Should Doctors and Pharmacists Have a Moral Objection to Treatment?

The Washington Post reports today that the California Supreme Court ruled day before yesterday that physicians do not have the right to withhold care from a patient on the basis of the patient's sexual orientation.  Meanwhile, this summer, religious conservatives in Washington state headed to court this year to appeal a lower court decision stating that pharmacists do not have the right to refuse to fill prescriptions to which they morally object. 

It is shocking that so many years after the AIDS epidemic, there is still question on this front.  During the earliest years of the epidemic, I lived in New York City and I chaired a group of volunteer lawyers who went into the hospital rooms of dying patients to render legal services, usually in the form of a deathbed will, sometimes in the form of a discrimination action.  I wrote a book about those years 1981-1991 called A Fragile Circle.  At that time, I saw people who were infected refused everything from care to jobs to restaurant service.  Health professionals refusing to touch patients - it was mind boggling to me.  Granted, people's actions were not based out of religious conviction as much as primal fear (I was afraid too), but it could have been.  And on the part of many, there was a feeling that those with AIDS deserved their fate.  It was an odd and eerie time and one that fills me to this day with painful memories.  But I never believed that nearly 30 years after the start of the AIDS epidemic, we would still be debating whether or not a healthcare professional had the right to turn someone away - from either treatment or from medicine.

Is there room in our system of care for the Balkanization of healthcare?  This is one voice that says no.  If physicians, nurses and pharmacists are not willing to accept patients for who they are or what their needs are, they need to be in some other line of work.  Imagine the chaos if, based on one's religious beliefs, lesbians with breast cancer had to hunt for a physician for treatment, or if a healthcare professional decided only to treat people of certain faiths?  It would not be a health care system because it wouldn't be a system at all - it would be a fragmentation.  Most might think that it would not get to such an extreme and perhaps they would be right.  But I've seen the extreme.  And it is extremely ugly. 

Comments

[Chris P]

To me the case helped clarify that although American citizens value free practice of religion, the practice of religion does not allow someone to project personal bigotry into their public practice. I want to read this court ruling as saying, "A religion is not hateful, but people are hateful."

[Michele]

And yet HHS is proposing the following: http://www.hhs.gov/news/press/2008pres/08/20080821reg.pdf.

And says, “This proposed regulation is about the legal right of a health care professional to practice according to their conscience,” HHS Secretary Mike Leavitt said. “Doctors and other health care providers should not be forced to choose between good professional standing and violating their conscience. Freedom of expression and action should not be surrendered upon the issuance of a health care degree.”

While the immediate impact will most certainly be to women attempting to access birth control of any form, you can be sure that the discrimination will not end there.

[mike]

So is your view that no matter action a doctor or pharmacist objects to, he or she should be forced by law (essentially at the point of a gun) to perform? Even if we head the way that certain European countries are and refusing care to for disabled infants who are euthanized? I doubt very much this is your view. Rather, I suspect, you don't like the moral objections others raise and think they should be squelched by law.

Take care with this view - someday it may be your moral objections that are squelched by the courts and you may not be so happy about it.

[Mark Senak]

Your draconian example of refusing to treat babies who are deformed is, I think, apples and oranges and does not relate to the matter at hand. What I am saying is simple. The practice of medicine is not a matter of religous belief. It is a matter of science and provision of treatment to those in need - not a pick and choose game that people can play.