Conscience Discrimination: The Hippocratic Oath and Anti-LGBT Legislation

By: Jeramy Ashton

The views expressed in this post are those of the author, and do not necessarily reflect views of the Journal, the William H. Bowen School of Law, or UA Little Rock.

“I will keep them from harm and injustice.” Upon entering the field of medicine, medical practitioners across the United States take an oath to “prescribe for the good of [one’s] patients.” The Hippocratic Oath, a famous code of medical ethics is used by medical schools across the country to remind physicians of the importance of their sacred duty. The modern oath narrowly reads that medical professionals will respect “scientific gains” and while in practice, remember the importance of warmth and sympathy. A growing number of alterations related to healthcare treatment have left society wondering to what extent do these words begin to lose their meaning. Are there caveats to such a vow? In holding on to the oath for so many years the answer is likely no, however, a variety of proposed exceptions allowing for medical providers to explicitly refuse a patient based on a “violation to the conscience” has many confused by the weight of the famous words. Through alterations to legislation and political divide, the oath still exclaims to vow to care for [all]. The tolerance of explicit prejudice in healthcare places minority communities at an unnecessary disadvantage from accessing preventative healthcare. A conflict with the conscience is not the fault of a patient seeking to ameliorate health and well-being and should not burden the workload of providers seeking to abide by their oath and care for the well-being of all.

It is commonly known that medical providers vow to “do no harm” and strive to consistently improve the health and well-being of our great nation. Historically however, a plethora of states have attempted to enact “conscience” related healthcare bans that would offer medical providers the right to turn away patients to avoid a conflict with a provider’s conscience or moral beliefs. The bigoted legislation including Arkansas’s Medical Ethics and Diversity Act and proposed Save Adolescents From Experimentation (SAFE) Act will allow for medical providers to exclude communities from their care and further marginalize disadvantaged communities. One cannot vow to keep every human from harm and injustice and later say that they desire protection from doing so.

In the 1980’s, The Emergency Medical Treatment and Labor Act (EMTALA) limited “conscience” related bans by preventing medical institutions from refusing to offer emergency medical care. Arkansas has joined other states such as Mississippi and Illinois in proposing a non-emergency conscience bill that will allow medical providers, pharmacists, and anyone in the line of treatment (including a receptionist) to explicitly reject a patient and in some cases, abolish access to essential healthcare needs for any reason that would violate the person’s conscience. In supporting the Arkansas legislation, supporters believe the Medical Ethics and Diversity Act will aid providers from being placed in a position that they “prefer not to.” A majority of supporters reside in a privileged position believing the legislation will not result in disastrous harm due to a number of providers still willing to see these patients.

Due to a historical [and continued] lack of preventative and mental health care related resources, LGBT people are severely encumbered by health disparities. Further marginalization will lead to detrimental repercussions on the already disadvantaged mental health of the community. The abject argument exists finding such legislation to be an asset­–inadvertently addressing the issue of implicit bias is masking explicit prejudice. The answer is not work harder to “find a provider who is comfortable.” A growing number of American’s are perplexed by the complexity of healthcare let alone facing financial burdens, phobias, and the additional hurdle of finding an in-network provider who is accepting patients and willing to see you. The answer is not cutting medical providers off from having to learn and fulfill their duty as a voluntary healer. The answer is not avoiding difficult conversations and working together to improve our nation’s health and well-being. Medical providers do not take an oath and vow to treat those they “prefer to,” or to “keep [some] from harm and injustice.” Our nation’s leaders preach, “preventative healthcare is key,” but dissolving access to healthcare resources is not the way to improve societal well-being.

If we choose to avoid growth, conversation, and knowledge in the early stages, we are setting our communities up for a tertiary disaster. The codification of anti LGBT+ related legislation is opening a new door of violations; an increase in harm; and ongoing injustice.



Posted in: Legal Comentary

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