Tuesday, November 15, 2022

Minton v Dignity Health

Evan Minton, a 35 year old transgender man, was turned away from Mercy San Juan Medical Center (a hospital in the Dignity Health medical chain) in California. Minton had a hysterectomy scheduled for months at this hospital and, up until a day before the procedure, he thought everything was fine. A nurse called two days prior to the surgery and Minton offhandedly mentioned he was transgender. The procedure, which is very commonly performed at that very hospital, was canceled the next day. Minton’s doctor regularly performs hysterectomies and made a statement saying it was clear that it was canceled based on Minton’s transgender status and it was the first time a surgery like this had ever been cancelled on her. The hospital cited religious reasons for canceling the surgery and Minton filed a lawsuit against Dignity Health, the largest medical provider in California. Minton sued based on the hospital's alleged violation of California’s Unruh Civil Rights Act. This is an anti-discrimination law in California’s Civil Code which states any business cannot engage in unlawful discrimination. The question at the basis of this case is whether or not Mercy San Juan Medical Center allowing a medical procedure that they deeply oppose on religious grounds violates their right to religious free exercise.

As established in Burwell v Hobby Lobby, corporations have personhood and should be treated legally as people. This case allowed Hobby Lobby (a for-profit store chain) to have a religious exemption from providing contraceptives in their healthcare plans. An important part of this decision was that the Green family (the owners of the Hobby Lobby stores) rooted the running of the stores in accordance with their deep religious principles. On the Hobby Lobby store website you can find the donations and ministry tab describing the multitudes of religious causes and churches that the Green family donates money to. A difference in the Dignity Health conglomerate is that on their website they are dedicated to diversity and not excluding any individuals, going so far as to have a tab on LGBTQ+ individuals. In their own words from their website, they “understand the unique health needs of the LGBTQ+ community, and [they] work hard to ensure that patients receive quality, inclusive, culturally competent care.” Additionally, their policy states that they will not “exclude, deny benefits to, or otherwise discriminate…on the grounds of race, color, national origin, disability, age, sexual orientation or gender identity and expression.” This statement from the hospital chain itself is one of the differences between Hobby Lobby and Dignity Health. However, the hospital had been deemed a Catholic hospital, as clear by the cross on the hospital itself. 

Minton was denied care in 2016 and the Supreme Court held onto the case until Fulton v Philadelphia was decided and then the case was denied review soon after. This makes Fulton v Philadelphia a relevant precedent in this case. In Fulton v Philadelphia, Philadelphia barred Catholic Social Services from placing kids in foster homes based on their same-sex couple discrimination. The Supreme Court decided that the city of Philadelphia violated Catholic Social Services free exercise. Catholic Social Services is a non-profit organization, however, and clearly religious based on just the name alone. Another relevant precedent is Cummings v Premier Rehab Keller. Cummings has been deaf since birth and is also legally blind, and when seeking physical therapy she asked for an ASL interpreter. Premier Rehab Keller refused and said she could communicate by writing, reading lips, or providing her own interpreter. Cummings went to another center but sued based on emotional distress. The Supreme Court ruled that emotional distress is not covered by the Constitution and that she could get her services elsewhere. This is relevant because Minton eventually went to another hospital to receive his gender affirming surgery after he was denied care in 2016. 

Furthermore, the lower courts decided that Dignity Health was in violation of California’s anti-discrimination laws. This decision is one that logically I agree with, however, based on the precedents relevant to this case, I do not believe the Supreme Court would have ruled in this way. Henceforth, my stance is that in the case of Minton v Dignity Health, Dignity Health has the right to deny care based on religious exemptions. Dignity Health, as a corporation, has the rights of personhood and therefore they are a private company which can deny care to anyone based on religious reservations. This is especially true based on recent state laws with which South Carolina has become the seventh state to enact a law that allows healthcare providers to deny care to anyone based on religious beliefs. This is especially directed at the LGBTQ+ community. Based on all of the relevant laws and precedents, my opinion sides with Dignity Health and their religious freedoms.  

Article:

https://www.aclu.org/press-releases/supreme-court-declines-review-ruling-favor-patient-who-was-denied-care-being 

Sources:

https://www.aclu.org/cases/dignity-health-v-minton 

https://www.scotusblog.com/case-files/cases/dignity-health-v-minton/ 

https://www.nclrights.org/our-work/cases/minton-v-dignity-health/ 

https://www.hobbylobby.com/ 

https://www.dignityhealth.org/sacramento/locations/mercy-san-juan-medical-center

 

7 comments:

  1. While I do agree that the precedents lean in favor of the hospital, I side with Minton on this issue, mainly for the reason of the slippery slope. If a hospital can turn down services to people based on parts of their identity they have no control over, it is likely there will be serious implications. People should be able to receive medical services regardless of how they identify, and if people can be refused a hysterectomy required to make their body align with how they feel what else could be refused? And while Minton was able to get surgery at another hospital, there are many medical services that don't have the luxury of waiting. Hospitals should not start turning down services as the precedent will be deadly.

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  2. Great job! I think citing the Fulton v Philadelphia and Burwell v Hobby Lobby really evaluated your argument! I think denying his treatment is justified as it requires the nurse to engage in a surgery that is directly related to the status of his gender, which is inconsistent with her religious beliefs. Futhermore, due to the corporate nature of the establishment, I believe, similarly to private businesses, they are justified to have these religious beliefs. However, I believe had the surgery been unrelated to his sex or gender or it had not been a corporation, I think there could be a greater case made for discrimination, as they would be directly discriminating on the basis of his identity.

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  3. I agree that Dignity Health was within their rights to deny service to Minton. Although this decision does seem to have violated the Unruh Civil Rights Act, the denial of service was done in order to preserve the deeply held religious beliefs of Dignity Health's Mercy San Juan Medical Center Employees. It is particularly worth noting that Minton's hysterectomy was not a medically necessary surgery. Minton was not at risk of dying or suffering permanent disability if the procedure was not completed. Minton can still visit any of the thousands of other medical centers in Southern California to have the procedure completed, so granting Dignity Health an exemption in this case has exceptionally few broad-reaching ramifications.

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  4. Great work! I agree with your assessment of this case and your conclusion. I especially like the way that you drew parallels between this case and that of Burwell v. Hobby Lobby, as there are definitely important precedents set regarding the personhood and rights of a corporation. However, I am a bit thrown off by the hospital's webpage and specifically, the statements regarding their acceptance of LGBTQ+ individuals and their efforts to "ensure that patients receive quality, inclusive, culturally competent care". This surely does not align with the actions the hospital has taken from day-to-day. I wonder if their inclusion of this policy on their website would have any effect on the way the Supreme Court would evaluate this case, and if it could potentially lead to a different result than we saw with Burwell v. Hobby Lobby.

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  5. You had a great post! I also agree with your stance because of the many examples you provided of precedent cases. I also liked how you incorporated the Hobby Lobby case as well because it goes to show that since the hospital has Catholic affiliation, they do have some say in what goes against their religion. Reading previous comments, I also seemed to be a bit thrown off by the hospital’s website talking about diversity and not discriminatating. It was ironic because the hospital directly discriminated against Milton by denying his surgery because of him being transgender. However, the religious beliefs must be upheld by the Constitution, therefore, that Dignity Health had the right to deny Milton the surgery based on their religious beliefs.

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  6. This is a great post! I agree with the points you made in this post. Bringing up the Hobby Lobby case sold me on your point. Hobby Lobby was able to maintain its corporation to align with its religious beliefs and then able to apply that to all of its employees. The hospital is acting in a similar way because they are able to enforce their religious beliefs through their work. The Constitution allows Dignity Health to deny this surgery to Minton. As another comment brought up, Minton's surgery was not necessary surgery to keep them alive. If this surgery was an emergent, necessary surgery, then I believe the outcome of this case would result different. There is a substantial burden placed on the religious workers within the hospital to decide between choosing to follow their religious beliefs or choosing to do surgery while breaking their religious beliefs. There are alternative means for Minton because they can go to another hospital nearby.

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  7. This is a great post. Its strange however that a hospital would deny medical treatment to someone because they are transgender--don't hospitals have a duty to provide medical care to anyone who needs it? Furthermore, since surgery was denied because of the persons transgender status, it seems rather viable for them to be able to sue the hospital for gender based discrimination.

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