The “right of conscience” rule passed by the Bush administration December 18 protects health workers who refuse care that violates their personal beliefs, reports The Washington Post. Originally targeted at abortion procedures, the final rule includes a broad scope of scenarios, such as treating HIV patients who are lesbian, gay, bisexual or transgender.

The right of conscience regulation cuts off federal funding for any state or local government, hospital, health plan, clinic or other entity that does not accommodate doctors, nurses, pharmacists and other employees—even secretaries and janitors—who refuse to participate in care they find ethically, morally or religiously objectionable. That could include servicing same-sex couples or offering end-of-life care and birth control.

“Doctors and other health-care providers should not be forced to choose between good professional standing and violating their conscience,” said Mike Leavitt, secretary of the Department of Health and Human Services, which issued the regulation.

According to the article, the rule, supported by abortion opponents and other conservative critics, will cost more than $44 million to implement and gives more than 584,000 health-care organizations until October 1 to turn in their letters of compliance. Organizations that don’t comply could have their funds cut or be required to return previous funding.

Senator Patty Murray (D–Wash.) introduced a bill last month with Senator Hillary Clinton (D–N.Y.) to repeal the rule. “We will not allow this rule to stand,” Murray said. “It threatens the rights of patients across the country.”