Abstract

In establishing a new Conscience and Religious Freedom Division within the Office of Civil Rights of the Department of Health and Human Services and issuing new proposed regulations, the Trump administration has significantly expanded the power of health care providers over the medical choices of patients and has privileged the moral agency of health care providers over that of individual patients. When finalized, these regulations will replace those promulgated during the Obama administration, just as those regulations replaced those promulgated in 2008 by the Bush administration. The 2018 proposed regulations interpret the federal conscience statutes more broadly than either of these predecessors. Among the many significant provisions in the proposed rules are definitional terms that reach a broader range of individuals and activities, the absence of balancing interests, and a powerful enforcement structure.