Monday, February 23, 2015

Pediatrician Denies Care To Child of Same-Sex Couple

On February 18th, it was reported that a Detroit couple's child was declined to be seen by her pediatrician. The reason for the pediatrician's refusal was the fact that the child had two mothers. Krista, the baby's biological mother, and Jami Contreras were the mothers who took their child to see Dr. Vesna Roi. Like most caring parents, Jami and Krista took the time to research and talk to the best pediatricians in the are for their newborn daughter, Bay.  They came across and decided upon Dr. Roi. Dr. Roi had been practicing pediatric medicine for 19 years. She was a doctor who took a holistic approach to treating children, which Jamie and Krista found to be an important criteria and one of the main reasons they chose Dr. Roi. Jami and Krista went into the doctor's office for a prenatal visit and explained that they were married and were very interested in having Dr. Roi as Bay's pediatrician. At the time, Dr. Roi showed no issues with the couple's sexual orientation and even told them to schedule an appointment when the child was born. The couple were optimistic about their baby's new pediatrician and scheduled the appointment.

Krista Contreras, 31, left, and her wife, Jami Contreras,The couple showed up to their scheduled appointment and were seated in the waiting room when much to their dismay another pediatrician who worked in the office came out to great them. The other pediatrician broke the news that Dr. Roi had changed her mind. Dr. Roi was quoted as saying that after "much prayer" she would be unable to act as Bay's Pediatrician because the Krista and Jami were lesbians. The couple was blindsided. Dr. Roi sent the couple an apology letter and claimed that she would be unable to form the bond with them that she does with the rest of her patients. She went on to say that they were welcome in the office anytime and could see another pediatrician if they would like. Dr. Roi was very apologetic, but firm in her beliefs and refuses to see Jami and Krista's child.

Even though Dr. Roi never explicitly stated that it was her religious beliefs that is preventing her from treating the child, it can be inferred from her statements in the letter such as "After much prayer..." and "Please know that I believe that God gives us free choice and I would never judge anyone based on what they do with that free choice..." The question is whether or not Dr. Roi has the right to discriminate against patients based on her religious beliefs.

The state of Michigan currently holds no law against discrimination against the LGBTQ community. In fact, only 22 states in the US do. Due to the lack of a law, there is no criminal or civil suit filed in this case. However, had there been statutes in place should Dr. Roi have been allowed an exception for her religious beliefs?

I believe that in this case, Dr. Roi should be compelled to see and treat the child. I believe that her religious exemption is trumped by the code and policies of the American Medical Association (AMA). "Respecting the diversity of patients is a fundamental value of the medical profession and reflected in long-standing AMA ethical policy opposing any refusal to care for patients based on race, gender, sexual orientation, gender identity, or any other criteria that would constitute invidious discrimination," the AMA said in a statement. These guidelines are only advisory, however I contend that they should be the guiding principles for all doctors. All doctors are also held to the ethical standards of the Hippocratic Oath, which I believe supersedes the religious convictions of Dr. Roi. This oath is often cited when doctors during war time treat enemy soldiers. Obviously they differ in belief, but these doctors are able to overlook this difference and treat any human to the best of their ability.

The most pertinent precedent to this case established by the US Supreme Court was in Reynolds v. United States. The court established in this case that there is a distinction between religious belief and the actions that stem from that belief. The state cannot establish law that mitigates belief. As a result, the Court believed the First Amendment forbade the state from legislating against opinion, but allowed it to legislate against action. In this case, there is a secular state interest in providing the best healthcare possible for the citizens of the state. There is substantial reasoning and precedent as to why Dr. Roi should be compelled to treat baby Bay.

I believe that this case has some similarities to the Phillips case, where the court compelled the Colorado baker to bake a wedding cake for a same-sex couple despite the baker's religious objection. In this case the good is medical care, which is a necessary good. In that case the good was a cake. The vitality of medical care along with the precedent set in Phillips further affirms my belief that courts would compel Dr. Roi to treat Jami and Krista's child despite her religious objection. I believe that Dr. Roi's religious objection holds no bearing here as the importance for proper medical care trumps her ability to discriminate. Jami and Krista sought out Dr. Roi and made an educated decision as to the doctor they wanted for their child and should not be denied proper care. The question I would raise is had the child been in critical condition, would Dr. Roi still object to treating her? I believe that she would put her beliefs aside.

Do you believe that Dr. Roi should be allowed to discriminate as to which patients she takes because of her religious beliefs?

11 comments:

Morgan M said...

I believe that while it is unfortunate that such circumstances arise, the government does not have the right to compel Dr. Roi to treat the child. Dr. Roi has clearly taken the time to think through her decision and the decision is clearly religious related. Dr. Roi has the right to exercise her freedom of religion, regardless of whether it discriminates against another person. Although this is of course not great for society, I still do not think that the government has the right to compel the doctor to treat the child.
If the situation was twisted and the doctor refused to give service to a clearly anti gay couple- would she have to? If we apply anti discriminatory laws, we must do them in every situation so that no person is discriminated against. Dr. Roi has the freedom to choose who she would like to serve and I do not think that the government should have a role in challenging that.
I also think that by making people treat others it could raise questions of ethics. Especially in the case of doctors or pediatricians, although we might not want to think that such things could happen, I wouldn't want someone to treat a child who holds bad views towards the parents. If we make people treat those who they do not want to it might be allowing for private or secretive discrimination, which could be more harmful for society than open discrimination.

Trevor T said...

I agree with Morgan. The lack of discrimination law protecting the LGBT community in Michigan is unfortunate and in my opinion wrong, but due to the lack of such law Dr. Roi has every right to discriminate her private service. She is justified to deny or accept service from whoever she pleases. Dr. Roi also has a right to exercise her freedom of religion and if she feels it would impact her ability to form a bond and take care of this families child then it is best that she make that clear and not become involved. The family is certainly being discriminated on based on sexual orientation, but in this state it is not illegal and therefore there is not constitutional conflict in my opinion. If she doesn’t feel comfortable treating the child then the parents shouldn’t feel comfortable having her treat the child either. No one is making the parents go to this doctor and Dr. Roi was apologetic and sympathetic to their situation, but felt she couldn’t preform her job to the best of her ability so she deferred the situation to someone else. The AMA ethical policy is nothing but a policy and is by no means binding and doesn’t take priority over the right to free exercise of religion and denial of a service. As we have mentioned in class it is complicated to attempt to legalize ethics or morality. Although I don’t personally support the decision of Dr. Roi to discriminate against a same sex couple and their child, I believe she is within her rights to do so.

Liz E said...

I agree that Dr. Roi was within her legal and constitutional limits to deny her services to a homosexual couple. If the state of Michigan does not have laws regarding discrimination of this manner then there is nothing a civil case can do about it. However, I would urge policymakers to reconsider this lack of a discrimination policy, especially in regards to medical care. Medical care should be a right and not a privilege. A newborn child should not be discriminated against because of the sex of her parents. Aside from that, I don't believe that doctors should be able to discriminate against patients. For me, baking cakes and officiating weddings is one thing, but healthcare is a completely different ballpark. Everyone should have access to the healthcare that they so choose and should not be discriminated against on the basis of their sex, race, sexual orientation, etc.

Alex L. said...

I agree with Morgan and Trevor above as I believe that as a private pediatrician Dr. Roi has the right to choose who she treats and who she does not treat. As long as the child is not in critical condition she cannot be compelled to take on this child as a patient. People, children included, are turned away from doctors for a variety of reasons such as when the doctor cannot support as many patients or perhaps when the patient notoriously does not show up to appointments. The bottom line is that doctors have the ability to pick and choose. Dr. Roi’s reasoning happens to be vested in religious beliefs, but she is entitled to those beliefs, whereas Krista and Jami are not entitled to have Dr. Roi as their child’s doctor.

Libby W said...

I agree with all commenters that Dr. Roi was not required to provide medical services for the child. However, I think the fact that she must abide by the Hippocratic Oath as a medical professional is the most important part of this issue. There may not be a law saying that she has to do this, but the oath she agreed to follows states that she will help anyone in need. She may then argue that she could still be helping Bay by assigning her to another high quality physician, but as the author pointed out, would she still refuse to provide care if this was a dire situation? I would hope that she would help the child, so when thinking from this perspective it would seem as though she should treat the child. By following the Hippocratic Oath I think she is required to help the child, but by law she does not have to.

Will P. said...

I believe that the government has no jurisdiction in this case to compel Dr. Roi to provide treatment to the couple's child. While it is clearly an unfortunate situation, there is no law requiring Dr. Roi to do so. Dr. Roi has clearly made a religious objection toward the couple, however has provided great assistance in providing them care in other ways. She has put them in touch with other physicians in her office. Given that it is a private practice, Dr. Roi has the right to refuse service to any patient she wishes. It is Dr. Roi's inherent right to refuse her services on religious grounds. I only contend that she had done so earlier in the process so the couple was not so reliant on her after the birth of their child.

Emily C. said...

I would argue that this case is different from the Phillips case regarding the baker and homosexual customer. I think in the Phillips case the baker had the right to refuse service because by baking the wedding cake it shows a support of the same-sex marriage which is contrary to the baker's religious beliefs; whereas providing medical care to a child of two homosexual parents is not directly endorsing homosexuality, and therefore does not have an immediate religious constraint.

I still would grant Dr. Roi the ability to refuse service in this case because her practice is private, but if she worked at a public hospital, I do not believe that her religious beliefs would grant her the right to refuse service to a child in these circumstances.

Nneoma I. said...

I absolutely believe that Dr. Roi should not be allowed to discriminate which patients she treats. As much as the doctor has the freedom to exercise her religion, her job as a medical professional holds her to a higher standard. Unlike the Phillips case, the doctor does not just provide a public service, but her profression holds weight over people's health and well being. Doctor's have an ethical standard to be non discriminatory in their practice. This is where protection laws and free exercise becomes tricky. In my opinion, denying a cake for a wedding and denying medical services are two completely different categories. Free exercise should not protect doctors from breaking the ethical code of medicine. All humans should have the right to health services regardless of their personal beliefs. The courts should find a way to enforce this.

Ben K. said...

I do not believe that Dr. Roi should be able to discriminate patients due to religious beliefs. Her actions can be understood as accomplishing a compelling state interest, that of caring for the citizenship of the state. Even though the State of Michigan does not have these laws against discrimination, the state should still uphold that the doctor must treat the patients. For other business models, to deny a customer based on religious affiliation is seen as wrong. However, denying someone from a public good, healthcare cannot be allowed. It would be like denying someone access to highways because they are Jewish.

Abby Copp said...

First, I would like to commend the author on this post for it being very informative and interesting! This circumstance proved to be problematic for me as far as my initial ability to make a decision, but I would have to agree mainly with the majority here. The most important part of the situation at hand is to remember that Dr. Roi did not break any law, therefore her actions were not legally unconstitutional. However, I am in full agreement with those who have said that healthcare treatment is a basic right for all, and it is based on this opinion that I say Dr. Roi should have put her religious beliefs to the side and agreed to treat the child. After all, it is not as though the child chose to be born to homosexual parents, so why deny her treatment from a better doctor (Dr. Roi)?

Nate McGuinness said...

Going back to the baker example from earlier this semester, I argued that the business owner should be compelled to bake the cake for the homosexual couple, looking toward the difference between belief and action as well as the notion that the state does have a compelling interest to wade into such situations because they are diffusing a potentially volatile situation, allowing for individual citizens to pick and choose who to provide such services to and who to refuse on the basis of factors outside of their control (i.e. sexual orientation) is inherently more a formula for disaster and instability within a state then simply denying that individual that broad arbitrary discriminatory power. The only factor here that makes me hesitant to say that the doctor should not be forced to treat the child is the fact that Dr. Roi has moved out of the public sphere and into a private practice, where doctors get to pick and choose their clients, which I agree with, however discriminating in this sense on the basis of something outside the clients control such as the parents sexual orientation falls under the same logic as before, if for instance the doctor refused because the patient had no health insurance and treating them would put their practice under that would be a more acceptable a logical reason. Generally though someone who enters into such a field and takes such a serious oath should especially not be able to conduct themselves like this.