The "Patients' Bill of Rights" will soon reach center stage.
Despite the sparring that has already begun, both the
President and Congress apparently agree that the time has
come to enshrine in law rights patients must be accorded
during medical treatment. This, to better ensure, and
enhance, the quality of health care in our nation.
But there is something missing. Indeed, there is one
protection -- one "right" -- that is glaringly absent from
the public discourse: "A patient has the right to receive
medical care that gives due deference to his or her
religious beliefs and moral convictions."
This is not a trivial concern. Many Americans of faith
approach health care issues imbued with the conviction that
the preservation of life, and the promotion of good health
and well-being, are religious imperatives that emanate from
the inherent sanctity of human life. We also believe -- a
belief embodied in the "patients' rights" concept itself --
that quality health care is inextricably linked to respect
for the patient and to his or her active involvement in the
decision-making process.
Religious concerns during medical treatment have evolved
over time. Thirty years ago, the problems that arose in
medical facilities dealt primarily with matters of religious
ritual. In the Orthodox Jewish community, for example, our
concerns centered mostly on the ability of Jewish patients
to receive appropriate medical treatment without being
forced to unnecessarily violate the Sabbath, holidays,
kosher dietary laws or other Jewish observances.
Highlighting these issues has helped sensitize health care
providers to the importance of accommodating the religious
practices of their patients.
But the scope of the problem has profoundly broadened in
recent years. It is no wonder. Advances and breakthroughs in
medical science and technology have deeply implicated
religious and moral beliefs in unprecedented ways.
From "beginning of life" issues related to infertility,
genetic screening, surrogate motherhood, genetic
engineering, cloning, and selective reduction, to "end of
life" issues involving euthanasia, assisted suicide,
withdrawal of life support systems, DNR orders, autopsies
and organ donations, Americans are confronted with an array
of moral decisions and choices today as never before.
Current trends in the provision of medical services -- such
as health care rationing and managed care -- inevitably
complicate these dilemmas even further.
With these momentous changes there must be a heightened
sensitivity toward matters of religious conscience and
conviction. Such concerns -- whether expressed directly from
the patient or, in cases of incapacitation, ascertained only
after active consultation with his or her
religious/spiritual advisor -- merit consideration and
sufficient weight when the "best interests" of the patient
and the most appropriate course of treatment, or non-
treatment, are determined.
"Due deference," of course, does not confer an absolute
right, and there is no argument here that a patient's
religious convictions are paramount in all circumstances.
For example, in those extraordinary cases where parents'
religious beliefs would withhold life-sustaining medical
care to their children, the U.S. Supreme Court has asserted
an overriding interest in the preservation of life that
would trump the parents' religious wishes. But those types
of cases are the exceptions that prove the rule; in ordinary
cases, religious wishes merit medical respect.
The notion of due deference to a patient's religious
convictions is surely not foreign to the law. In New York,
for example, there exists a range of religious accommodation
provisions that cover such medical issues as DNR orders,
health care proxies, determination of death,
autopsies/dissections, and anatomical gifts. Under these
laws, health care providers must generally respect the
religious beliefs of their patients -- and are even
obligated to make a reasonable, good faith effort to
ascertain what those beliefs might be.
Americans deserve this protection. Respecting a person's
religious and moral beliefs is integral to human dignity and
a matter of the most fundamental of civil rights -- it has
even been shown to be helpful in the healing process itself
-- and deserves no less protection in a "Patients' Bill of
Rights" than matters of confidentiality, choice, cost
information and other compelling objectives already
identified.
AM ECHAD RESOURCES: Abba Cohen is Washington director and
counsel for Agudath Israel of America; this article first
appeared in the Baltimore Jewish Times.
