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Posted on November 6, 2019 at 7:00 AM

Rights of conscience, the moral concept that physicians or other medical providers should be able to choose not to provide or participate in medical treatments which they believe to be morally wrong, continues to be widely debated in our society. A recent article in Vox titled “He needed a gender-affirming procedure. The hospital said no.” Expresses some things that I think are misunderstandings of what this debate is about.

Although it
mentions other faith-based institutions, the article is primarily about the
types of procedures which Roman Catholic hospitals in the United States do not
provide under the Ethical and Religious Directives for Catholic Health Care Services. Throughout the article it is
stated that Roman Catholic hospitals have refused needed care to persons
seeking care in those hospitals. It also raises the concern that people may die
because they are not provided necessary emergency care and care from another
hospital willing to provide the care may be too far away. My main concern with
this article is that there appears to be a misunderstanding about the
distinction between needed and desired treatment. Among the things listed as
needed care are “fertility treatment, gender-affirming care, or tubal ligations.”
The article begins with the case in which a Roman Catholic hospital would not
provide an elective hysterectomy to a biologically female person who identified
as being male. The hospital’s reason for not providing this elective surgery
was not because it was desired as a part of the person’s gender transition.
They chose not to provide the surgery because of their belief that removing a
healthy uterus impairs fertility in a way that should not be done.

There is a
difference between desired elective treatments that people may choose to do
even though there is no medical reason why they need to be done and treatment
that is either life-saving or needed for other medical reasons. Such things as
fertility treatments, gender affirming surgeries, tubal ligations, and
abortions are elective treatments that an individual may choose to do but are
not medically necessary. There is an appropriate difference between the
obligation of a physician or hospital to provide medically necessary and
life-saving care and the presumed obligation to provide elective medical
treatments that are desired but not medically necessary.

I am not
Roman Catholic, but I practiced in a Roman Catholic hospital for about 30
years. I served on the ethics committee at that hospital as well. I became very
familiar with the ethical and religious directives and the type of things they
direct Catholic hospitals not to do. These things are elective treatments or
procedures that a person may desire, but which are not medically necessary. I
also became familiar with the important role that Roman Catholic hospitals play
in providing care for the poor and marginalized, many times providing care for
people that other hospitals and physicians would not. Those who think that our
society would be better without Roman Catholic and other faith-based hospitals
are quite mistaken. If those hospitals are forced out of our society by those
who would require them to do anything that anyone requests even when they
believe that those things are wrong, the poor and marginalized in our society
will suffer greatly.

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