Religious Freedom and Discrimination

PregnantWomanLast week I listened to the church’s press conference about balancing LGBTQ rights and religious freedom.  One thing stood out in particular that really troubled me.  Giving examples of when religious freedom should come first, Elder Holland said:

For example, a Latter-Day Saint physician who objects to performing abortions or artificial insemination for a lesbian couple should not be forced against his or her conscience to do so, especially when others are readily available to perform that function.

I feel concerned by this because I think there is a fundamental divide between the two examples he gave.  I agree that physicians who believe abortion is wrong should have the right to say they will not perform them.  However, in that case the problem is the procedure itself, and so doctors who object refuse the service to everyone equally.  Other doctors may draw the line elsewhere — perhaps he or she is comfortable performing abortions when the fetus has no chance of survival, or when the mother’s life is endangered, but not when those conditions are not met.  Again, I think this is fair because the line of when the doctor will perform an abortion is defined by medical circumstances and is applied equally.

The decision, however, to refuse artificial insemination to lesbians is not in the same category. In such a case the doctor would be making the decision not in terms of medical necessity, or objections to the procedure itself, but out of an objection to the perceived sin of the patient.  Where then is the line? If the doctor has the right to deny medical attention based on a belief that the person has sinned or is actively sinning, should all sins be subject to such penalties? Could that possibly be just?

I am eight and a half months pregnant.  I see my doctor regularly.  This week I had an ultrasound to check on the baby’s growth.  Then I met with my doctor who conferred with me about my mental and physical health.  As usual, she tested my urine, checked my blood pressure and answered my questions.  Yet this week I have done things that are certainly against my religion.  I do not know what if any faith she belongs to, but suppose she were LDS and thus held the same religious values?

This week I have judged other people, both aloud and in my heart.  This is a sin that Christ openly and severely condemned and has also been denounced by modern-day prophets and apostles.  I have gossiped.  I have been slothful.  I have not opened my scriptures a single time, despite the the fact that this is a commandment, and is frequently reinforced by church leaders. I have been guilty of gluttony repeatedly.  On Sunday evening I seriously contemplated going to Dairy Queen and only decided against it because my nausea made me change my mind, not because I was fully committed to observing the Sabbath regardless of my cravings.  I have no doubt that I have many other sins to account for that are not coming to mind right now.  This week my sins seem a bit petty and small, and I have repented but realistically, I’ll make most of these mistakes again. In the course of my life I have done far worse.  So have we all.  Yet despite all of this, despite my clear and repeated violations of God’s commandments, there was no question that I might be denied some or all of my doctor’s services.  I feel confident that if I had an LDS doctor the outcome would have been the same.

According to church teachings, participating in a homosexual relationship violates the law of chastity and is therefore sinful.  While my own beliefs are more liberal, the church’s official stance is pretty clear.  My problem is this:  If a doctor accepts the church’s definition of homosexuality that makes acting on same-gender attraction a sin, what makes that a worse sin than anything else?  All sin distances us from God.  The exact nature of the sin does not really matter, because any sin is rebellion against God.

If I, a sinner, can yet receive the very best medical care our town has to offer, without reference to my past or current sins, then what makes other sinners different?  Is it okay to refuse to perform an appendectomy on someone who drinks coffee?  Drinking coffee is a violation of the Word of Wisdom and will keep you out of the Temple just as much as any violation of the law of chastity. As members of the church, we condemn coffee drinking and do not do it.  Should religious freedom dictate that we have the right to deny service to coffee drinkers, based on our beliefs?

In the past I taught history courses at our local university.  Should I have refused to grade the papers of students who broke the Sabbath? What about students who shoplifted? Or gambled? What about students who abused their partners or children?  As a mandated reporter I would have a responsibility to share any information on abuse I had with the appropriate authorities.  The university might strip my students of their standing for a variety of reasons, but until and unless such actions took place, I would not have the right to deny them my services as a teacher on my own authority.  I had no right to fail students for reasons unrelated to class performance, however much I might personally dislike them or their life choices.  It wouldn’t be just.  Their violations of my moral framework do not mean I can selectively deny them service on that basis.

I am concerned when I hear church leaders or members use the rhetoric of religious freedom as justification for discrimination.  God has commanded us to “do justly, and to love mercy, and to walk humbly with thy God.” (Micah 6:8).  God is just. Our Heavenly Parents want us to try our hardest to follow their examples.  When we fail to do so, it should be by accident and not by design.  If our religious beliefs seem to validate acting unjustly, then somewhere along the line we have misunderstood what God wants from us.

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21 Responses

  1. Julie says:

    I think you missed the point of Elder Oaks’ examples 😉

  2. mylifeintune says:

    I liked your perspective on the differences between the two examples: I agree; to an extent they ARE different. I think E. Holland’s point, though, was less about the ethical ramifications of providing medical (or other) services to people who sin, and more about the moral dilemma of aiding in bringing children into such a family. I believe E. Holland is arguing if a doctor believes that it is not in a child’s best interest to be born to a homosexual partnership, s/he should have the right to refer the patient/s elsewhere. By this standard, doctors would also be able to refuse to inseminate single women or women in unmarried partnerships.

    I’m not sure that I agree with him, but I think this rationale makes more sense than “we should be able to deny services to SINNERS.” Because, as you succinctly pointed out, where does the madness end?

    • Em says:

      I see your point. However, I still think the slippery slope problem remains even if you look at it not as sin but as family fitness. The church has very clear teachings on what family gender roles should be. The proclamation outlines that men should provide and women should nurture. So if a couple comes in wanting fertility help and the wife has a high-power job that involves long hours, and the husband is committed to staying home with children, could an LDS doctor fairly refuse service? After all, the lifestyle of the parents is not in harmony with the church’s teachings. (Even if the couple isn’t LDS and isn’t working within the same moral framework to begin with). If the doctor firmly believes that only mothers can properly care for a child, and the only way to do that is through staying at home (which some LDS people believe) is it right to deny fertility help to working mothers?

      The argument that people can just find someone else doesn’t really hold water. For one thing, that is not true of areas with few medical options. It also doesn’t change the ethical question of whether it is morally right to deny someone services that you willingly provide to others. It seems to me to be a moral safety valve — it is okay to discriminate, as long as there is someone else who won’t.

      To me one of the reasons this statement is problematic is that an apostle said it on record. So therefore, to some, it becomes a defensible basis to engage in what I feel is clearly discrimination.

      • mylifeintune says:

        “I still think the slippery slope problem remains even if you look at it not as sin but as family fitness.”

        Yes, exactly. It’s still a slippery slope, but of a different nature. Like Silverrain pointed out, there are other instances where a doctor might not feel comfortable helping a couple conceive a child (if they are racist or abusive). Should doctors be able to refuse service to anyone based on matters of conscience? What about trying to save the life of a killer? I worked in the hospital where the Fort Hood shooter was being treated, and there were a couple of nurses who refused to treat him and were still permitted to keep their jobs. Should Jehovah Witness doctors be forced to perform blood transfusions? Should a doctor that disagrees with premarital sex be permitted to refuse treatment to a pregnant teenager? What if she’s in labor and he’s the on-call doctor?

        I feel that fertility doctors shouldn’t withhold service in the vast majority of instances because, for the most part, people who undergo expensive fertility treatments truly want a child and are committed to care for it. There are children born hourly into horrific situations. Birth, in 99% of cases, doesn’t require the sanction of a doctor. The letters going around the internet about children of gay parents feeling cheated by not having their other-gendered parent don’t really hold water for me because so many children aren’t born into homes of the loving mother + loving father ideal.

        I’m not advocating either way on this–I think it’s a complex issue. Personally, I would want to be treated by a doctor who wanted to treat me (or receive services from someone who wanted my patronage), but as you said, it isn’t always that simple.

  3. Patty says:

    I was bothered that the offer of support to LGBT fair housing and employment was linked to expectations of concessions in return. It made the offer of support appear grudging and ungenerous. I couldn’t imagine it being well-received by most non-LDS people.
    Also, would a referral to another doctor be such a terrible thing? Why would you want a procedure performed by someone who was uncomfortable doing it? Isn’t there some way to solve these kinds of problems without being so confrontational?

    • Em says:

      I definitely see your point on the referral — you’d rather have a doctor who is comfortable with you. On the other hand, many places do not have a wide range of options in terms of fertility specialists, so a referral may mean a substantial difference in travel cost, cost of care or quality of care. I’m concerned that the possibility of referrals is used to excuse a position that at its heart is unfair. Forcing doctors to do something they are uncomfortable doing can certainly be problematic, but I’m still uncomfortable with the church endorsing what is effectively discrimination by another name.

  4. Caroline says:

    Em,
    Love this post — you make some great points about why refusing to inseminate a lesbian couple is substantively different that refusing to perform abortions. I agree with you about the disturbing implications of this example. Have we so fetishized the male/female nuclear family that we are comfortable justifying refusing medical attention to those who don’t fit that pattern, but want desperately to build a family of their own? Like you say, Em, we can and should do better.

  5. SilverRain says:

    This is clearly morally complicated. For example, what if you were to substitute in something clearly morally wrong, like should a doctor be required to inseminate an infertile couple who belongs to a white supremacist group? Or one s/he suspects is abusive?

    Because if you take away an individual’s freedom to choose in cases of same-sex couples, you also take away their right to choose in those kinds of cases.

    It is tempting to want to legislate morality to enforce our view of what is right. Sometimes it is appropriate to do just that. But there is always a cost. Believing such law would only perform the way we want it to is not supported by history.

    Given that, I’d generally prefer to err on the side of legally allowing people the ability to act according to their own conscience, whatever the social costs of those choices may be.

    It’s far better than forcing people to act against their deeply held beliefs, driving those beliefs underground and making it much more difficult to know what is really going on. A law requiring someone to inseminate a couple they don’t believe should have children is still powerless to force them to do a good job of it.

  6. Anarene Holt Yim says:

    Em, I like the way you’ve framed this dilemma. It certainly is a complex issue. But the church is using a double standard here.

    It seems to me that if the leaders can make exceptions for murder in times of war or if a member is a professional soldier, then the church should certainly be willing to make exceptions for medical professionals to feel good about providing health care to all their patients–not just the ones who have church-approved sex lives. Either that, or change their position on the military and fight for a law that says that soldiers don’t have to shoot people if they don’t want to, or at a minimum, support better laws protecting conscientious objectors.

    I guess what I’m saying is that there’s no consistency in the church’s arguments. We’re more squeamish about sex than we are about murder, and I have a problem with that.

  7. Ziff says:

    Great post, Em. As you so rightly point out, it’s bizarre that we’ve turned homosexuality into the queen mother of all sins, where if someone is gay, we want to be able to categorically deny them stuff in a way that we don’t try to categorically deny stuff to everyone who commits other sins. (That is accepting the Church’s current stance that homosexuality is a sin.) It’s like we’re deciding that it somehow makes people evil in a more global way than all the other sins we can think of. It’s ridiculous.

  8. Liz says:

    Thank you for writing about this, Em, because this specific example has been bugging me since he said it. I would be curious to see how other examples would/should play out – for example, if a same-sex couple were court-ordered to take parenting classes, for example, could a Mormon instructor refuse to give them classes? And if a same-sex couple brought their child in to a Mormon pediatrician, could the pediatrician refuse services to them, since he/she doesn’t approve of their situation? What kind of weird line is this??

    Whether or not this kind of discrimination is legally permitted, it certainly doesn’t seem terribly moral to refuse services to people on account of their sexual orientation.

  9. This is not a matter of judging sins, but in determining what potential family configurations you (the provider) find acceptable.

    Many places, including governments, are already standing quite stably on your slippery slope. Artificial insemination, just like adoption, goes through quite a lot to determine acceptability, all the way down to how much money you make. Ideal family configuration is hardly settled science. Turning down a lesbian couple would be the same for some as turning down a single woman with no support network, or even a single man using surrogacy.

    This area is full of discrimination. The trouble is deciding what discrimination you’re willing to accept.

    (Unrelated random thought – we have sperm banks, do we also have egg banks?)

    • Hillary says:

      As someone who has experienced artificial insemination, I can confirm that you do not have to offer any proof of income in order to obtain that service. Artificial insemination is a relatively inexpensive procedure, rarely exceeding a few hundred dollars. In the infertility world, that is (sadly) peanuts. You do have to jump through innumerable hoops to adopt. Financial counseling is also offered for more expensive fertility services such as IVF, but just like any other medical procedures, if you say you can pay and commit to doing so, you will be given that service.

      The bottom line is that it’s not a physician’s place to determine optimum or ideal family configuration. If you’re a doctor and you make your business in offering fertility treatments to the public, then you should be grown up and professional enough to separate medical treatment from private religious beliefs. I feel like this is especially true in emergency situations or situations where people have limited choice when selecting a physician. It absolutely disgusts me that a physician would refuse service to anyone on religious grounds. There’s a reason they take the Hippocratic oath. Perhaps instead of worrying inanely about how to protect our religiously-based prejudices, why not focus more on what Christ would think of those religiously-based prejudices to begin with?

      • Glad to hear someone with a different experience. my own with my wife was quite different and did involve proof of income and much, much more than a few hundred dollars.

        My other point was that beliefs do not necessarily need to be religious. Weather you believe it is their place or not, doctors (and adoption placement agencies) have had to make it their place to determine weather or not the family is ideal for adding a new life to it. What of configurations we don’t find acceptable? Should a doctor not also be able to refuse service to a brother and sister who want artificial insemination?

        Hippocratic Oath is not a catch-all. Like most everything, it’s up to interpretation. If it were not, no doctor could perform an abortion under any circumstances.

      • Christi says:

        To do IVF we had to be able to pay for it (we weren’t asked where we got the money). That’s it. There was no other conversation about if we met any arbitrary conditions necessary to be good parents. We go to one of the more popular/respected clinics in the SLC area.

  10. Em says:

    Thank you all for your input. I agree that this is a complex issue, and the specific example he chose is especially fraught. I spoke with a friend who is an OB and LDS and his position was far more lenient than I might have supposed. It seems possible, or even likely that many LDS OBs have long considered these issues and have privately reached a position that is less discriminatory. After all, doctors have been debating ethics and discussing these issues deeply for a long time.

    I guess I think it is problematic to refuse services purely on the basis of sexual orientation and no other considerations. As someone above pointed out, where does that stop? If you believe homosexual partnerships and families to be wrong, period, do you deny other family related services? Counseling? Daycare? OB care after a baby has been conceived?

    • Em says:

      Also, it wasn’t so long ago that the church spoke out against interracial marriage. If your religious beliefs dictate interracial relationships to be wrong, is it okay to deny fertility services to those couples?
      I guess I just think if someone (a couple, a single mom) has saved up enough money for fertility treatment, and is willing to go through with it, then that baby is wanted. A wanted baby has a better chance in life than the millions of unwanted babies that are born into “the right” circumstances.

  11. MB says:

    I think Silverrain has a good point. Forcing people to do things that they believe are wrong or destructive is generally not a good idea for society in general.

    Most of the perspectives written above consider the rights of the prospective parents. However, a physician can also lose his license due to irresponsible practice of medicine if a woman requests artificial insemination multiple times over a number of years, he complies with all of her requests, she has eight single births within 10 years as a result and criminally neglects those children. In that case he is considered professionally negligent for failing to consider the welfare of the children whose conception and birth he made possible.

    Somewhere between the right of a woman to receive assistance in conception and the consideration of the future welfare of an unborn child there is a line. And in a pluralistic society like ours, there are a million different possible scenarios and thousands of opinions on those scenarios as to where the line is.

    Our laws have determined that artificial insemination is legal and there are many health practitioners who offer that service, but it would be folly for legislatures to try to draw arbitrary lines as to if or when an individual may refuse to participate in it. To do so would create deep resentment among physicians and, and, inevitably, in some cases havoc in lives of unborn children.

    Allowing physicians to determine what they think is wisest in the cases presented to them makes much more sense. When you do that, certainly some physicians will choose to deny services to different people than the ones you would hope they would, causing those people to seek services elsewhere. And that is annoying and inconvenient. But that scenario is not nearly as potentially destructive, in some cases, as the alternative of legislating the prevention of a physician’s right to refuse to do something that he or she believes will cause harm, in direct violation of the Hippocratic oath and his or her conscious.

    Democratic life is a constant balance between the freedom of the individual to choose how to respond to a situation and society’s understanding of what is in the best interest of society, particularly the young and those unable to defend themselves. In cases, like this, where society is hugely divided all across the nation about what is in the best interest of those individuals, blanket legislation requiring compliance with just one view of the situation is usually far less effective than allowing physicians to act according to their moral conscience.

    • MB says:

      “his or her conscience”

    • Juliathepoet says:

      When has this *ever* happened?

      Physician lose his license due to irresponsible practice of medicine if a woman requests artificial insemination multiple times over a number of years, he complies with all of her requests, she has eight single births within 10 years as a result and criminally neglects those children.

      It is this kind of strangely surreal thinking that leads to a lot of nonsense about religious freedom disappearing if non-heterosexuals are guaranteed the same human rights as heterosexuals are.

      Religion, profession, workplace and a person’s intimate partner all involve at least some level of choice. Depending on a number of factors, more choices may be available for those with more privilege in a factor which they don’t have control over.

      Religion is a choice that has been elevated to that higher level for purposes of not being discriminated because religious affiliation has traditionally been handed down. When it comes to the other non-discrimination factors, it is obviously completely out of the control of the person. I hope it is obvious that there is something difference between choosing to become a fertility doctor and the race, color, sex or gender, national origin, age, mental or physical disabilities, and sexual orientation.

      My school also places other choices besides religion into the list of choices that can’t lead to discrimination, including marital status, parenthood, pregnancy, genetic information and veteran status.

      My biggest problem with the examples given, are that they seem completely within the education and professional choices, made by the person, who wants to be allowed to discriminate. It really does not matter to me how sincerely held their belief is, because they have options, other than to deny services, including choosing another career path.

      Which can be done at anytime. I know a doctor who completed an OB residency, started working in a fairly large teaching hospital, and abortions within the state guidelines on a routine basis. After 6 years he moved to a smaller clinic and left the teaching hospital environment. For him, the impetus was losing both the mother and child, on four occasions in the span of a few months, because the mother, (or her guardian in the case of a teenager who was pregnant) refused to terminate the pregnancy when the momother’s life was at risk.

      For him, he wasn’t able to keep watching women die in childbirth when he knew that there had been clear indications of the danger. He went back and did an additional psychiatry fellowship, and now works with rape and incest victims, in a clinic that serves young women who are in protective custody, or have been kicked out of their homes.

      He both performs abortions and collects fetal tissue/fluid/blood that is used to identify the men who are the fathers, and he delivers babies as well. Most are adopted, but some will go home with their mothers. I asked him one time what he would have done if it had been doing an abortion that had been too much, something he morally objected to. I don’t remember his answer, because he had so many of them. There were at least 15, maybe 20, things that he could have done with the training he had at the point he left that teaching hospital, which would have been a seamless transition.

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