Healthcare workers treat patients. We do not judge who they are or what choices they made to need our service. Doctors and nurses do not treat the patients we like and turn away those who are not aligned with our morals and values. We do not pick and choose. Separating ourselves from value judgments is a critical step in proper patient care.
We treat the patient in front of us. No matter who they are.
The Arkansas legislature decided to toss this principle tenet of healthcare out the window.
Doctors and nurses in Arkansas can now refuse to treat patients based on moral or religious objections. Arkansas Governor Asa Hutchinson signed, The Medical Ethics and Diversity Act, SB 289, into law on March 26th.
The law states its purpose is “to protect all medical practitioners, healthcare institutions, and healthcare payers from discrimination, punishment, or retaliation as a result of any instance of conscientious medical objection.”
Health providers’ moral objections are the focus of the new Arkansas law, but the law does not protect patients from discriminatory practices from a healthcare provider. Instead, Governor Asa Hutchinson relies on federal law “that prohibits discrimination on the basis of race, sex, gender, and national origin.”
The Arkansas Medical Ethics and Diversity Act, SB 289, does not include language protecting against discrimination based on sexual orientation or gender identity.
Most media reports have framed the law as blatantly anti-LGBTQ legislation. The Human Rights Campaign fought against the bill because it allows doctors to refuse care for transgender and LGBTQ patients. Arkansas health providers can now legally refuse services to anyone based on a moral objection as long as it is not an emergency or violate federal EMTALA guidelines.
But the wording of the law goes way beyond issues of sexuality and gender. The law permits any healthcare provider to deny any medical services based on religious or moral objections.
ACLU of Arkansas Executive Director Holly Dickson pointed out the risks stating, “making it easier to deny people health care isn’t just wrong, it’s dangerous.”
The Arkansas law fails to acknowledge one of the most challenging aspects of medical care. Doctors, nurses, and other healthcare providers work hard to avoid value judgments when providing care. We work to see all patients as worthy and try to avoid bias.
Medical care is about placing value on each person’s life. Although challenging, health providers try to avoid considering patient culpability when treating people. Our personal feelings must be checked at the door. We treat the person in front of us.
Pulmonologists do not refuse to treat or blame a chain smoker for getting lung cancer. Trauma surgeons treat drunk driving victims and the perpetrators equally. We do not refuse care to gang members who get shot or deny Covid-19 treatments to those who refuse to wear a mask.
In Obstetrics and Gynecology, we provide care to pregnant women who use illegal drugs and prescribe PrEP therapy to those with multiple unprotected sexual partners. We don’t insert personal bias or value judgments into patient care. We try very hard to do exactly the opposite.
Our job is to counsel patients on the risks of their life choices. We do not deny care to those who live their lives in ways differently than we do even if we find certain choices morally offensive.
Patient care is about the patient. Not the provider.
Multiple medical organizations are speaking out. So far, the Arkansas law is opposed by the American Academy of Pediatrics, the American Psychiatric Association, the American Psychological Association, the American Medical Association, the National Association of Social Workers, the University of Arkansas for Medical Sciences, and the American College of Emergency Physicians. Other organizations are likely to oppose the law as well.
This statement by the Arkansas Chapter of the National Association of Social Workers summarizes the general consensus saying, “no patient should ever be obstructed from receiving legal healthcare based solely on a provider’s personal values.”
Arkansas legislators and Governor Hutchinson must know this law will be challenged in court. Let’s hope the court remembers when it comes to patient care, the patient always comes first.