Star-spangled healthcare discrimination

In January, the Trump administration announced its intentions to make it easier for healthcare professionals to opt out of performing or assisting in procedures that go against their personal or religious beliefs.

Now, maybe you’ve already heard about this development. If so, you might not think it’s such a bad idea. But before anyone rushes to judgment, I want everyone to take a good, hard look at what it really means…

First, some background, in case you missed it: Earlier this year, the Department of Health and Human Services (HHS) declared its intentions to create a new Conscience and Religious Freedom Division. It would operate within its Office for Civil Rights. And its purpose would be to “more vigorously and effectively enforce existing laws” that allow health professionals to refuse services on moral grounds.

First of all, the “Conscience and Religious Freedom Division”? What happened to separation of church and state?

I agree that there’s a sacred place for ethics in medicine… But this? This is another story entirely.

When I was a medical student and resident, I had to take care of whoever showed up in the emergency room, regardless of their belief systems, life choices, or the procedures they might need. Suffice it to say, staying up all night tending to a revolving door of career alcoholics, criminals, and drug addicts was not my idea of a good time.

But I was there to provide medical services not to judge the individual patient.

And more to the point, it was my obligation and duty as a physician to provide care to anyone who needed it. Not to pick and choose whom I deemed “worthy” of that care. Or to decide what services my patients should or shouldn’t have had access to.

So, back to the HHS debacle, and you’ll see why I bring all this up.

If you look at the HHS website, you’ll find some examples of procedures that would be listed under this new office’s purview — including abortion, sterilization, and assisted suicide. On the surface, this might seem sensible and understandable.

But there is a lot of leeway for moral objection beyond these procedures that isn’t spelled out here. And given the broad range of potential interpretations on the table, one need not imagine the Pandora’s box this opens… because sadly, in many places, it’s already happening.

Consider the case of Tamesha Means, a Michigan woman who was 18 weeks pregnant when her water broke. She went to Mercy Health Partners — the only hospital in her county — only to be denied treatment for her miscarriage and sent home… twice. This, despite severe pain and extreme risk to her health.

It’s truly inhumane. A doctor’s prime directive is to first do no harm… yet this hospital’s religious policies could have killed a young woman.

Tamesha Means’ story perfectly illustrates how the creation of this new Conscience and Religious Freedom Division doubles as government-sanctioned healthcare discrimination — against women and lesbian, gay, bisexual, transgender, and queer (LGBTQ) patients in particular. That it will be operating within a branch of the HHS tasked with protecting the civil rights of Americans only adds insult to injury.

No American should have to pass the moral litmus tests of doctors, hospital staff, or administrators in order to receive quality health care. And we don’t need the government interfering in medical ethics when our professional organizations — from the American College of Obstetricians and Gynecologists (ACOG) to the American Medical Association (AMA) — offer very clear guidance on these matters already.

This is not a complicated issue. We have laws — and the creation of this new office is a direct attempt to undermine the most fundamental principles of the profession I love so much. Healthcare should not allow for discrimination — not ever, not in any form. It’s un-American — and hiding it under the guise of “religious freedom” doesn’t make it any less so.

The United States is not a theocracy. We do not govern according to religious law. We govern according to secular law — which is exactly why we have the freedom to do as we please in our personal lives. That is what makes America great.

Blatantly promoting discrimination by giving doctors carte blanche to refuse care that they are duty-bound to provide is not the American way. It is, however, the fascist way of doing things. Divisive moves just like this started many countries on very tragic journeys…

We follow them down this slippery slope at our own, very real, peril.