Michigan Close to Enacting Medical “Moral Objection” Law

John Moolenaar (Source: State of Michigan)

Michigan is on the verge of adopting legislation that will allow health care professionals and facilities to opt out treating patients based on their “conscience.”

Conscience is defined as “sincerely held convictions arising from a belief in God or the tenants of an established religion, or from the ethical or moral principles of a generally recognized philosophy or belief system that an individual asserting those convictions can reference as a basis for those convictions.”

Senate Bill 975, known as the “Religious Liberty and Conscience Protection Act,” has passed the legislature and is headed for the governor’s desk. It will allow medical care to be dispensed based on the religious views of medical professionals. The problems with this bill are multiple. Michigan Live capsulized the background and issues at hand:

Since 1978, state law has allowed hospitals, doctors and other medical professionals to refuse to perform abortions.

The new bill goes beyond that, allowing employers and health insurance providers to refuse to pay for abortions, contraception or other services and medications that they oppose as a matter of conscience. Similar legislation has been discussed by lawmakers for about 10 years.

It addresses concerns over the portion of the Affordable Care Act that requires insurers and employers to provide free contraception including birth control and sterilization. The mandate has been the subject of several lawsuits from Catholic and other religious groups.

The Senate bill also offers liability protection to health facilities, providers and payers who decide not to perform or offer coverage for any kind of medical service, such as sterilization or care in certain end-of-life situations.

There are exceptions for patients who need emergency care and no one else is available, or if the objection request is made in the presence of the patient. Employees and job applicants are protected from discrimination based on their objections, but not if the objectionable service is a regular or substantial part of the job.

Mercifully, the state House added an amendment that “health condition, race, religion, color, national origin, sex, age, disability, marital status, sexual preference or source of payment” cannot be used as a reason to deny medical treatment. Without that, this bill would be loaded with objectionable provisions that could discriminate against gay or unmarried people or those of a different religion. The opportunities to do this are still there, but now they must be more subtle.

For example, the treatment of sexually transmitted diseases could be denied. An infection is only possible if at least one of the parties involved is not a virgin. A doctor who opposes sex outside of marriage might determine that STDs are an example of immoral behavior and refuse treatment for those cases. Marital status of infidelity would play a role in that decision making without the doctor having to admit it.

The impact on health care for women may be the most noticeable. Besides abortions, family planning services could be denied. Yet the list of possible health care denials extends even further. Some religions oppose blood transfusions. It is not unimaginable that a Jewish or Muslim gastroenterologist might deny treatment to patients that eat pork. That may sound extreme, but the limit to denying health care is limited only by one’s religious beliefs. Some of that can be very extreme.

While the bill would require medical personnel to perform emergency treatment, even if it conflicts with personal beliefs, the same medical personnel will determine what an emergency is.

Recently, a pregnant woman died in Ireland because abortions are illegal. She suffered a blood infection from a miscarriage. While not an exact situation that might occur in Michigan, it points to the critical nature of medical emergencies. Something not deemed enough of an emergency one day to be life threatening, may be the next day. By then, it is too late. Yet Michigan wants to codify this into law.

In addition, SB 975 upends the entire concept of comprehensive care and that a patient comes first. With this law, the conscience of the health care provider is paramount over the illness of the patient.

Despite that, State Senator John Moolenaar, the bill’s sponsor, said the bill would “establish a solid, yet workable framework for protecting the fundamental rights for all Michigan citizens.”

That’s “all” if only health care providers are considered. That is a cruel distortion of “fundamental rights” when medical care can be denied based on the belief system of the doctor.

There is another element in this bill that is important to consider. In some rural areas, health care is limited. A medical facility, run by a religious organization, may be the closest available. That facility might reject some medical conditions. A burden of finding a facility further away would be placed on the patient. Some of those patients may be poor or lack transportation, increasing the chances that delayed treatment may result. One of the closest things to an absolute truth in medicine is that delaying treatment is never a good thing. Even if the illness is not life threatening, the patient may be forced to endure extended suffering because a doctor feels that it is his or her’s moral superiority not to assist the sick in some situations.

Michigan is on the edge of deciding that a doctor’s conscience is more important than a patient’s sickness. There’s no way that can be considered a good thing.

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