Hobby Lobby Ruling Raises Question -- Can Religious Doctors Deny Transfusions?
June 30, 2014 7:57 PM
(Source: National Blood Donors Month)
Likewise, can Jehovah Witnesses deny their employees coverage for blood transfusions under the RFRA?
Could a doctor who owns their own independent practice or clinic deny patients a life saving transfusion, if they providing blood transfusions is against their religion?
Could an employer ask insurers to prevent employees from receiving payment for blood transfusions?
[PDF] by the Supreme Court of the United States (SCOTUS) in the case
Burwell v. Hobby Lobby Stores, Inc.
leaves open the possibility that doctors and business owners may now be able to refuse their employees/patients from life-saving blood transfusions. And it's actually a legal issue that could be tested in the wild as there
are some Jehovah's Witnesses
working as medical doctors in the U.S. today, and even more that own their own businesses, employing non-witnesses.
Jehovah's Witness's guiding doctrine -- The Watchtower -- declares unequivocally:
Blood must not be eaten or transfused, even in the case of a medical emergency.
State Supreme Courts and appellate courts in some states have
[PDF] an adult patient's right to refuse treatment (for themself) for religious reasons. Could they refuse their employees or patients that right too, claiming their freedom of religion was at stake?
[Image Source: Atomic Market]
That could not be so, under the
The Patient Protection and Affordable Care Act
(PPACA) 2010 H.R.3590 (aka "Obamacare") -- or so it seemed. Under that law employers were
mandated to provide their employees access to no-cost access to twenty different kinds of contraceptives
-- similar policies apply to other "essential" treatments such as blood transfusions. This provision was designed in part because in the U.S., drugs are regulated by the
U.S. Food and Drug Administration
(FDA). Due to this regulation Americans
cannot freely purchase birth control at or near cost
; even generics carry relatively large markups.
However, the court ruled that under
The Religious Freedom Restoration Act
(RFRA) of 1993 a corporation owned by religions may be able to exclude opt not to follow federal mandates to provide certain kinds of treatments. The argument was that Obamacare was infringing on the corporations' (which are viewed as a "person" with freedoms in U.S. courts) were rights under the RFRA, hence a lower court decision granting an exemption from providing birth control to employees was upheld.
Patients and employees could potentially be denied blood transfusions if corporations choose to exercise their religious "rights". [Image Source: Rex]
The New York Times
posed the issue that pharmacists
who own their own businesses could deny patients birth control under the RFRA. It points to one study that suggests that 6 percent of pharmacists would refuse to give patients birth control
they could do so legally.
For now, the issue is somewhat overstated as Wal-Mart Stores Inc. (
) offers one brand of off-prescription generic
for $4 USD
(per monthly pack) -- which is still not at cost, but at least much lower. On the flip side that's one formulation out of 10-15 common birth control formulations -- the rest cost between
$20-100 off prescription
at last check. And to be fair most don't realize that Hobby Lobby -- the defendant in the case -- had offered to pay for some forms of Birth Control, just not 4 out of the 20 suggested options, including Plan B.
Returning to the issue of blood transfusions, the decision states:
This decision concerns only the contraceptive mandate and should not be understood to hold that all insurance-coverage mandates, e.g., for vaccinations or blood transfusions, must necessarily fall if they conflict with an employer’s religious beliefs. Nor does it provide a shield for employers who might cloak illegal discrimination as a religious practice.
The phrase is "not necessarily'. So the door is still open to demand that at some point -- but it will remain an issue for future courts to rule on and decide. Or other interesting scenarios could also occur, such as an Islamic doctor not wanting to use pig-derived pharmaceutical.
The Supreme Court does assert that racism towards employees was not protected by religious exemptions. But for something like blood transfusions, which do not represent an immediate transmittable public health risk if refused, such a religious freedom exemption might be possible, even if deadly.
SCOTUS [ruling -- PDF]
The New York Times
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