UO Magazine > Religion and Medicine

“Listening to people and offering guidance—that’s the key,” he says of his approach. So is a belief in God. “One survey showed that 80 percent of patients believe in God, but when they surveyed psychiatrists, 95 percent of them don’t, and a fairly high percentage of family practice doctors don’t believe in God.” He insists, “Many people find it helpful to integrate God into their lifestyle. If they are going somewhere where they not getting spiritual guidance, then that’s an unmet need for them.”

He recognizes that some patients are not interested in the spiritual guidance he offers—particularly since it comes

laced with some strong value judgments. “Probably, most gays are not receptive to changing their lifestyle, regardless of the health implications. As far as addressing that lifestyle, you can approach it as a straight medical issue: You are sleeping around; you have an increased risk of HIV; and if you get HIV, there’s a good chance you’ll die.”

“I believe that homosexuality is a choice,” he continues. “There’s no gay gene that’s been found. If you look at some of the theories in psychiatry, they say maybe they had a distant father, or they didn’t bond with their mother. There is counseling where people had a homosexual lifestyle, and are now living heterosexually. If it were genetic, that wouldn’t happen. But most people who come to me, they’re not receptive to that.” [The American Psychiatric Association, which does not consider homosexuality a mental disorder, has formally opposed “conversion therapy,” declaring in 2000, “Recent publicized efforts to repathologize homosexuality by claiming that it can be cured are often guided not by rigorous scientific or psychiatric research, but sometimes by religious and political forces opposed to full civil rights for gay men and lesbians.”]

Rowland, like Bolton, often prays with his patients. One such patient is Daniel Glover, 36, an arborist from Folsom, Louisiana, who was seriously injured in a fall from a tree and has endured multiple surgeries. Glover says, “I discussed with Dr. Rowland my spirituality. Once I found out he was a devout Christian, I asked him if he minded if I prayed. He obliges me. We stand up, hold hands, and I bow my head and I pray to my god.”

“I think prayer can make a difference in people’s lives,” says Rowland, “especially in situations where maybe there isn’t an answer medically.”

Guadalupe Benitez was a 28-year old lesbian from Oceanside, California, who was eager to start a family with her partner. It was 1999, and after a year of unsuccessful attempts to become pregnant through artificial insemination, Benitez’s physician referred her to a fertility specialist. At her first visit, the specialist informed her that “it was against her religion to help a same-sex couple bring a life in the world,” Benitez says. The doctor agreed to administer fertility drugs. But nine months later, following months of drug therapy and one operation, doctors at


	THE BATTLE IN THE STATES Conflicts between patients and health-care providers who object to providing services on religious grounds have led to legislation on all sides of the issue. According to the Guttmacher Institute: • 46 states allow some health-care providers to refuse to provide abortion services; • 13 states allow some health-care providers to refuse to provide contraceptive services; • 17 states allow some health-care providers to refuse to provide sterilization services. Providing emergency contraception has proved to be especially controversial. In August 2006, the FDA approved the use of Plan B emergency contraception (EC), also known as the “morning after pill,” as an over-the-counter medication for women 18 and over; it is available by prescription to those under 18. But when Melinda Stone, 38, asked for Plan B at the Wal-Mart pharmacy in Sebastian, Florida, in January 2007, she was falsely told that the store didn’t carry it, then informed that she needed a prescription. According to Stone, the pharmacist told her, “It’s up to each store what their policy is.” The pharmacist then lectured her that taking EC was tantamount to having an abortion, since—in his view—life begins at conception. Stone complained to Planned Parenthood, which confronted Wal-Mart's management. Wal-Mart then instructed its Florida pharmacists to dispense Plan B. But when a Unique Opportunities representative contacted the Wal-Mart in Sebastian in May 2007 to ask for Plan B, we were informed that the pharmacy “surely does not” have it now, but that the store could have some the next day. The efficacy of the medication is highest in the first 12 to 24 hours. Pharmacists who object to dispensing EC and other birth control have some well organized backing. Karen Bauer, the president of Pharmacists for Life International, is working to ensure that “killing humans at various stages of development is eliminated from pharmacy practice.” The National Women’s Law Center reports: • Four states—Arkansas, Georgia, Mississippi, and South Dakota—have laws that allow pharmacists to refuse to fill prescriptions due to their personal beliefs; • Six states require pharmacists to ensure that prescriptions are filled; • Five states have issued policies prohibiting pharmacists from obstructing patient access to medication or refusing to transfer patient information to another pharmacy. In addition, some physicians and pharmacists are refusing to dispense regular birth control pills to unmarried women, citing their religious beliefs. On May 16, 2007, Connecticut Gov. M. Jodi Rell signed a law requiring all hospitals in the state to provide emergency contraception to rape victims. The law passed over the strong objections of the Catholic Church, which insisted that EC violates the religious beliefs of the church. Some Catholic hospitals in Connecticut refused to dispense EC, while others required rape victims to take an ovulation test before administering the birth control pills. In a concession to the church, lawmakers are allowing hospitals to contract with a third-party provider to give out the contraceptive medication. Meanwhile, the public has weighed in: An August 2006 poll by the Pew Research Center for the People and the Press found that 80 percent of Americans believe that pharmacists should not be able to refuse to sell birth control based on their religious beliefs.

the ob/gyn practice declared that “they were Christian and they would not help a same-sex couple have a child.” One physician told Benitez and her partner to find another doctor “like any normal couple.”

“It was a shock to me,” says Benitez, who works as a medical assistant. “I could not believe that he was saying ‘we will not treat you because you are a homosexual.’” Benitez still fumes at the memory. “I didn’t come there because I was gay. I came there because I had a medical condition.”

Months later, Benitez found another fertility specialist, and conceived a boy, and later twin girls. But her medical ordeal left her struggling with depression and led her to seek psychotherapy. In 2001, she decided to fight back. She filed suit, charging the fertility doctors with discrimination. The landmark case is now headed to the California Supreme Court.

“This is the first case that addresses the question of whether a physician or other medical provider can assert a religious objection to treating a particular type of patient,” says Jenny Pizer, senior counsel with Lambda Legal, the firm which represents Benitez. “We have decided as a society that it is critically important that people not be turned away because of who they are, whether at a lunch counter or a doctor’s office.”

Religious doctors insist there is a larger issue at stake. “We have a marketplace and patients have alternatives,” says Rudd of CMDA. “We are weighing access and convenience issues against a doctor’s fundamental right to exercise their freedom of religion.”

In Benitez’s case, her insurance only offered full coverage for her to see the specialist who ultimately refused to treat her. “The health-care marketplace in the 21st century is not an ideal world,” says Uttley of Mergerwatch. “Patients have limited options as to where and from whom they can receive health care. So it is not uncommon to have a situation in which a patient does not have another choice. When that happens, the consequence of a physician’s desire to exercise their religious conscience is that the patient suffers from a lack of medical care.”

Lainie F. Ross, MD, PhD, the associate director of the MacLean Center for Clinical Medical Ethics at the University of Chicago, puts it more bluntly. “Individual physicians are allowed to make martyrs of themselves. They are not allowed to make martyrs of their patients.”

Medical controversy is not necessarily bad for health care. “Patients are well served by physicians who conscientiously seek their patients’ good, and do so in a way that shows respect for patients in spite of disagreements, and that is candid about how a doctor’s convictions may or may not limit the sorts of practices they are willing to provide,” says Farr Curlin, MD, of the University of Chicago, the lead author of the recent NEJM study of the role of religion and conscience in medical care.

But. Ross insists, “When you have a right of conscientious objection, rights have responsibilities. One responsibility is to refer a patient to another doctor. They can’t just refuse to do certain things.”

For Benitez, becoming a mother was only the beginning of a larger struggle that was foist upon her. “I just want justice for all. I want to make sure this is not done to somebody else—for my children, for their children—that they will not be discriminated against. If you are going to provide services for one person, you have to provide them for all. If you can’t accept that, maybe you shouldn’t be in the medical field.”