Linda Dunn
It’s rare for me to read a column with which I disagree so strongly that I feel compelled to write a response. However, the column by Marke Franke in the Daily Reporter for November 3 is one that I cannot ignore.
Yes, faith-based hospitals play an important role in our healthcare system, and I agree health care professionals should not be coerced into performing procedures in violation of their consciences. However, I take issue with the idea that a medical provider should not be required to provide referral information when they have that information available.
He phrased it as, “I can’t in good conscience do what you ask but supposedly I can in good conscience send you to someone who will?”
Yes, in my non-professional opinion. Sometimes, you should.
The long standing guide to medical care has been “primum no nocere” – “first, do no harm.” If you withhold information that could save someone’s life or even “just” affect their quality of life, aren’t you doing harm?
I will limit my potentially long list of examples to one that should be obvious to anyone who has ever had a friend, relative, or co-worker with a “fallopian tube pregnancy.”
There are limited options for treatment of ectopic pregnancies: (1) Monitor; (2) Partial or complete removal of the fallopian tube; (3) salpingostomy – slit the fallopian tube and remove the trophoblastic cells along with damaged tubal tissue; and (4) administer methotrexate which prevents the trophoblastic cells from continuing to divide and damage the tube. There is no option that results in a live birth.
Ohio legislators tried to legislate their way out of this situation back in 2019 with a pro-life bill that required doctors, to avoid criminal charges, including murder, for abortion to “…[attempt to] reimplant an ectopic pregnancy into the women’s uterus… ”
As many tried to explain to Ohio lawmakers: This is not medically possible. Maybe if we had Star-Trek-era medicine or a Harry Potter Book of Magic Spells … but this is real life and it is not possible … not even with the strongest possibly worded legislation and promised criminal enforcement.
In El Salvador — which has had the type of total abortion ban that many of us believe we want codified into law — they take a strongly “pro-life” approach to this ethical issue: monitor a tubal pregnancy until the tube ruptures and then provide medical care.
Most patients survive.
Most patients don’t have a second ectopic pregnancy and lose their ability to conceive either but if they do, IVF is a legally available option. Should we expect faith-based care providers to offer us a referral?
Some religions hold that any technological intervention into the process of human reproduction is immoral. If medical personnel believe that adoption is the only moral path for infertile patients, then do they have the right to refuse to refer a patient to someone who offers legally available alternatives? If so, how can we know in advance if our medical provider shares our same belief system about our particular health issue and will provide us the level of care we desire? We could discuss this in advance but that’s not always an option when emergencies develop.
Many won’t agree with me on this, but I firmly believe that medical personnel should be unshackled from personal biases and faith-based policies that prohibit them from providing patients the facts (and sometimes even referrals) they need to make potentially life-altering decisions about their health needs.
Perhaps more readers would agree with me if I’d written instead about my friend, whose doctor may have believed that bringing a pregnancy to term for a short life of pain and suffering was immoral … or there could have been some other reason why abortion was his firm and only recommendation.
(They found specialists and alternatives and their daughter is now a teenager.)
One of the problems with “faith-based” care — and why we have so many sharp disagreements, not just on life’s beginning but also its ending — is that we cannot seem to agree on whose beliefs should prevail. We’re all certain that we’re right and the other person is at least misguided and ill-informed if not outright evil.
Battles over who decides when to extend or withhold care has been argued in many courts countless times and has led to long court battles in which few are seldom satisfied with the outcome.
So yes, there are indeed times when I believe that faith-based medical organizations and/or medical people should essentially say, “I can’t in good conscience do what you ask but I can in good conscience send you to someone who will.”
Is this really too much to expect from those whom we entrust with our health?
A lifelong resident of Hancock County, Linda Dunn is an author and retired Department of Defense employee.
