Where Doctors Refuse to Treat You

Jul 15, 2018 by

By Dr. Leana S. Wen  
A woman is bleeding from a miscarriage. She sits in her doctor’s office and waits for eight hours. Nobody tells her why she’s not being seen. When she finally goes to the E.R., she’s bleeding so profusely that she needs blood transfusions and an emergency hysterectomy.
In another hospital, a man is denied surgery for a broken arm because he’s transgender. A woman is told she can’t get birth control because she’s unmarried. A child won’t be given vaccinations because he has same-sex parents.
You might be wondering what barbaric society could allow laws that permit such blatant discrimination. That society is ours, and the laws are already in place. In January, the Trump administration created a Conscience and Religious Freedom division in the Department of Health and Human Services. The ostensible aim is to protect the right of health care workers to opt out of procedures that they have religions objections to. The government issued regulations to expand that right so that all of the above scenarios could be justified based on the provider’s religious beliefs. There is now no requirement to inform the patient of why care is denied or to offer a referral to someone who can provide it.
By giving legal cover for discrimination, providers can claim religion as a blanket protection for their own misogyny, racism and homophobia. This will worsen the problem of health care access for those who already face many barriers to care. Women, minorities and L.G.B.T. individuals, particularly those living in areas with few providers, will suffer the most. Many will be forced to forgo care altogether.
The new regulations will also change the nature of the healing professions. In medical school, I learned that a doctor’s primary duty is to the patient. When there is a conflict, the Association of American Medical Colleges instructs, “the health and rights of the patient, who is in the more vulnerable position, must be given precedence.” We doctors, nurses and other health care professionals chose our field. Our patients can’t choose when and how they are ill and, often, which doctor’s hands they might end up in. It is our job — and our privilege — to take care of patients. We don’t judge the people we serve. We don’t allow our beliefs to override their needs. And we certainly don’t deny lifesaving care.
The Trump administration claims that its goal is to protect the autonomy of providers, but it is censoring health professionals. In May, it added a “gag rule” to the Title X family planning program: Providers of clinics that receive federal funding can’t speak about abortion, even when patients ask about it. Providers are required to emphasize “fertility awareness” like the rhythm method rather than F.D.A.-approved contraception like condoms and IUDs. Health professionals are allowed to deny care on religious grounds, but those who provide patients with accurate, scientific information would be breaking the law.
In the coming months, these laws will be challenged in the courts. Now is the time to speak out against this regulation and its terrifying impacts. Health professionals must stand up and speak out for their patients. Everyone else should submit comments to the Trump administration and make your voices heard. It’s up to all of us to fight for the fundamental right to health.
Dr. Leana S. Wen (@DrLeanaWen) is the Health Commissioner of Baltimore City. She is an emergency physician and patient and community advocate. 

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