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More Patients Denied Care Due to Hospital Policies, Ideological Beliefs

Rachel

Well, this is gonna piss you right off…

More Patients Denied Care Due to Hospital Policies, Ideological Beliefs, Report Says

June 1, 2010 — An increasing number of patients are being denied certain kinds of medical care — such as abortion or contraceptive services — because of hospital policies based on ideological or religious beliefs, according to a report released last week by the National Health Law Program, the Los Angeles Times’ “Booster Shots” reports. The report analyzed policies at hospital systems representing more than 650 medical facilities in the U.S.

(Tip of the hat to NARAL Pro-Choice Ohio, for bringing this to my attention. I love those women.)

35 thoughts on More Patients Denied Care Due to Hospital Policies, Ideological Beliefs

  1. You’re right, this does piss me right off. My opinion on this is the same as my opinion on the issue of pharmacists denying emergency contraception to women–it should absolutely not be tolerated. Other people with strong religious or moral beliefs are not allowed to impose them on others in a medical setting. Would a pharmacist who was a Scientologist be allowed to refuse to fill prescriptions for antidepressants? No. Would a nurse or doctor who was a Jehovah’s Witness be allowed to deny a patient a blood transfusion? No. Would a hospital dietician who was vegan be allowed to deny animal-based foods to patients? No.

  2. Absolutely undoubtedly, many of the same people who support refusal clauses would be rushing to support military deserters who, by not fighting in wars, refuse to do what they voluntarily signed up for, right? Right? After all, misogynists have no more of a right to conscience than anyone else, right? If it was truly about conscience and not about slut-shaming they would have to take this view. Since I’m pretty sure the very people who support refusal clauses do not apply those to other situations, I think it is clear what refusal clauses are really about: punishing and controlling women.

  3. Would a pharmacist who was a Scientologist be allowed to refuse to fill prescriptions for antidepressants? No. Would a nurse or doctor who was a Jehovah’s Witness be allowed to deny a patient a blood transfusion? No. Would a hospital dietician who was vegan be allowed to deny animal-based foods to patients? No.

    What this law comes down to is a sort of temporary compromise between the pro-life and pro-choice positions. Since we can’t make reproductive privilege illegal (yet), we try to enact “conscience protection” laws as a compromise, since it’s really as much of our platform as we can write into law at the moment. But what doesn’t make any sense is why some people who support reproductive privilege also support conscience protections. This makes no sense at all.

  4. “My opinion on this is the same as my opinion on the issue of pharmacists denying emergency contraception to women–it should absolutely not be tolerated.”

    Good idea! You should impose your ideology on someone else’s ideology. The nerve of them!

  6. Courtney is saying their refusal should not be tolerated. I agree with her: pharmacists and medical professionals are free to make moral choices for themselves, not for others. Their duty while at work is to dispense legal medications and treatments.

    What can we do to get this to stop? Sue? Can they be fined? Who do we go to to get this addressed?
    More activism is required in this area, I can see.

  7. Getting all the Christians out of the hospital/ pharmacy business would be a start. You never see Jewish or Muslim pharmacists or doctors pulling this crap.
    Half snark..

  8. Waaaa: you got it! usually, “people with strong religious… beliefs” (religious right, etc) are admittedly intolerant of contributing to the taking of innocent life (sometimes referred to as “healthcare”), as with abortion or abortifacients, etc. It’s you poor “tolerant” Left, et al that continue to embarrass yourselves by your secret love affair with intolerance (as noted above). Thanks for emphasizing my point!

  9. Oh joy. Here we have another pro-life fanatic to tell all the ignorant misinformed bleeding heart liberals that we’re really the intolerant ones for believing people don’t have a right to practice their moral beliefs at the expense of the health and lives of millions of women.

    Hey, jopaga whose “intolerance” do you think will do more damage in this case?

    If you’re trying to master the art of concern trolling, you’ll have to do better than this.

  10. Jopaga, so, setting aside for now any ethical problems involved in the job itself, could a volunteer soldier refuse to go to war because he/she doesn’t like it?

    Jopaga, so, setting aside for now any ethical problems involved in the job itself, could someone who willingly takes a stripper job refuse to wear anything other than a burkha because of his/her religious beliefs?

    Sometimes, when you have particular personal religious or other philosophical positions you believe strongly– it means CERTAIN JOBS ARE CLOSED TO YOU. If you cannot dispense all legal medications, than don’t be a pharmacist! If you cannot refer patients to alternative legal providers and/or take care of them in an emergency for any range of legal procedures you are qualified to do, than don’t be a doctor!

    If your religion means vast realms of medicine aren’t allowed to be offered, DON’T start an entire hospital!

  11. White, cut it out with the “reproductive privilege” bullshit. Reproductive privilege* is being able to reproduce or choose not to reproduce without laws taking away your most basic human right because of that choice. Ie. what men have.

    *It is, of course, a right, but people are denied it.

  12. No one’s lost on the irony of jopaga coming to a feminist website to impose his or her ideology on us, when we’re choosing to use our own space to discuss our ideology, right?

    Whatever, loser. You don’t get to decide when “life” begins, and every bullshit moral qualm you’ve exhibited fails if you’re wrong. Are you God? No? Maybe you should stop acting like you have his or her moral authority. I hear that puts your kind in a make believe prison for the rest of your afterlife.

  13. Jopaga: I’d direct you to Matthew 6: 19-24. Christians have to make a choice: either they can be of the world or they can merely be in it. I can understand being opposed to abortion, I can understand agitating against it, I can understand finding it horrifying and repugnant.

    What I cannot understand, respect, or tolerate is the entitlement and deceit that have been woven together in the modern pro-life movement. You cannot become a health care provider with an eye towards enforcing your religious beliefs, you cannot lie, you cannot play the victim, you cannot become an integral part of a secular industry and then cry religion when you are asked to do your job. Christians opposed to abortion knew what they were getting into when they went to med school, when they became a nurse, when they specialized in OB/GYN, or when they entered a pharmacy program. To borrow one of your movement’s favored tropes: there were other options. To put yourself in a position to stop abortion is not only to tell a series of lies, but also to profit from a deep engagement with a world of profit which your own God despises.

    I find the way that modern substance abuse counseling works to be ethically unacceptable. As a result, even though it is profitable and I have the qualifications, I don’t do that kind of work or take those kinds of patients. That is the cost of having strong beliefs. Anything else is deceit.

  14. This reminds me of when I went to the doctor when I was 17 for a UTI, and I got a lecture from my family doctor about how I should not be having sex before marriage because it’s a sin and he would not give me a birth control prescription because they don’t encourage premarital sex around here and blah blah blah. I did not ask him for birth control, for one thing. He also thought I was fucking around with multiple guys (without asking me, of course, not that it was any of his business) so he gave me some speech about how STDs were inevitable. Keep in mind that I didn’t say ANYTHING to provoke this lecture, I didn’t even tell him I was having sex, I just came in to get treated for a UTI.

    That was how I found out my doctor was a christian, and started going to a walk-in clinic instead, where no one berated me about my sex life and I could just get treated like a normal person.

  15. Our family doctor was anti-abortion. When women came to his clinic asking for an abortion, he gave them directions to the abortion clinic down the road.
    The existence of the abortion clinic down the road gave him the freedom to do this. I sometimes wonder what he would have done if there wasn’t.

  17. jemand: you must be assuming that all laws are just and therefore, if they’re “legal”, we ought to be in lockstep, or go elsewhere. Correct me if I’m wrong.

    Slavery was once legal, even if it wasn’t just. Women too were unable to own land or vote, etc. All legal, but entirely unjust. We’re all subject to morality in life, it’s only a question of which morality we’ll follow. The moral principles that guide your life apparently hold some individuals as more valuable than others (or you’re just completely oblivious to what an abortion is). Many, however, can’t and should not have to tolerate a double standard on the value of all individuals’ lives even if, legally, it is acceptable.

  18. PrettyAmiable: I’m sorry, I didn’t realize I was imposing. You are free to be pro-choice once again! really sorry about that. As for when life begins though… it usually begins in the beginning, right? I’m pretty sure your friends at Planned Parenthood and NARAL would begrudgingly agree. never publicly, of course. They’d be out of business if life didn’t didn’t begin then.

    You’re obviously certain when life begins yourself, since you’d never act like YOU have the moral authority to allow someone to take another’s life. All these abortions must then be occurring BEFORE life begins, right? How do abort something that isn’t alive?

  19. Politicalguineapig: neither you or I know enough about him to be sure.

    jopaga: religious freedom doesn’t mean being able to impose your belief systems on others. If this argument was couched in terms of division of state and church, would you be arguing for the church to take precedence?

    William : intelligent, thoughtful, ethical and sensitive men are terribly sexy. If you worked for Citibank, the managers would have to sack you for distracting all the women on site.

  20. Jopaga, you can work to *change the law*

    Or, you can *break the law*

    But you can’t break the law and expect impunity! You cannot refuse to do your job and insist you still get PAID for your job because, religious freedom! You can change the law, or you can break it, but you cannot just break the law and assume that we’ll just *ignore* it for you because YOU and YOU get a pass for your personal philosophy.

    If we did THAT nobody would ever go to jail. Nobody would ever be fined. Nobody would EVER lose their jobs.

  21. jopaga: The moral principles that guide your life apparently hold some individuals as more valuable than others

    Every time I see a pro-lifer claiming that, I point out to them that the moral principles that guide pro-lifers definitively hold some inidividuals as less valuable than others: all girls and women, especially if pregnant.

    And every time, when pro-lifers try to claim this is not so, they get tangled up in their own intellectual confusion. (Examples at my own blog: Why pro-choice is the only moral option and The day I killed.

    It’s understandable: running a political campaign with one goal and with a cover story that completely contradicts the actual goal, is naturally going to trip people up…

    I’m sure you’re no different, Jopaga: the only difference is that you’re on a blog where your indifference to women’s lives and health is a minority opinion.

  22. As a nurse, I’ve found that most patients’ knowledge of the ethical obligations of healthcare providers is lacking. In my state, hospitals are required to inform patients of their rights and responsibilities. This is frequently accomplished by posting notices of those rights and responsibilities in hospital common areas or by distributing a list of them to every patient upon admission. Unfortunately, few patients actually read the thing. Even if they did, it’s difficult for someone with minimal medical knowledge to be able to assess whether or not they’ve been informed of all “appropriate alternatives” to their treatment. This is how hospitals and providers get away with restricting services. Hospitals aren’t required to advertise those treatment options (such as abortion or emergency contraception) that they categorically do not provide, but they should be.

    Of course, current laws and professional practice standards in the areas of informed consent and full disclosure state that healthcare providers are obligated to inform patients of all available treatment options, even if those services are not available at the hospital in which they practice. Clearly, the practitioners at these hospitals are not actually doing this; if they were, it’s likely that they would be referring patients out to other, less restrictive hospitals all the time. The motivation for practitioners to withhold information in these cases is twofold: first, hospitals generally don’t like to lose patients to other hospitals (less money for them!), and second, practitioners who work at these hospitals may agree with the moral stance of the hospital itself. While both motivations are decried to some extent by both the medical and nursing codes of ethics, many patients are none the wiser, and few of these incidents ever go reported. Thus, there is little impetus for healthcare providers to actually tell their patients the truth (besides, you know, wanting to actually uphold their professional codes of ethics).

    My recommendation is that patients make a habit out of reporting practitioners who withhold information or fail to render services on moral grounds (without assisting the patient in making alternative arrangements) to their state medical, nursing or pharmacists’ board. Here are a few specifics as to what healthcare providers are obligated to do.

    Nurses:

    From the ANA’s Code of Ethics for Nurses

    Physicians:

    From the AMA’s Code of Ethics for Physicians

    Unfortunately, the APA’s Code of Ethics for Pharmacists is so vague that there really aren’t any excerpts worth posting here. Another battle, I guess…

  23. Ugh, HTML fail. Sorry; here’s what that was supposed to say.

    Nurses:

    “Where a particular treatment, intervention, activity, or practice is morally objectionable to the nurse…the nurse is justified in refusing to participate on moral grounds. Such grounds exclude personal preference, prejudice, convenience, or arbitrariness. Conscientious objection may not insulate the nurse against formal or informal penalty….When possible, such a refusal should be made known in advance and in time for alternate arrangements to be made for patient care. The nurse is obliged to provide for the patient’s safety, to avoid patient abandonment, and to withdraw only when assured that alternative sources of nursing care are available to the patient.”
    From the ANA’s Code of Ethics for Nurses

    Physicians:

    Physicians are free to choose whom they will serve. The physician should, however, respond to the best of his or her ability in cases of emergency where first aid treatment is essential. Once having undertaken a case, the physician should not neglect the patient…The patient has the right to receive information from physicians and to discuss the benefits, risks, and costs of appropriate treatment alternatives….The physician may not discontinue treatment of a patient as long as further treatment is medically indicated, without giving the patient reasonable assistance and sufficient opportunity to make alternative arrangements for care.”
    From the AMA’s Code of Ethics for Physicians

    Unfortunately, the APA’s Code of Ethics for Pharmacists is so vague that there really aren’t any excerpts worth posting here. Another battle, I guess…

  24. “You’re obviously certain when life begins yourself, since you’d never act like YOU have the moral authority to allow someone to take another’s life.”

    Sure am! Or rather, I’m sure when it’s not life. And it’s not when a sperm cell hits an egg and it starts multiplying. That’s not “life” to me, and the only reason it’s life to you is because you somehow think that this parasitic mass of ick has a soul. There’s LOTS of people who don’t believe in souls, PS, and sometimes we need to go to the hospital too. If you don’t want a fucking abortion, don’t have one. Tell me, do you count your age as “23 and nine months” on your 23rd birthday? Or do you say you’ve been alive 23 years? Yeah. You don’t think you were living in utero either. Also, a fun aside, my assumption of moral authority won’t land me in hell 😉

    “All these abortions must then be occurring BEFORE life begins, right? How do abort something that isn’t alive?”

    Uhhh… when someone is murdered at the age of 67 (in a church no less) would you call that an abortion? Because if so, your side participates in abortions all the fucking time. Please stop being intellectually dishonest.

  25. “All these abortions must then be occurring BEFORE life begins, right? How do abort something that isn’t alive?”

    I am pro-choice. Actually, I often use the word “pro-abortion” to describe myself. Yet I do recognize that abortion is taking a life. I also, however, believe that when people take antibiotics to kill bacteria they are taking a life. I can support abortion and recognize that a life is being destroyed because I do not believe that it is always and forever immoral for a person to end a life. I believe that a woman’s right to bodily autonomy trumps that of any life that the unborn fetus may or may not have. In short, the life of the fetus is irrelevant in relation to my and other women’s right to not have our bodies infringed upon against our will. Just as I have a right to not be raped and used in that regard, I have the right to not allow any other living thing to use my body against my will. I also have the right to defend myself from harm from any other living being. Going through pregnancy and giving childbirth causes physical damage to a woman’s body. Some of that damage is permanent. This is obviously true in the case of women who actually -die- as a result of childbirth. If something or someone is endangering my health or well-being, I have the right to defend myself against it. This is true whether we are speaking of bacteria, a tick, or a fetus.

    While it may be possible to defend myself against unwanted intrusion when dealing with life outside my body, the only way to stop the intrusion when the life is inside my body is to destroy it. The fetus can not reside outside my body alive so it is the only option. In cases where the fetus can reside outside the woman’s body, it’s still ultimately the woman’s decision as to how the fetus should be removed because, again, it is her body. No one has the right to force me to go through labor or endure a c-section against my will. No one has the right to force me to endure any form of physical pain or damage without my consent.

  26. “While it may be possible to defend myself against unwanted intrusion when dealing with life outside my body, the only way to stop the intrusion when the life is inside my body is to destroy it.”

    That should have read “while it may be possible to defend myself against unwanted intrusion when dealing with a life outside my body without taking that life,”

    Sorry.

  27. Hey, Rachel, is it legal for a patient to ask a doctor what religion they are, if the patient believes it may have a bearing on her health and treatment?

  28. Politicalguineapig, that won’t necessarily help you. Plenty of Christians aren’t anti-choice (such as Dr. Tiller).

    jopaga: what jemand said. it’s perfectly reasonable to say that a law is unjust, but you’d better be prepared to face the consequences of breaking it. Or did you think that sit-ins at segregated lunch counters were all rainbows and puppies?

  29. Jopaga: I find it disappointing that you seem able to engage only with those comments which your limited imagination can answer with disingenuous and snide responses. You don’t seem interested in discussion so much as asking us to watch you thrash about somewhere between a temper tantrum and a 3 AM public access television sermon.

    Whats worse is that your pattern of responses seems to suggest that it isn’t worth further engaging with your comments. You clearly aren’t here to speak with others but to work out some kind of personal issue. It is unfortunate that this issue has so triggered you, but really I think that it deserves to be addressed on it’s own merits, not as a sparring dummy for whatever idiosyncratic concern lurks beneath what passes for your advocacy here.

  32. @politicalguineapig – To the best of my knowledge, it’s not illegal to ask unless you’re the one who’s actually hiring the physician (a luxury that’s generally reserved for hospitals and Michael Jackson). If anyone has any evidence to the contrary, please let us know! For what it’s worth, though, I don’t think the physician would have a legal obligation to answer you– though if they do give you an answer, I believe they are required (ethically, if not legally) to be truthful.

    In any case, I think a more effective way to choose a new physician would be to ask them up front whether or not they have any moral objections to birth control, emergency contraception and abortion. And try to do a little research into the institution in which the physician works, if it’s more than just a private practice. Most affiliations are fairly easy to find online. And of course, Planned Parenthood and many community health clinics are a safe bet.

  33. I’m way late to the game (been a busy week here) but, I’d like to point something out.

    Some women are refused health care of all sorts fairly routinely in the United States all the time on the grounds of a “religious” or personal belief that the practitioner feels is being violated.

    They are trans women. And some men get the same treatment: they are, of course, trans men.

    I have gone into a doctor’s office and been informed that I would not be helped when they learned that I was trans. MY only recourse is to find a different doctor. I can, of course, file a complaint, but that doesn’t get me anything, and it doesn’t change the fact I still have to find a different doctor.

    Some women have gone to the doctor and been told that their cold is a bad reaction to the medicine they take – medicine which does not produce cold or flu-like symptoms and is usually called hormones.

    The last time I looked for a doctor it took me 8 attempts to find one. And, despite the effort to do so, I still have to overcome a fear of being treated like crap when I go — a fear sometimes so overwhelming that I’ll simply put off tests I need to take for two months or more simply because I’d really rather be horribly sick than go through humiliation and harsh treatment.

    And knowing that, just to start, makes my reaction to things like this much, much worse, as I know that if I’m afraid to go to a place that I perceive as unsafe just in general, it’s going to be worse for people who expect it to be safe and find themselves subjected to something that I already consider an offense worth losing a license over.

    Those doctors are given a license to do their work. Like the license to run a business, there are certain obligations that come with that — and they should be subject to the same rules that any business i subject to on those grounds.

    Refusing to do the very thing they went to school for tells me they are lousy doctors. And they should be widely known as lousy doctors.

    So let’s get their names and start publicizing them. Yeah, they’ll get business from people who agree with them, but that’s not the point. It’s not to drive them out of business.

    It’s to make sure that the people they would, in the end, abuse, aren’t blindsided by it.

  34. Rachel, thanks! I haven’t had any issues with my doctor, but it never hurts to know what I can ask and how I can take steps to get whatever services I might need.

  35. As far as what patients can and cannot ask. As far as I know there is nothing that would be illegal for a patient to ask. Doctors have responsibilities to patients, beyond paying your bill and not assaulting them you have no responsibilities to your doctor.

    Its pretty routine for my patients to ask me my age, my background, my politics, my religion, my marital status, my sexual orientation, pretty much anything you can imagine. I tend not to answer those kinds of questions, but patients ask and I feel I do have a responsibility to at least explain why I won’t answer (I’m a psychotherapist so the field is a bit different). If a patient dislikes what I have to say (as does occasionally happen) I have to recognize that it is their right to leave if they wish and that I have a responsibility to give them a good list of referrals to providers I know who won’t have similar problems. A patient should never be afraid to ask a question.

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