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Can A Doctor Refuse To Treat A Pregnant Woman?

When a person becomes a doctor they recite the Hippocratic Oath, in which they vow to treat the sick and the injured. The phrase "first, do no harm" is often attributed to the oath, but it doesn't actually appear in it (it's from another text by the philosopher Hippocrates). The oath has been updated as medicine has evolved, but the ancient version of the oath actually made doctors swear not to provide a woman with an "abortive remedy." In the modern age, even though abortions are legal, there are still doctors who won't perform them. Can a doctor refuse to treat a pregnant woman based on their religious beliefs? The laws vary depending on where you live, but in some places they can.

The practice of medicine — and therefore what's expected of physicians — has evolved since Hippocrates' time. That's why the oath that new doctors take has changed as the times have. That doesn't mean that some physicians aren't beholden to old ways of thinking about and practicing medicine. While it could be argued that doctors have a professional — and perhaps even moral — obligation to treat a patient regardless of their personal, political, or religious beliefs, there are certainly healthcare professionals who count their individual, personal freedoms over the health and wellbeing of their patients.

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This is a particularly thorny issue where reproductive health is concerned. Contraception, premarital sex, and abortion are all issues that many Christian religions find deeply offensive. As is laid out by the Constitution, for someone who is adherent to the beliefs of those religions, they are well within their right to be offended. Additional laws dictate to what extent they are allowed to prioritize their religious freedom over another person's rights. For physicians, who often have the life of another person in their hands, the question of whether it's ever appropriate for them to put their personal beliefs first has come up again and again.

From a legal perspective, the decisions tend to be made on a state level; under the Affordable Care Act, physicians have been federally prohibited from discriminating based on a number of factors, including sex, gender, and race. After the Hobby Lobby case — which asserted that businesses could refuse to provide contraceptive coverage to employees if it went against their religious beliefs — several states became interested in dismantling provisions of the ACA that would allow religious beliefs to serve as a justification for denying coverage or, in the case of healthcare providers, services.

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Back in January, a court in the state of Texas ruled that doctors could refuse to treat transgender patients, or patients who had previously had an abortion, based on their religious beliefs, according to Mic. The ruling, which came from U.S. District Judge Reed O'Connor, prioritized the religious freedom of individual physicians over the healthcare needs of patients.

Even prior to rulings that make it perfectly legal to do so, physicians have certainly been known to assert their religious freedom as grounds for refusing to treat patients, particularly where birth control and abortion is concerned. They have, at times, also included pharmacists who refuse to fill prescriptions for emergency contraception, according to USA Today. Due to a number of rulings made over the last few presidential administrations, physicians have largely been protected in their right to refuse treatment based on moral or religious objections. Their ability to receive government funding in spite of denying service has also remained protected — even in the ACA, which rescinded some of the other protections put in place by the Bush administration, according to the Department of Health and Human Services. Healthcare organizations and institutions that are religiously-affiliated (such as Catholic hospitals) often refuse to perform a number of reproductive health services based on their religious beliefs, according to the National Women's Law Center.

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Whether the denial comes from an entire healthcare system, or one individual physician, the National Women's Law Center also pointed out a number of detrimental effects to patients. Certainly health risks, economic impact, and even death are among the most pressing, but patients may also have their rights infringed upon if a physician asserts that their rights take precedence.

The dynamic between physician and patient is not an equal one: if a physician asserts that their religious freedom is more important than a patient's right to refuse treatment, or to access emergency services, then the patient's Constitutional rights have been violated — including their right to life and health. Until both medicine and the law work in the best interest of the patient, that unequal and ultimately harmful power dynamic isn't likely to change.