Many politicians are increasingly focused on creating protections for individuals and businesses who deny services to people based on so-called “religious freedom,” like the Colorado baker who wouldn’t make a wedding cake for a gay couple. But a recent move by the Trump administration goes beyond offensive to potentially deadly.

Last month, the Department of Health and Human Services created a “Division of Conscience and Religious Freedom,” which appears primarily intended to shield health care workers who refuse to perform services based on religious or moral grounds. This will have serious consequences on patient care, negatively affecting the lives of people at their most vulnerable.

When I became a registered nurse, I committed myself to a code of ethics that first and foremost protects human dignity and a patient's right to self-determination. We as nurses provide medical care regardless of who the person is, their background, their lifestyle or the choices they make.

Today, there are already protections for health care workers claiming religious exemptions in 45 states. However, developing a civil rights division within HHS specifically to investigate claims and enforce protections is chilling.

Many people will think the HHS decision is solely about abortion care. It is sad fact that so many women in this country struggle to find access to this safe and legally protected medical procedure. I am deeply concerned about nurses feeling more empowered to deny participation in these abortion services. Terminating a pregnancy is sometimes a life or death situation for women in cases of ectopic pregnancy, severe preeclampsia or severe infection. In such tragic situations no women should have to worry that nurse or other medical provider will simply abandon them. Nurses and other health care professionals regularly face moral and ethical challenges in our work, but blatant discrimination and refusal to care for someone in life-threatening situations is wrong.

With few details accompanying the HHS announcement, there is reason to believe that health care workers will be legally protected in discriminating against patients for a variety of reasons. We should be concerned about the negative impact this announcement could have on the LGBTQ population in particular. I am outright scared for my transgender and gender non-conforming patients, a population that is increasingly the target of “bathroom bills” and other forms of legally sanctioned bigotry.

Already in Baltimore and around the country transgender people are marginalized by a health care system that places little importance on their health care needs. Talk to any transgender person here in Baltimore and they will tell you how difficult it is to get medical care that affirms who they are; overhearing hateful language and attitudes toward transgender patients is not uncommon. I am fearful enhanced protections for religious exemptions will encourage certain nurses to not hesitate in refusing critical and lifesaving care to LGBTQ individuals. One only has to perform a simple Google search to find alarming cases of transgender individuals being denied basic medical care.

The second I walk in the hospital or clinic door I leave my personal beliefs and biases behind. The expectation is that I provide compassionate care to my patients no matter who they are. This is not an option for nurses, it is a requirement. I am calling on all nurses to reject the message this administration is sending that anyone in health care can pick and choose whom they care for. For our patients, we are their best advocate. We are at the bedside 24 hours a day. It is this unique position in the health care system as caregivers that gives us a powerful voice to stand up to injustice. When we see other nurses and medical providers committing a wrong, we speak up. When our elected officials threaten the quality care we provide to patients every day, we need to speak up too. The move by the Department of Health and Human Services to “protect religious freedom” among health care professionals has the potential to risk lives, and I for one am using my voice to stand up and fulfill my role as my patients’ best advocate.

Patrick Hennessy is a registered nurse; his email is pnhennessy0413@gmail.com.