Sunday, August 05, 2007

Do No Harm

Are doctors and other health care providers bound by law to provide all services to all clients, or can they allow their consciences to dictate what services they offer and to whom?

When my mother was carrying me in her womb, she and my father had to choose a hospital in which she would give birth. The issue was not simply cost and quality of care. They were also concerned about the religious aspects of the care they would be offered, specifically around saving my mother’s life in the case that giving birth to me would threaten her life.

Not knowing me well, my mom and dad chose to save my mother’s life over my own in accordance with Jewish law. I assume today, based on decades of parental self-sacrifice, if they had to make the same choice, they would choose my life over her life, but that is beside the point. The point then and now is this: can doctors withhold care based not on medical principles and practices but on religious ones?

For example, according to recent articles in the news some doctors are refusing to prescribe Viagra to gay men, refusing to artificially inseminate lesbians, and refusing to provide assistance to single adults seeking to adopt. The issue for the doctor is that doing these things violates the doctor’s sense of right and wrong.

The doctors feel they are within their rights to follow their conscience. Their patients feel that they are being discriminated against. Both are correct. A doctor who has no problem prescribing Viagra to a man who intends to lawfully and one would hope lovingly insert his longer–lasting erection in his wife’s vagina, may refuse to proscribe the same drug to a man who intends to implant his penis in a difference orifice of another man because the doctor opposes sex between men. Should the doctor be forced to enhance gay sex, or risk being sued if she or he doesn’t? I don’t think so.

Doctors and other healthcare providers should be able to perform their jobs as they see fit within the ethical and legal guidelines of their profession. But these guidelines need not force the healthcare provider to violate conscience.

The solution is simple: First, allow patients to go anywhere they want for any procedure they want. Laws and insurance policies that limit access to doctors may be forcing patients to live by religious standards not their own. People must be free to find like–minded medical professionals. Second, healthcare providers should be obligated to provide all patients with a brochure that clearly states what they won’t do. Doctors who protest such disclosure are tacitly admitting that their discrimination is wrong. If you believe in what you say you believe in, then spell it out and let people choose in advance whether to come to you as a doctor or not.

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