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Health Care Refusals: Undermining Quality Care for Women

2010 | Download

People in the United States expect the health care they receive to reflect medical practice grounded in evidence and endorsed by scientists and clinicians. For physicians, nurses, pharmacists and other health care providers, the primary commitment and duty is to provide the best care possible to the patient. Failure to adhere to prevailing “standards of care,” defined as medically necessary services, harms the individual patient, undermines the health care system, and jeopardizes the health of the general public. It is the responsibility of health care providers and policy makers to ensure that medical guidelines are enforced and that patients receive quality health care services that meet the standard of care.

The basic principles of modern health care delivery are evidence-based practice, patient centeredness, and prevention. Collectively they ensure quality care. These principles may be compromised by a range of structural factors such as lack of insurance, restricted geographic access, cost, language barriers, and immigration status. Current political movements are promoting strategies to address these structural barriers to quality of care.

At the same time, health care refusals and denials of care are proliferating in the U.S. based on ideological and political justifications that have nothing to do with scientific evidence, good medical practice, or patient needs. These refusals and denials of care should be scrutinized to assess their impact on quality health care and redressed when they fall below the standard of care.

Unlike structural defects in the health care system, ideological restrictions are not being addressed in the current health care debate; they will not be resolved by current reform proposals; and, in fact, there is a serious risk that these restrictions will be institutionalized without careful evaluation of their public health impact.

This report specifically addresses those health care refusals and denials of care rooted in political ideology or institutional or personal religious objections and evaluates their potential impact on access to care.  

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This report was written by the National Health Law Program, a national public interest law firm that seeks to improve health care for America’s working and unemployed poor, minorities, the elderly and people with disabilities. NHeLP serves legal services programs, communitybased organizations, the private bar, providers and individuals who work to preserve a health care safety net for the millions of uninsured or underinsured low-income people.