Art Caplan: When Religion Trumps Medicine

By Art Caplan

Cross-post from

Imagine that you were in a terrible car accident and suffered a huge loss of blood. An ambulance comes and takes you, dazed and in pain, to the only hospital within a hundred mile area of the accident. That hospital happens to be affiliated with the Jehovah’s Witnesses. Everything at the hospital is state of the art. The doctors and nurses are all well trained. There is only one hitch in terms of your medical care. You need blood transfusions or you are going to die. The hospital does not have a blood bank. Nor does it offer transfusions. They believe blood transfusion violates their faith. The doctor suggests you be given a lot of fluids to maintain your ‘volume’ and that you hope for the best. Wouldn’t you demand that the Witness affiliated hospital put aside their faith-based beliefs and do what is medically indicated and either provide a transfusion or try to arrange one? If you did not recover would you expect your family to accept the fact that your death could easily have been prevented but for the hospital’s decision to put theology over medicine?

This is exactly the reason the ACLU is suing the United States Conference of Catholic Bishops. The suit, filed in late November, argues that the Catholic Bishops’ religious directives for hospitals–which generally bar discussion or performance of abortions—can and have resulted in negligent care for patients.

Their case in point is Tamesha Means. Three years ago when she was then 27 the mother of two was 18 weeks pregnant when her water broke. She called a friend to take her to the one hospital within a half-hour’s drive; the Catholic Church affiliated Mercy Health Partners.

During the trip to the hospital–and two return trips, one later that night and then again the next morning–she says she was discharged with medication and instructions to wait for her pain to subside. Means says she was not offered the option to induce labor or terminate the pregnancy. No one told her the fetus, at 18 weeks, was hugely unlikely to survive.

“The pain was unbearable,” Means said according to a recent media interview from her home in Muskegon, Michigan, “I told them ‘I need you guys to help me.’ They told me there was nothing they could do”.

Without being offered “the medically appropriate treatment option of terminating her pregnancy,” the ACLU suit argues, Means “suffered severe, unnecessary, and foreseeable physical and emotional pain.”

The ACLU is right. At a minimum, patients deserve to know all medically appropriate options within the standard of care of the medical profession. Patients have the right to know where to get those options if they are not available at the facility where they are being seen. And if no other facility is available to perform them then patients have a right to expect that a hospital will put aside its theology and do what is medically best for each patient even if that means violating a deeply held religious view.

We have heard a lot recently about pharmacists who won’t fill prescriptions for birth control and doctors who wont write prescriptions for emergency contraception for personal moral reasons. There are many hospitals that don’t offer or won’t do certain medical procedures on religious grounds. Conscience and doctrine are fine but they cannot trump patient interests and health. If you are the only health facility that can provide emergency contraception or end a doomed pregnancy where the mother’s health is at risk then you ought be ready to either quickly find someone who will or provide it. When religion meets medicine the patient should not be expected to have to pray that they are in a facility that will do what medicine thinks best.

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