I can’t even begin to describe how angry it makes me that many states are considering sanctioning the idea that health care providers can deny people care based on religious beliefs. Forget about pharmacists who exercise their religion at work and refuse to fill prescriptions for birth control medication; the absolute truth — no exaggeration at all — is that “right of refusal” laws like these could grant a doctor the right to put you on a ventilator even if you have a perfectly valid, legal living will stating your preference otherwise, and could allow everyone from doctors to social workers and pharmacists to completely decline care for gay patients. Hell, they’d even let fundamentalist pediatricians and internists refuse to treat sexually-transmitted diseases in unmarried patients, and Jehovah’s Witness physicians could refuse to give patients blood transfusions.

This crap is the perfect illustration of the idiocy of mixing religion and government. With laws allowing medical providers to enforce their religious beliefs on patients, where do you draw the line? What religious beliefs are acceptably covered by these laws? Who determines if some provider’s religious beliefs are worthy of protection? Ultimately it comes down to this: why are a doctor’s religious beliefs more important than the will of the patient?


Wow - thanks for bringing this to my attention Jason. I know there have been tensions around these issues for years, but I had no idea it had progressed to this point.

Ironically, one of the benefits of Canadian-style single-payer insurance is that you *know* which interested political organization is working with medical associations to make public policy. In the US there are so many overlapping players I think it facilitates shenanigans like this to occur. Maybe not.

• Posted by: Michael Boyle [TypeKey Profile Page] on Jan 31, 2006, 2:13 PM

Truly frightening. What this means for the world of employment law is equally scary. If employees can refuse to perform certain tasks because of religious beliefs, do employers have a legitimate business interest in making hiring decisions based on an applicants religious beliefs? The answer would most certainly be “yes.”

And, why should medical care workers have some heightened right to religious freedom that I don’t enjoy? Why shouldn’t law firms be prohibited from firing attorneys that refuse to work on Saturdays, Sundays or other religious holidays? I’m not particularly religious, but passing a law that would limit legal work on any sabbath would cause a stampede of born-again lawyers at locals churchs, temples and mosques.

Once we cross that line of recognizing certain religious beliefs and modifying the rights and privileges of other citizens based on those religious beliefs, we invite the will of the majority to oppress the religious minority. Send a copy of any eighth grade civics book to the proponents of this legislation and remind them that this country was founded on religious freedom — including the my freedom to ignore my doctor’s religious beliefs that may kill me.

• Posted by: Dan O'Brien on Jan 31, 2006, 4:51 PM

We wouldn’t accept a grocery checkout clerk who, citing vegetarianism, refused to sell us hamburger. Why should we accept a pharmacist who refuses to fill valid prescriptions?

More disturbingly, there seems to be nothing in the APhA’s ethics guidelines that prohibits this. I want vigilant pharmacists who think for themselves…but I want pharmacists who are more concerned with things like drug interactions than the fate of my soul.

• Posted by: Vidiot on Feb 1, 2006, 2:02 PM

Vidiot - we do accept grocers who refuse to sell meat. There are plenty of vegetarian grocery stores, as well as organic grocery stores where they refuse to sell GMOs. Should it not be the right of a grocer to refuse to sell GMOs? It is clearly ignorance and bigotry on their part, but is it not their right to be ignorant? Is it not their right to be a bigot?

• Posted by: PLC on Feb 2, 2006, 10:23 AM

Yeah, it’s a bit like comparing apples and oranges. In a grocery store, the choice of the grocer doesn’t have the chance of explicitly invalidating my ability to make my own decisions — if I don’t like the choices offered by the grocery, I can go somewhere else. In the world of “right of refusal”, though, I might be unconscious and taken to an emergency room where a doc chooses to intubate and ventilate me in direct contradiction of my expressly-stated wishes, all because that doc believes that his sanctity-of-life beliefs override my death-with-dignity beliefs. On the flip side, I might be in shock and refused a blood transfusion by an intensivist who doesn’t believe in blood transfusions.

In the cases of when patients might be (health-wise) in a position to exercise choice, it’s unfortunate that our current national healthcare system places explicit, arbitrary limits on the healthcare providers any one person might be able to utilize (e.g., in-network HMO providers, covered pharmacies, etc.). So again, in contrast to the grocery examples, patients might have no alternative but a provider that chooses to express his or her right to refuse otherwise legal, approved, and sanctioned care, something that is reasonably frightening.

• Posted by: Jason on Feb 2, 2006, 10:33 AM

I definitely get what you’re saying about the living will scenario - in such a situation, the doctor would be performing an act on thier patient, against that patient’s will, which I don’t think will ever be held to be constitutional. You shouldn’t be able to force someone to accept treatment (unless they’ve been declared incompetent).

In the other cases, however, I don’t think that doctors or pharmacists should be forced to provide services or products against their will… However, their employer should certainly be allowed to fire them for this refusal.

Basically, I always come down on the side of freedom.

• Posted by: PLC on Feb 2, 2006, 7:26 PM

I brought this issue up over lunch with friends and was surprised by the fervor with which everyone joined issue. After debating the degree to which one’s religious beliefs should be protected in this context, we took what we considered to be an easy out. By accepting the privilege of practicing their profession, pharmacists, as licensed professionals, have consented to abide by the professional standards established by the state in which they are licensed and the federal government. Their religious beliefs are not reflected in those standards, unless the Legislature says they are. I know the Legislature wants to provide those protections, as Jason suggests, but it’s a bit disengenuous to agree to comply with the a profession’s standards in exchange for a license, then, at a later time, protest the privilege conferred upon them. If you can’t do your job, it’s time for a career change. As an attorney, I don’t have the right, based on my religious beliefs, to withhold information from a client because it conflicts with those beliefs. If I choose to do so, I’ve breached my professional duty to my client. I am my client’s counsel, not their parent and not their guardian. Likewise, my pharmacist can tell me why a drug is potentially bad; but, eternal damnation should not be a potential side effect.

• Posted by: Dan O'Brien on Feb 6, 2006, 6:22 PM
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