Asa Hutchinson, the governor of Arkansas, has recently signed into law a bill that will permit medical professionals to refuse to treat patients based on religious or moral objections. Critics assert that the law will give doctors sweeping abilities to turn away LGBTQ patients.

The Medical Ethics and Diversity Act, slated to take effect in late summer, gives health care workers the right not to participate in non-emergency services or treatments that conflict with their personal beliefs. Hutchinson defended his approval of the law, a similar version of which he had opposed in 2017. The governor noted that the 2021 version of the bill was more narrowly drafted to limit the right of objection to providing certain health care services, rather than to all types of services provided to certain types of people. Hutchinson noted, “the federal laws that prohibit discrimination on the basis of race, sex, gender, and national origin continue to apply to the delivery of health care services.”

While the law is limited to objections to non-emergency services, it could result in difficult choices for persons in need of emergency care. For example, if a person undergoing gender-confirming hormone therapy required extended hospitalization for a condition unrelated to their hormone therapy, the medical professionals providing emergency care could choose not to provide hormone therapy while the patient is in the hospital. Likewise, birth control is sometimes prescribed for reasons unrelated to the patient’s desire not to get pregnant, such as for dermatological reasons, but a pharmacist could nevertheless choose not to fill a patient’s prescription for birth control over religious or moral concerns.

According to a statement released by NARAL, a pro-choice group, refusal laws such as these are particularly dangerous for women. The laws, NARAL states, “permit a broad range of individuals and institutions—including hospitals, health-care providers, pharmacists, employers, and insurers—to refuse to provide, pay, counsel, or even refer for medical treatment.”

Numerous other groups have come out against the bill, one of several making their way through the Arkansas legislature that target the trans community. ACLU of Arkansas director Holly Dickson argued that the law is “another brazen attempt to make it easier to discriminate against people and deny Arkansans the health care services they need.” Alphonso David, the president of the Human Rights Campaign, stated that the Arkansas governor “is proving himself to be a cruel opponent of equality by signing this draconian medical refusal bill.”

The Arkansas law is similar to a rule instituted by the Trump administration in 2019. The rule, issued by the Department of Health and Human Services (HHS), would have permitted medical care providers to refuse requests to provide services such as the provision of birth control, assisted suicide, abortions, or sterilization if the provider has a moral or religious conviction that conflicts with the procedure. The rule allowed for objections by individuals who were even tangentially related to the provision of medical services, such as the receptionist who checked in the patient seeking an abortion, or the nurse taking the patient’s blood pressure prior to a sterilization procedure. In response to this rule, 19 states, the District of Columbia, three local governments, and an assortment of other organizations sued the HHS to have this rule overturned. In November 2019, U.S. District Court Judge Paul A. Engelmayer found that the rule could not be legally enforced and tossed it in its entirety, only weeks before the rule was scheduled to enter into effect. The judge noted that other federal laws provide for conscience objections and that the rule would only add confusion to an otherwise settled area.