conscience” objections for medical providers. In March 2021, Arkansas Gov. Asa Hutchinson signed a similar proposal into law. Earlier this year, the Nebraska legislature considered another such measure.
Commonly rejected procedures listed in other states include abortion, certain contraception, genetic experimentation, death penalty executions and the sterilization of minors, according to Republican state Sen. Larry Grooms.
Proponents in South Carolina said that the law allows providers to opt out of specific procedures — not discriminate against specific patients.
“If you have a moral religious or ethical objection to a particular procedure, then that would mean you’re opposed to that procedure for all patients,” Grooms said last month as the state Senate originally debated the bill.
But when specific types of care are disproportionately necessary for certain groups of people — gender-affirming hormone therapy for a transgender person or fertility treatments for a same-sex couple, for example — then the law is discriminatory, according to Ivy Hill, a leader in the SC United for Justice and Equality coalition.
“We already face so many additional barriers in accessing healthcare and this just adds another one,” Hill, who is the community health program director with the Campaign for Southern Equality, told The Associated Press.
Last month, a group of 50 healthcare professionals urged the governor in a letter to veto the bill. The group warned that the measure would negatively impact LGBTQ people, who might already face barriers to accessing services such as HIV prevention and treatment, gender affirming care and family planning services.
Upon the state House's passage of the bill in April, the Human Rights Campaign, the nation’s largest LGBTQ civil rights organization, issued a statement opposing the measure.
“It is disturbing that some politicians in South Carolina are prioritizing individual providers’ beliefs ahead of patient health and wellbeing. This legislation is dangerously silent in regards to the needs of patients and fails to consider the impact that expanding refusals can have on their health,” Sarah Warbelow, the Human Rights Campaign’s legal director, said in a statement in April.
The Roman Catholic Diocese of Charleston supported the law in a Friday press release.
“Every American has the freedom to live according to his or her ethical and religious beliefs –- doctors, nurses, and medical care providers must not be treated differently," the diocese said in a statement. “When freedom of conscience is compromised, patient care is compromised."
State senators debated whether or not the measure would improve efforts to expand healthcare services across the state. Speaking against the proposal, Democrat state Sen. Vernon Stephens suggested that rural patients who lack easy access to healthcare facilities might struggle to find alternatives should a doctor deny their procedure.
Grooms said the bill would help the state retain physicians — particularly older ones — who fear discipline for not performing procedures to which they object.
Hill pointed transgender people in South Carolina concerned about healthcare access to the Campaign for Southern Equality's “Trans in the South” guide.
“For LGBT folks and for trans folks in South Carolina, I want them to know that they're not alone," Hill said.
James Pollard is a corps member for the Associated Press/Report for America Statehouse News Initiative. Report for America is a nonprofit national service program that places journalists in local newsrooms to report on undercovered issues. Follow James Pollard on Twitter.