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Strong Medicine: First, Do No Harm (Unless You’re Religious)

Headlines were made in Britain this week when it emerged that some checkout workers at one of our largest supermarket chains, Sainsbury’s, are refusing to handle alcohol products because of their Muslim beliefs. The supermarket has pronounced itself happy to accommodate their sensibilities, and so if your cashier objects to the bottle of wine you’ve got in your basket, you’ll have to wait for another member of staff to come across and ring the purchase through for you. There has been some pleasingly acerbic commentary from the blogosphere as a result, notably Scottish schoolteacher Shuggy, who’s now on the lookout for a new posting:

One can only be impressed with people who refuse to do their job yet still get paid for it. If anyone's aware of a religion that proscribes dealing with obnoxious adolescents could they let me know and I'll sign up.

Quite. But a private retailer is perfectly entitled to make whatever arrangements it sees fit with its employees; if my local Sainsbury’s has long lines at the checkout, maybe next time I’ll take my custom elsewhere. The consequences of allowing people to pick and choose which parts of their jobs they are happy to perform, however, go much further than queuing to buy booze. Some Muslim doctors in the British National Health Service are going so far as to purposely avoid lectures on alcohol-related or sexually transmitted diseases, because it offends their religious beliefs. From the Sunday Times:

Some trainee doctors say learning to treat the diseases conflicts with their faith, which states that Muslims should not drink alcohol and rejects sexual promiscuity.

A small number of Muslim medical students have even refused to treat patients of the opposite sex. One male student was prepared to fail his final exams rather than carry out a basic examination of a female patient.

Nor, of course, is this solely a Muslim issue. In the US such religious considerations are more often voiced by Christian doctors, particularly in the context of emergency contraception and fertility treatments. Notable cases have included a lesbian woman in California was refused artificial insemination because of her sexual orientation, and a doctor in Washington refused to fill out the prescription that would have put lead in a gay man’s pencil.

Religious groups argue that individual physicians and pharmacists should be allowed to choose what procedures they will perform (being pro-choice isn’t always bad, then, eh?). And some degree of accommodation for religious sensibilities does seem sensible – no doctor is forced to perform abortions, and indeed many on both sides of the Atlantic do not, and this is surely right.

But abortion in the US and UK is, by and large, freely available. You schedule an appointment to have the procedure done and it is done; you don’t give a damn if someone has passed on performing it. And, despite the best efforts of activists, time limits are generally fairly generous; a delay of a day or two is seldom of much consequence. But not all medical situations have time on their side.

Picture the case of the woman who has been raped and goes to an emergency room to try and get the morning-after pill, only to be turned away on religious grounds. It’s been claimed – by a pro-choice Catholic group – that only 167 of 597 Catholic hospitals in the US offer emergency contraception to women who have been raped. Quite apart from the emotional distress involved in having to go from hospital to hospital to find a non-judgemental pharmacist (“I sympathise, honey, but you don’t have the right to kill that baby”), emergency contraception is more effective the quicker it is taken. (Nor, by the way, is this a mere debating point. It’s estimated that there are 25,000 pregnancies in the US every year as a result of rape. Read that sentence again.)

Freedom of religion is an important right and, in the sphere of private worship, inviolable, but it seems to me that if you take the Hippocratic oath then you don’t get to turn patients away at the door because you don’t approve of their lifestyles. I say this as a libertarian who believes, strongly, in an individual’s freedom to believe whatever he likes and practice his religion accordingly. But when we have a situation where doctors are not even willing to learn about diseases like gonorrhea, or cirrhosis of the liver, simply because they disapprove of the lifestyle choices that hasten their onset, then those choices are putting lives at risk, and that’s just not acceptable. Refusing to show up for those bits of the course you don’t care for just shouldn’t be an option.

And who’s to say it ends here? What about white supremacists that don’t want to treat black patients? Are we to permit Christian fundamentalists to refuse treatment to drug users? Democrats? Jews? (If so, that’s Aaron Sorkin fucked.) And if you think that’s ridiculous, exactly what is the bloody difference? If you call yourself a doctor, and you’re tempted – even for a second – to pass on treating a patient with liver damage because your religion forbids you from drinking alcohol, you might want to stop and ask yourself if you aren’t in the wrong profession. Wouldn’t you be happier cutting hair or running a dry cleaner’s instead? 

Bigotry is bigotry, no matter what religious garb you dress it in. It’s a shame so many people are willing to make excuses for it.

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