WASHINGTON - The Bush administration, in its final days, issued a federal rule yesterday reinforcing protections for doctors and health-care workers who refuse to participate in abortions and other procedures on religious or moral grounds.

Critics say the protections are so broad they limit a patient's right to get care and accurate information. They fear the rule could make it possible for a pharmacy clerk to refuse to sell birth-control pills without ramifications from an employer.

Under long-standing federal law, institutions may not discriminate against individuals who refuse to perform abortions or provide a referral for one.

"Doctors and other health-care providers should not be forced to choose between good professional standing and violating their conscience," said Heath and Human Services Secretary Mike Leavitt.

The rule requires recipients of federal funding to certify compliance with laws protecting conscience rights.

Despite multiple laws on the books protecting providers, the administration argued that the rule was needed "to raise awareness of federal conscience protections and provide for their enforcement."

But many groups described the rule as a last-minute push designed to make it harder for women to get services such as contraception or counseling if they are pregnant and want to learn all of their options.

Several medical associations, more than 100 members of Congress, governors, and 13 attorneys general were among the many thousands who wrote the department to protest the proposed rule. Opponents didn't like the rule any better after it was finalized.

"In just a matter of months, the Bush administration has undone three decades of federal protections for both medical professionals and their patients," said Nancy Northup, president of the Center for Reproductive Rights. "It replaced them with a policy that seriously risks the health of millions of women, then tried to pass it off as benevolent."

Abortion opponents hailed the rule. "This is a huge victory for religious freedom and the First Amendment," said Tony Perkins, president of the Family Research Council.

President-elect Barack Obama's transition team issued a statement saying that he "will review all eleventh-hour regulations and will address them once he is president."

Campaigning in August, Obama criticized the proposal, saying that "this proposed regulation complicates, rather than clarifies the law."