SAN FRANCISCO — Doctors may not discriminate against gays and lesbians in medical treatment, even if the procedures being sought conflict with physicians' religious beliefs, the California Supreme Court decided unanimously Monday.
In its second major decision advancing gay rights this year, the state high court ruled that religious physicians must obey a state law that bars businesses from discriminating on the basis of sexual orientation.
"The 1st Amendment's right to the free exercise of religion does not exempt defendant physicians here from conforming their conduct to the . . . antidiscrimination requirements," Justice Joyce L. Kennard wrote for the court.
The decision stemmed from a lawsuit filed by Guadalupe T. Benitez, an Oceanside lesbian who lives with her partner and wanted to become pregnant with donated sperm.
Benitez filed a suit after Dr. Christine Brody, an obstetrician and gynecologist at the North Coast Women's Care Medical Group in Vista, said she would not perform an intrauterine insemination. In her lawsuit, Benitez alleged that Brody said her religious views prevented her from providing the procedure to a lesbian.
Another physician at the clinic, Dr. Douglas Fenton, later told Benitez that the staff was uncomfortable helping her conceive a child and advised her to find another doctor outside the medical group, Benitez said.
The doctors denied the allegations. Brody said she would not perform the procedure on any unmarried woman, heterosexual or homosexual.
The state high court said the doctors' constitutional rights to freedom of religion did not trump the state antidiscrimination law because the state has a compelling interest in ensuring full and equal access to medical care.
But the doctors "remain free to voice their objections, religious or otherwise, to the [law's] prohibition against sexual orientation discrimination," Kennard wrote.
The court also said the doctors could testify at a trial that their religious beliefs barred them from doing the procedure for reasons other than the patient's sexual orientation.
Robert Tyler, general counsel for Advocates for Faith and Freedom, predicted that the ruling would spur voters "to recognize the radical agenda of our opposition" and support a November ballot initiative that would amend the state Constitution to ban same-sex marriage in California. A state Supreme Court ruling in May made gay marriage legal.
Kenneth R. Pedroza, who represented the doctors, said the ruling would probably cause many physicians to refuse to perform inseminations at all. Pedroza said Brody did not violate the law because it did not bar discrimination on the basis of marital status when Benitez sought insemination in 1999. The state law has since been amended.
Asked whether Brody would perform the procedure on a married lesbian, Pedroza said: "I don't know."
But Jennifer C. Pizer, senior counsel for Lambda Legal, said Benitez's experience was "sadly common" for lesbians seeking reproductive healthcare.
"We get calls routinely about it," she said.
Benitez, 36, who is now the mother of three, said she has been pursuing her case for 10 years.
"This isn't just a win for me personally and for other lesbian women," Benitez said. "It's a win for everyone because everyone could be the next target if doctors choose their patients based on religious views about other groups of people."
Justice Marvin R. Baxter, the court's most conservative justice, said in a separate concurring opinion that doctors could protect against liability by referring patients to other doctors in their practice who did not share their religious objections.
But he conceded that sole practitioners might have little choice and hinted that he might vote in a future case to spare them from the requirement.
"I am not so certain this balance of competing interests would produce the same result in the case of a sole practitioner," Baxter wrote. The court did not specifically address that question.
A spokesman for the California Medical Assn. said it opposes "invidious discrimination" and believes it is "not protected by a claim of a religious belief." The spokesman said he did not know what practical effect the decision would have on doctors and stressed that the group has no position on what the outcome of the lawsuit should be.
A trial court ruled for Benitez, but an appeals court overturned that decision in favor of the doctors. After the case landed in the state high court, civil libertarian groups sided with Benitez, and religious groups, including Jewish and Islamic clergy, argued that doctors were entitled to disavow treatments that conflicted with their beliefs.
Monday's ruling clears the way for Benitez's case to go to trial.