Topic: Professions & Institutions

Doctors Who Discriminate
(8/8/2005)

Guadelupe Benitez, who is a lesbian, assumed that the fertility clinic where she had received 11 months of preparatory treatment would inseminate her when the time came. But doctors Christine Brody and Douglas Fenton from the North Coast Women's Care Medical Group clinic in San Diego refused to do so because they object to giving this treatment to gays or unmarried heterosexual women.

It violates their Fundamentalist Christian beliefs.

They are being sued, of course, but the doctors claim that their religious convictions exempt them from California's civil rights laws. And anyone who pretends to know how the Golden State's infamously creative courts will resolve the matter is dreaming. Nevertheless, this controversy has all the ethical weight on one side, and it isn't the doctors'.

There's a simple answer for radical Fundamentalists who think their religious tenets excuse them from administering the same medical treatment to all, even those whom they believe are stained with sin: Don't go into medicine. And just to be clear, don't go into the pharmacy trade, either, so you won't be one of those misguided pharmacists who won't fill birth control prescriptions for single women. Medicine is a profession, and professions, as opposed to occupations, developed as specialized career pursuits requiring extensive knowledge and training designed to provide help to people in life's daily struggles: the lawyer, the clergy, and the doctor. Today everyone from a pool-cleaner to a lap-dancer claims to be a professional, but that's just another example of the regrettable creeping imprecision of our language. Professionals are supposed to have professional standards and professional codes of ethics. And unless their personal feelings will actually interfere with the effective execution of their professional duties, it is a violation of those ethics to withhold services from someone based on dislike, disagreement, or prejudice. Emergency room surgeons save the lives of victims of crime, the criminals who stabbed them and the cops who shot them. Lawyers defend artists, crack dealers and U.S. presidents. Priests take confessions from embezzlers and U.S. Senators. That's their job.

I know the argument Brody and Fenton will make: helping a gay woman do what is prohibited in the Bible (they say) makes them complicit in sin. The response to that is simple: then your profession puts you at risk of being complicit in sin, then it's time to do something else. The logical extension of the principle these Fundamentalist doctors want to establish would undermine public health as well as civil rights.

Last fall, Benitez won a legal ruling in a trial court that doctors in a for-profit medical group must comply with California's anti-discrimination laws, and treat all patients equally, whatever the doctors' personal religious beliefs may be. That's the right ruling. As Oscar De La O, the Executive Director of Bienestar Human Services, the largest Latino community based non-profit agency in the country providing HIV-related and other health services, said,

"Our experience teaches us that a religious exception to anti-discrimination laws means an end to fair health care access for all.  If doctors are allowed to deny treatment to people with whom they have a religious objection, clients such as ours will again be put at great risk and the stigma of HIV/AIDS will intensify, with terrible repercussions."

Nobody is arguing that a doctor cannot make moral and ethical judgements about what procedures he or she will perform in their practice. No doctor has to perform abortions, for example, but if a doctor does perform them for some patients, it is wrong to refuse to similarly treat others. One can name the wrong unfairness, or bigotry, or bias, but it is a wrong nonetheless.

But then it must be similarly wrong for a plastic surgeon to refuse to put breast implants in a 15 year-old girl, correct? No. A doctor's ethical creed is "First do no harm." Withholding fertility treatments simply because of sexual orientation is harming a patient for the benefit of the doctor's religious beliefs. Withholding surgery that a doctor feels is physically and emotionally inappropriate for a young woman is a legitimate exercise of professional judgement.

Deciding that whole groups must not have access to treatment that is available to others, however, is neither professional nor good judgement. It is doing harm, and it is an act of prejudice. The Ethics Scoreboard hopes the California courts speak loud, clear, and quickly on this issue, before anyone else is hurt.

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