“Religious refusals” are leaving rural patients without health care options

He needed a gender-affirming procedure. The hospital said no.

As rural hospitals shutter, and faith-based care grows, “religious refusals” are leaving some patients without options.

By s.e. smith Updated Nov 1, 2019, 9:30am EDT

In the summer of 2016, Evan Minton was preparing for his scheduled hysterectomy at Mercy San Juan Medical Center in Carmichael, California, just outside Sacramento. The procedure, part of his gender-affirming care, should have been routine.

But the day before, the hospital abruptly canceled his surgery; the hospital was Catholic, and a procedure that results in sterilization is a violation of the Ethical and Religious Directives that, with rare exceptions, govern Catholic hospitals. Minton had experienced what’s known as “religious refusal,” a growing — and divisive — phenomenon in which health care is denied on the basis of religious beliefs.

Catholic facilities argue that the directives are protected under religious liberty laws. Minton, who was unavailable for comment, felt he’d been denied care on the basis of his gender identity, making it a civil rights issue, and in September, a court agreed to let him continue a lawsuit against Dignity Health, which operated the hospital where he was denied care. (It later referred him to a Methodist facility in the same chain that performed his surgery.)

Minton’s fight for health care is the latest in a growing list of court battles over religious liberty and civil rights; the Supreme Court just heard a trio of cases about whether firing people on the basis of gender identity or sexual orientation is acceptable, and last year ruled in the Masterpiece Cakeshop case, which revolved around whether a Christian baker could refuse service to a gay couple requesting a wedding cake.

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When patients go to the doctor, they expect treatment rooted in the latest medical advancements, not interpretations of the Bible. But as medical facilities continue to close or merge with better-funded institutions, Christian hospitals, which may hew to religious doctrine when making treatment decisions, are becoming a lone source of care for many Americans.

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