Physicians must provide all options to patients, whether they might agree with them – or not.

Like the vast majority of my colleagues – 86 percent according to the New England Journal of Medicine – I believe physicians have an obligation to provide information about all treatment options to a patient.

While I recognize health care providers may not always agree with decisions patients make about their health or health care, conscientious refusals are particularly widespread in the arena of reproductive medicine.

Recently, President Bush proposed regulations to expand the rights of health care providers to refuse treatment or referrals for patients for services that “compromise the moral integrity of an individual or institution.”

Not only would this expansion apply to physicians, but also to individuals and institutions involved, even remotely, in providing the service. If implemented, these regulations would create an unprecedented federal rule that lets health care providers deny women comprehensive reproductive health care.

Simply put, these regulations would shield health care personnel from liability for refusing to perform almost any health care-related task against their conscience. Insurers and employers as health care payers, pharmacists and pharmacies in filling prescriptions, hospital employees assigned to complete insurance forms, and even ambulance drivers assigned to transport a patient to another facility would be covered.

Are these regulations really necessary? For decades, federal and state laws have given individuals and institutions the right to refuse abortion services and sterilization based on their religious or moral beliefs.

In Maine, the immunity and employment protection law went into effect in 1978, clearly prohibiting discrimination against “physicians, nurses, or other persons by refusing or withholding employment from or denying admittance, when such physician, nurse of other person refuses to perform, or assist in the performance of an abortion ” Even obstetrical gynecology residency programs are not required to have residents complete abortion skills training.

The real intent of the draft rules is to drastically limit access to reproductive health services – especially abortion services. The rule would affect more than 584,000 hospitals, clinics and medical facilities that receive federal funding.

It would create chaos and put personal practitioner preference above two of medicine’s basic keystones: never to do deliberate harm to anyone for anyone else’s interest and to keep the good of the patient as the highest priority.

Providing complete, scientifically accurate information about options for reproductive health, including abortion, is fundamental to respect patient autonomy and forms the basis of informed decision-making in reproductive medicine.

Providers who refuse to disclose such information on moral or religious grounds fail in their fundamental duty to enable patients to make decisions for themselves.

At the minimum, health care providers have the duty to refer patients in a timely manner to other providers, if they do not feel they can provide the standard of reproductive services their patients request.

As a physician, one of my duties is ensuring patients have the access necessary to widely used medical services, including abortion and contraception. More than one of every three women will have an abortion in their lifetime. Nearly half of pregnancies are unplanned; each year in Maine, 30 percent of these pregnancies result in an abortion.

More globally, with 17.5 million American women in need of publicly funded family planning services, restricting access to basic reproductive health care is simply bad medicine.

Dr. Joey Banks, M.D., of Auburn is a faculty member of the Family Medicine Residency Program at Central Maine Medical Center. Her views are not necessarily the views of CMMC or the CMMC FMR.