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A rights checkup

The state high court ruling is clear: Doctors can follow their faith but can't discriminate against patients.

August 21, 2008

Most people would agree that doctors, like everyone else, should be able to live according to their religious principles, and that gay and lesbian people, like everyone else, should have access to medical care. But which takes priority when those two rights clash? Ruling in a San Diego County case, the California Supreme Court chose the right to medical care, correctly focusing on the basic principle of nondiscrimination.

The case involved a lesbian, Guadalupe T. Benitez, who was turned away when she sought artificial insemination from an obstetrics and gynecology medical group. Benitez claimed she was refused because of her sexual orientation; the doctors said they wouldn't perform the procedure on any unmarried woman. In 1999, when the incident occurred, the doctors would have been within their rights, though state law now bars discrimination based on marital status.

Those points remain in dispute. But the justices were clear on one point: Doctors, in the course of operating a business, cannot refuse a patient because of his or her sexual orientation, just as they would not be allowed to reject patients based on their race.

This leaves doctors who hold certain religious beliefs in an uncomfortable situation, one they can best manage by helping individual patients find the best practitioners for their specific medical needs. But they have not lost all rights to practice within their beliefs. Physicians can refuse to perform any procedure, such as abortion or in vitro fertilization, that they find morally objectionable. But if they do perform such procedures, they cannot provide them to some groups of patients and not to others. It is true that artificial insemination is an elective procedure, not a matter of saving life or limb, but that's not the issue here.

A clothing store may choose not to sell polo shirts. But once it sells polo shirts, it cannot withhold them from customers based on their race, religion, sexual orientation and so forth. Various religious groups, including Jewish and Islamic clergy, sided with the doctors in this case. It's intriguing to ponder what they would make of a doctor who declined, based on personal convictions, to provide care for patients who belonged to religious minorities.

The case already has some people crying judicial activism, as they did in the ruling that recognized the right to same-sex marriage in California. The principle is indeed the same, though activism has nothing to do with it. The court is simply noting, with clarity and consistency, that as a protected class, gays and lesbians are entitled to equal treatment.

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