Arthur L. Caplan
Hi. I’m Art Caplan. I’m at the Division of Medical Ethics at the NYU School of Medicine. Conscientious objection—everybody seems to be talking about it these days. What are the rights of physicians, pharmacists, nurses, or other healthcare workers to say that something may be legal but they refuse to do it?
This issue has come up particularly as more and more health systems are merging. You see Catholic hospitals merging with secular hospitals. Catholic hospitals have a huge presence in the American world of hospitals and nursing homes, probably accounting for 40% of all facilities. When mergers take place, whose values predominate? . . [Full text]
(Project response: Freedom of conscience in healthcare: “an interesting moral swamp?”)
A Clash of Organizational and Individual Conscience
The 2016 Colorado End-of-Life Options Act includes a provision unique among states with such laws, specifically privileging individual health care professionals, including physicians and pharmacists, to choose whether to write and fill prescriptions for life-ending medications, such as high-dose secobarbital or various combinations of morphine, diazepam, beta-blockers, and digoxin, without regard to the position their employer has taken on the law. This provision virtually guaranteed the Colorado law would eventually be challenged, which happened in August 2019.1 The current legal case directly pits the conscience rights of individual health care professionals against those of religiously affiliated corporations. Because 5 of the top 10 US hospital systems by net revenue are now religiously affiliated,2 and these systems often restrict medical care in a variety of ways,3 how the case is resolved could have far-reaching implications for US health care, extending well beyond the relatively rare use of aid-in-dying medications at the end of life.
Wynia M. Colorado End-of-Life Options Act: A Clash of Organizational and Individual Conscience. JAMA. 2019;322(20):1953-1954. doi:10.1001/jama.2019.16438
Centura Health, a Catholic health care network in Colorado, fired a doctor who attempted to help a terminally ill man end his life. According to KDVR, the lawsuit filed against Centura will be going back to state court where questions about freedom of religion could be raised.
Dr. Barbara Morris wanted to prescribe life-ending drugs to Neil Mahoney, a 64-year-old with incurable cancer. Centura’s policies against assisted suicide allegedly violated state law. KCNC reports that after asking a state court to declare that she could not be sanctioned for attempting to help her patient end his life, Dr. Morris was dismissed from her position. . . . [Full text]
Wesley J. Smith
Colorado doctor Barbara Morris wants to assist her patient’s suicide. She works at Centura Health, a Catholic/Seventh Day Adventist-owned hospital that prohibits its employees from participating in assisted suicide, legal in Colorado.
Morris sued to be allowed to participate in her patient’s suicide by doctor — which would not happen in the hospital. The hospital responded by firing Morris for violating the terms of her contract by seeking to engage in acts in the context of her employment that violate the hospital’s religiously based moral beliefs.
Morris contends she can’t be prohibited from assisting her patient’s suicide because the Colorado law only allows health care facilities to opt-out if the suicide will occur on-site. The hospital is seeking shelter in the Trump administration’s medical conscience protection policies.
Expect more of these kinds of disputes as many U.S. hospitals are Catholic or otherwise religiously affiliated with churches that reject abortion and assisted suicide doctrinally. From the Kaiser Health News story:
More doctors and patients in the country are providing and receiving health care subject to religious restrictions. About 1 in 6 acute care beds nationally is in a hospital that is Catholic-owned or -affiliated, said Lois Uttley, a program director for the consumer advocacy group Community Catalyst. In Colorado, one-third of the state’s hospitals operate under Catholic guidelines.
The ACLU has already sued several Catholic hospitals over the last few years seeking to force them to violate Church doctrine on issues ranging from sterilization, to abortion, to sex-change surgeries.
Medical conscience disputes are going to become far more common as health care becomes immersed in our accelerating cultural conflicts and vexing questions of federalism. Bottom line: The ultimate goal of those who seek to force medical professionals and institutions to violate their religious beliefs, I believe, is to drive pro-lifers and Hippocratic Oath-adherents out of medicine.
7 The Denver Channel
The Associated Press
DENVER (AP) — After watching his mother die slowly when he stopped her medication, Neil Mahoney knew he wanted the option of ending his own life peacefully when a doctor told him in July that he had months to live after being diagnosed with cancer.
A physician was willing to help him do that under Colorado’s medically assisted suicide law, but she was fired by Centura Health, a Christian-affiliated health system, for violating its guidelines on the issue. . . [Full text]
Kaiser Health News
DENVER — A Christian-run health system in Colorado has fired a veteran doctor who went to court to fight for the right of her patient to use the state’s medical aid-in-dying law, citing religious doctrine that describes “assisted suicide” as “intrinsically evil.”
Centura Health Corp. this week abruptly terminated Dr. Barbara Morris, 65, a geriatrician with 40 years of experience, who had planned to help her patient, Cornelius “Neil” Mahoney, 64, end his life at his home. Mahoney, who has terminal cancer, is eligible to use the state’s law, overwhelmingly approved by Colorado voters in 2016.
The growing number of state aid-in-dying provisions are increasingly coming into conflict with the precepts of faith-based hospitals, which oppose the practice on religious grounds. . . [Full text]