The State of California recently asked a federal court to stop the implementation of new federal rules protecting health care providers who refuse to give treatment based on the providers’ religious beliefs or “conscience.” The State argues that “California laws carefully balance conscience protections with Californians’ right to full and equal access to healthcare” and cites the health care conscience law in our Probate Code as an example of this “balanced” approach. While the lawsuit against the feds may be worthwhile, California ought to be addressing its own poorly written health care conscience and medical futility laws that leave patients with virtually no protections from having their care denied or withdrawn.

California’s health care conscience laws are far from balanced. As with the new federal rules, they permit health care providers to refuse to provide care “for reasons of conscience.” (Probate Code Section 4734). However unlike the federal rules, which are limited to specific treatment decisions (e.g., abortion and physician-assisted suicide), the California law has no limits at all.  There is no definition or standard for “reasons of conscience,” patients are given no right to state their case for treatment, and they have no right to appeal. The California laws are broad and one-sided.  In fact, providers who refuse to provide treatment for reasons of conscience are given total immunity from any legal or disciplinary consequences for any harm suffered by the patient as a result. (Probate Code Section 4740).

Before the State attacks the federal rules, it should reform its own rules that are worse.