HHS issues warning to University of Vermont Medical Center saying it forced nurse to assist in abortion

Marble exterior of the Hubert H. Humphrey Building in Washington, D.C. Text on building reads "Department of Health and Human Services."
Department of Health and Human Services announced the creation of a new “conscience and religious freedom division” in the Office for Civil Rights last year. (Rose Meltzer)

The Trump administration announced Wednesday it issued a notice against the University of Vermont Medical Center (UVMC) saying it violating federal law after officials say a nurse at the health center was "unlawfully forced" to assist in an elective abortion despite voicing objections.

The Department of Health and Human Services (HHS) Office for Civil Rights (OCR) said the May 2018 incident was a violation of the Church Amendments to the Public Health Service Act. The amendment protects the conscience rights of health providers that object to performing or assisting in abortions or sterilization procedures.

"If the Church amendment means anything at all, it means that no one can be forced to perform an abortion on the fear of losing their job or being reported to licensing authorities," said OCR Director Roger Severino in a call with reporters. "We are hopeful UVMC comes into compliance and we stand ready, willing and able to help them to change their policies and practices to do so."

It is not being brought up under the "conscience" rule finalized in May to strengthen protections for healthcare workers who refuse to provide care that violates their religious or moral beliefs, Severino said. That rule, which goes into effect Nov. 22, has drawn sharp debate and lawsuits over concerns it would allow discrimination against patients, including women and LGBTQ people.

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According to the OCR, the nurse complainant said she knew she was going to be assisting in a patient's dilation and curettage, or D&C, procedure. However, they said, she believed it was due to a miscarriage, not an elective procedure. Knowing the nurse objected to assisting abortions, OCR said the doctor told the nurse upon entering the room, "Don't hate me."

The nurse objected and said there were other staff members who could have taken the nurse's place, but she was required to participate anyway due to a fear that UVMC would fire or report her to licensing authorities, OCR officials said. 

OCR said they investigated the incident and interviewed "several" UVMC healthcare personnel who also indicated they've been "intentionally, unnecessarily and knowingly scheduled" by UVMC to assist with elective abortions against objections.

OCR officials said they gave UVMC 30 days to indicate whether it intends to change its policies or the OCR will take the matter to the Health Resources and Services Administration (HRSA), which provides grant funds to UVMC and could potentially revoke those federal funds. For the most recently completed three-year period ending in 2018, UVMC reported its received $1.6 million in federal grants from the HRSA.

UVMC denies the allegations.

"The University of Vermont Medical Center has robust, formal protections that safeguard both our employees’ religious, ethical and cultural beliefs, and our patients’ rights to access safe and legal abortion," a spokeswoman said in a statement. "We do not discriminate against any employees for exercising their rights to opt out of procedures to which they object. These procedures cover initiation and cessation of life support, organ transplant, sterilization and termination of pregnancy. Every day, the UVM Medical Center works hard to protect the rights of the thousands of patients who seek our services and the many employees who assist in providing them."

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UVMC officials said they were "disappointed" to learn about the announcement of the notice of violation through the press. "When the Medical Center first learned of the allegations that are the subject of OCR’s letter, we promptly and thoroughly investigated them and determined that they were not supported by the facts," they said.

In response to questions, they declined to elaborate on specifics of the case. 

"Because this issue involves patient care and personnel matters, we cannot go into as much detail as OCR did today, however, we have engaged with representatives from OCR about the complaint over the past nine months," officials said in the statement. "From the outset and as recently as this month, we have offered to discuss our policies and practices, and to receive OCR’s advice on how those policies and practices may be improved consistent with our obligations to our patients. Unfortunately, OCR instead chose to proceed with the announcement it issued today."

HHS announced the creation of a new “conscience and religious freedom division” in the HHS OCR last year.

Since it was created, there has been a significant uptick in conscience and religious discrimination complaints under the Trump administration. During the Obama administration, there were a total of 10 conscience-related or religious discrimination violation complaints to the OCR from health providers, while under the Trump administration, there have been 1,333 complaints.

Of those complaints, 784 were retained including 343 complaints alleging conscience violations and 441 complaints classified as raising religious freedom or religious discrimination allegations.