Can an emergency medical technician refuse to transport a patient to an abortion clinic, or a pediatrician refuse to perform a circumcision?
In most situations, the answer is yes, but the legal issues in Maryland are far from settled.
“How does a pharmacy?s refusal to carry an emergency contraceptive effect a poor teenager living in a rural area only served by one pharmacy,” lawyer Robin Wilson asked a group of lawyers, doctors, clergy and health care professionals Tuesday. “Most pharmacies only carry 15 percent of all available drugs.”
Yet there is no hue and cry when a person can?t find a hypoallergenic form of suppository, even after visiting several pharmacies, Wilson said.
Maryland guarantees any physician the right not to perform or take any part in procedures involving artificial insemination, sterilization or abortion ? provided the refusal does not endanger anyone?s life. In reality, however legal contracts and medical ethics can be much more restricting.
In the pharmacy case, the public domain has developed a response with Web sites that rank major pharmacies by their policies on objections of conscience.
Other problems arise in hospital settings when patients refuse certain treatment based on religious exceptions.
“We tend to get mostly end-of-life issues,” said Herbert Lodder, chaplain and ethics board member at Johns Hopkins Bayview Medical Center. “My personal inclination is to see most of them as communication issues.”
Often patients may not understand their medical options or a doctor?s explanation. In those instances they can talk to one of the four on-call ethics board members.
In the delivery room, anesthesiologist Paul Van Nice, of Shady Grove Adventist Hospital in Rockville, has had Muslim women object to having a manadminister an epesiotomy, the most common form of pain relief for labor.
“It?s never turned into a major issue, because we?ve always been able to accommodate them with a woman anesthesiologist,” he said. “In cases where we can?t, usually the woman herself reorganizes her priorities.”
In emergency situations, Wilson said, the best policy is live and let live, often a compromise can be reached that doesn?t violate anyone?s conscience.
