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District of Columbia

Refusal to Provide Medical Services


The District of Columbia allows certain individuals or entities to refuse to participate in certain aspects of direct patient care.

To whom does the refusal clause apply?  Individuals.

What does the refusal clause allow?  No department head may discipline or penalize employees who refuse to participate in direct patient care that conflicts with their religious or ethical beliefs.

Must the refusal be in writing?  Yes.  Employees must notify their immediate supervisors in writing of any procedures that conflict with their religious or ethical beliefs.  This request must be received before any assignment.

Does the law require the refusing individual or entity to notify the persons affected?  No.

Are there circumstances under which a refusal clause may not be exercised?  Yes.  If a patient's safety is in jeopardy, the employee must provide for patient safety and avoid abandonment. Withdrawing from care or treatment is only acceptable after an alternative source of care has been made available.

Does the law provide a mechanism for women to otherwise obtain specific reproductive-health services, information, or referrals if an individual and/or entity exercises a refusal clause?  No.

Does the law require the refusing individual or entity to provide medically and factually accurate information or provide a referral for abortion services?  No.

D.C. Mun. Regs. tit. 22-B, § 9006.

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