Bioethics Medicine

Refused treatment due to a practitioner’s religious beliefs

Via Kevin, MD, here’s a Washington Post article describing how the religious beliefs of health care practitioners result in the denial of care. Here are some examples:

Cynthia Copeland also had a run-in with a pharmacist in 2004. He wrongly assumed she was planning an abortion because she had a prescription for a drug that can be used for that purpose. In fact, Copeland had already had undergone a procedure to remove a fetus that had no pulse, and she needed the drug to complete the process.

“I was sitting there in the drugstore waiting and heard the pharmacist say really loudly, ‘I refuse to participate in an abortion,’ ” said Copeland, 39, who lives near Los Angeles. “I felt so violated. The miscarriage was about grief, and that was made public in a way that really compounded my grief.”

Such self-righteousness that this pharmacist would violate professional ethics (not to mention the HIPAA privacy requirements) in order to humiliate a woman who, to him, was doing something immoral should be grounds for a complaint to the state. Hasn’t this pharmacist ever heard of keeping a patient’s private information private? Even if I agreed with his refusing to fill such prescriptions for elective abortions, I would still consider this guy self-righteous scum for intentionally publicly humiliating a patient and, worse, for not having found out the reason for the prescription before doing so.


Cheryl Bray, 42, a real estate broker in Encinitas, Calif., was flabbergasted that a family practitioner turned her away when she sought a routine physical needed to adopt a baby from Mexico. The doctor said he objected to a single woman’s adopting a child.

“He said something about how, according to his religious beliefs, children should have two parents,” said Bray, whose complaint against the doctor earlier this year was dismissed by the state medical board. “I was under a tight deadline. I started crying. I cried in his office, and then I went back to my car and cried for a long time before I could drive home.”

This is even worse. What is the harm of examining this child? Does this doctor consider life in an orphanage better than life with a single parent who will love and care for the child?

From my perspective, once you take on the role of a physician, patients must come first:

“As soon as you become a licensed professional, you take on certain obligations to act like a professional, which means your patients come first,” said R. Alta Charo, a bioethicist and lawyer at the University of Wisconsin at Madison. “You are not supposed to use your professional status as a vehicle for cultural conquest.”

Religious objections can be dangerous in emergencies and when health workers refuse to refer patients or inform them about other options, especially in poor or rural areas where there are fewer options.

“It’s a very disturbing trend,” said Lourdes Rivera of the National Health Law Program, a nonprofit patient advocacy group.

Doctors, nurses and other health-care workers who cannot find a way to fulfill their responsibilities should chose other professions, some say.

“If your religious orientation is such that you can’t discharge your professional responsibilities, then you shouldn’t take on those responsibilities in the first place,” said Ken Kipnis, a philosophy professor at the University of Hawaii at Manoa. “You should find other work.”

Exactly. Weighing freedom of conscience against one’s obligations can be difficult, and, yes, there are gray areas. However, if your religious beliefs are such that not only can you not carry out the obligations of your specialty but you can’t even at the very least inform a patient of certain medically appropriate options or refer that patient to another health care practitioner, then you shouldn’t be in that specialty–even more so if your “conscience” will result in the harm of a patient.

By Orac

Orac is the nom de blog of a humble surgeon/scientist who has an ego just big enough to delude himself that someone, somewhere might actually give a rodent's posterior about his copious verbal meanderings, but just barely small enough to admit to himself that few probably will. That surgeon is otherwise known as David Gorski.

That this particular surgeon has chosen his nom de blog based on a rather cranky and arrogant computer shaped like a clear box of blinking lights that he originally encountered when he became a fan of a 35 year old British SF television show whose special effects were renowned for their BBC/Doctor Who-style low budget look, but whose stories nonetheless resulted in some of the best, most innovative science fiction ever televised, should tell you nearly all that you need to know about Orac. (That, and the length of the preceding sentence.)

DISCLAIMER:: The various written meanderings here are the opinions of Orac and Orac alone, written on his own time. They should never be construed as representing the opinions of any other person or entity, especially Orac's cancer center, department of surgery, medical school, or university. Also note that Orac is nonpartisan; he is more than willing to criticize the statements of anyone, regardless of of political leanings, if that anyone advocates pseudoscience or quackery. Finally, medical commentary is not to be construed in any way as medical advice.

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