No it would not violate it, they do not believe in ingesting blood. Doesn’t say anywhere that they can’t provide the option to other people.
Religious freedom means you are free to practice your religion within the laws of the state, not a free for all.
Nothing but H2O served!
Also, if there is such a thing as a “Christian Science Hospital”- there wouldn’t have to be a dept. of surgery, X-ray, pathology, etc.-just a bunch of guys praying…and a big morgue!
There are medical procedures which must be performed in a facility offering certain services, and regulations pertaining to inpatient care. I believe blood transfusions are often one of the services required for internal surgery. So these regulations define the minimum services a hospital must provide to be legally considered a hospital.
I don’t see how the set of services provided matters much to this question in general. A hospital can’t perform a service it doesn’t have. Not every hospital has CAT Scan machine, and they shouldn’t be required to either. But if they have a CAT Scan machine they shouldn’t be allowed to deny it’s use for any necessary medical procedure as determined by a doctor.
I’ve no idea, but if we’re going to mark off a spectrum of medical services ranging from “generalized and useful that anyone calling himself a medical professional should be able to provide” to “esoteric and specialized that not everyone calling himself a medical professional will necessarily provide or be interested in providing”, I assume blood transfusions to be closer to the former than the latter.
Ugh. This is a complicated question. But let me try to hit the high points:
This is not true. I’m also curious what internal surgery is. As opposed to external surgery?
The definition of hospital, and the licensing thereof differs from state to state. In general, there are no legally required minimum services per se but… it’s complicated. Obviously a hospital that specializes in orthopedics is different from one that specializes in psychiatric problems. The state can always deny your application if they think it’s appropriate. You may or may not be required to have an emergency room depending on state law. You may or may not need to prove the community needs your services before you can open a hospital. PA, for example, requires a certificate of need before you can open a new hospital. TX does not. It varies quite a bit from state to state and it can be a political process.
However, on top of getting a hospital license, you are also subject to review from various organizations such as the Joint Commission, etc which make getting a hospital license seem like a walk in the park. They regulate everything from what type of hats you can wear to how much clearance you have under the ceilings of your supply closets, in addition to a million other factors. But while there are unaccredited hospitals, many, many parties won’t do business with you unless you are accredited.
Now, let’s say you open a new hospital and choose not to be accredited. Now no insurance companies, including Medicare, which represents pretty much everyone over the age of 65, will be willing to pay you anything. But whatever, you manage to convince the state to give you a license, you take cash only, and somehow survive in competition with the other hospitals who are clawing for market share in a business with incredible overhead. Are you diagnosing and treating medical conditions? Congratulations! You are practicing medicine! I hope you have a license. If you don’t, you are now a felon. But let’s say you do. Can you treat people and refuse them blood transfusions?
In a true emergency, no, you can not. If you do, prepare for a lawsuit and a suspension of your medical license. Now your facility might not have the ability to provide a necessary service, but you then have to make arrangements for a transfer. This is incredibly common by the way. Most small community hospitals are constantly transferring to larger hospitals because they can’t provide the level of care needed. However, in an elective setting, sure. As long as the patient is aware of everything before and consents, that would be fine. But if you are performing procedures or rendering treatment that is unusual i.e. outside the standard of care, you are open to problems with the state Medical Board, as well as huge malpractice liability. But you could do it.
Most doctors haven’t ordered a blood transfusion in years. Many people seem to be under the impression that’s simple and risk free. It’s not. More importantly, the doctor is arguably the least important part of the process. You need a lab with a blood bank, techs, nurses, equipment, and a rigorous system in place to transfuse blood. If you have a small hospital that specializes in rehabilitation and someone who’s been shot in the liver shows up in the lobby, you’re going to be transferring them, not treating them.
So, to answer the OP’s questions:
The hospitals he’s proposing are unlikely to get a license from the state but weirder things have happened I suppose.
Hospitals are not a limited commodity. In states without a certificate of need, they pop up, fail, and are acquired by various hospital systems constantly. Any one hospital, or hospital system, doesn’t control anything. Just go to another hospital. Or another community. Or, in cases where the treatment you need is unusual, which is pretty common in some parts of the country, another state. And define full spectrum of available and medically approved treatments? No hospital in the world offers that!
Accepted medical thinking isn’t as monolithic as you think, I suspect. But the key point is, in general, barring an emergency, a doctor isn’t obligated to provide a particular treatment or even treat you at all. If a surgeon doesn’t particularly like doing gallbladder surgery, they don’t have to do that operation. Now if he’s taking call at a hospital and someone needs emergency gallbladder surgery that’s another (very, very complicated) story. But electively? He can be a toe surgeon and open a toe surgery speciality hospital (assuming the state approves his application) and never provide any other type of treatment in his life. You can’t force the hospital he works at to offer gallbladder surgery either, even on an emergent basis. They may just have to transfer that patient to another center that does offer it.
I think you’re making a good point about lawsuits and licensing boards.
Would I be correct in saying that hospitals are constrained and compelled by the threat of civil actions and license loss as much as anything? It would be difficult to write a bill listing all required services.
So then would a pharmacy or pharmacist be constrained or compelled in the same way? Suppose there’s an immediate need for an animal derived medication. Heparin? Non-recombinant insulin? I don’t know, I’m obviously not a physician, but it’s something that has to be given tonight - right now - to do any good. Further suppose that the only pharmacy for 60 miles is owned and operated by someone who, for religious reasons, won’t dispense animal derived drugs. Finally suppose that this has lifelong, or at least years long, consequences for the patient.
Can the pharmacy/pharmacist be successfully sued? Obviously they can be sued, you can sue anyone for anything, but should the pharmacy then be immune because their action was due to their religious beliefs and thus protected by the first amendment?
If they’re not immune, then I wonder what they could be sued for. [del]Eighteen years of support[/del] Treatment for whatever years long complications arise due to their exercising of their conscience?
There is simple way around this problem. If a hospital is licensed as such then it should have to provide the full range of basic care to the community it serves. If it is run by a religious organization, and it is the only source available within the area, then it should have to employ a minimal rotation of lay doctors to provide the basic services that the rest of the hospital in general finds ethically or religiously proscribed. We could set up a subsidized program to help pay for these services. A doctor’s first duty is to the health and welfare of their patient’s bodies, not their souls.
Is there a difference between elective and non-elective procedures in this?
For example, I doubt many people would be angry if a hospital failed to provide a full suite of cosmetic surgery options, although those are safe an legal. On the other hand, blood transfusions are a medical necessity - people die without them.
Abortion falls in that spectrum - some are life-saving; others are purely elective. I don’t think I’d begrudge a hospital that refused to do non-lifesaving abortions for whatever reasons, religious or not, just as I wouldn’t care if a hospital did not offer rhinoplasty for non-medical reasons.
I’m flashing back to the 15-page thread we had on pharmacists who refuse to dispense contraceptives or abortion drugs.
OK, but again - how far are you comfortable with this notion? Can you stretch your comfort zone enough to support that stance when the community’s mores are not yours? If I want to open a hospital in an area with enough ethnic minority people whose cultures practice Female Genital Mutilation, must I hire a staff to perform infibulations on 12 year old girls?
You state it’s not true, then make the same claim yourself. The fact that regulations vary state by state doesn’t change the fact that regulations exist. You can’t remove someone’s appendix in a barber shop. You need licensed anethesiology facilities, blood supply, and sufficient facilities to deal with problems that may arise from that type of surgery. To get a cyst on my back removed the surgeon had to the extremely simple operation in a hospital because of the proximity to my heart. States have these regulations, and they define what a hospital is.
This story is nice and all but everything costs money—a fact you never seem to forget in other contexts, interestingly—and if you’ve blown your budget on a hospital that then turns around and is run by a bunch of witch doctors then you are pointlessly fucked.
But the question isn’t whether they could pass medical school, but whether they would refuse treatments taught at medical school because of magical sky pixies.
You can’t start with the religious rules and try to force-fit a hospital that only provides the allowable services. If someone gets hurt, and there’s a hosiptal close by, they are going to appear there for treatment, and Doctors can not refuse it.
You have to start with the existing medical standards of treatment and ask whether they, or something demonstrably outcome-equivalent can be performed within the religious proscriptions. Sad to say, in most cases this is not true.
I’m not even sure what we’re talking about anymore, when we are talking about religiously owned hospitals.
For example, the Jewish General Hospital in Montreal is one of the best hospitals in the city. All medical procedures there are offered there with no restrictions based on religion. In fact, I think that nowadays the majority of the workers, and probably the patients too, are not Jewish.
And that’s fine. The problem is when a hospital enacts religious restrictions on all patients regardless of the patients beliefs. The hospital you mentioned doesn’t do that, so there’s no issue. But nobody can deny that there are hospitals that do have such restrictions.
Yes but only for a while. If the religious hospital refuses to do certain procedures, the government should use eminent domain, forcibly take the hospital, and convert it into a government-run secular hospital that will treat everybody
Even if the procedures the hospital does not provide are not life threatening? Would you take over a hospital by emiment domain for failing to offer tummy tucks? Circumcision? Or what about procedures they might not be equipped for like liver transplants or artifical hearts?
Obviously there are a whole lot of procedures we can’t demand all hospitals provide, so how do you decide which ones must be provided before you shut it down and have the government take it over?
Leaving aside the constitutionality of the gov’t seizing the property of a religious organization in these circumstances.
That’s hardly a basic service provided for medical necessity.
Hard to say. For elective abortions, contraception, and the like, the effects are obviously not life-threatening, but I believe it violates something fundamental that needs to be protected. So yeah, to err on the side of protecting women and other people from religiously motivated care, the hospital either needs to offer up the services that a typical hospital does, or be taken over. I was originally going to say we should give exceptions to specialized treatments that can’t be offered everywhere due to cost or rarity, but that just gives these religious organizations direction in which to move towards to make sure their interpretation of religious doctrine makes a specific procedure, such as abortion, onerous
So government, I believe, should have the power to decide which religious hospitals to take over in the interests of fair coverage
On what are you basing these claims, exactly?
To reiterate, the statement: “I believe blood transfusions are often one of the services required for internal surgery” is incorrect. Surgical procedures are routinely preformed without access to blood transfusions.
A surgeon wouldn’t remove someone’s appendix in a barbershop because that would be incredibly stupid. However they can, and do, remove subcutaneous tumors, deride wounds, perform facial reconstruction, perform amputations, etc, in the office, without the aid of an anesthesiologist, without blood products, and without specialized facilities. It’s left to the judgement of the doctor in these cases. If they wanted to repair a complex facial laceration in a barbershop, that is their right, and no one would bat an eye. Happens all the time for friends and family.
In general, a doctor can refuse treatment for anything that’s not an emergency, full stop. They can also often refuse to treat you even in an emergency in many cases. That is, like I said, a complicated discussion but we can get into it if people are interested. But this discussion is sort of pointless if people don’t accept these basic principles.
Okay, stop right there. There’s no such thing as a typical hospital. A hospital, by common definition, is just a place where medical care is provided to inpatients. That’s it. Many hospitals have no capacity to perform surgery of any kind and don’t have a blood bank at all. Rehabilitation and psychiatric hospitals are the first ones that pop to mind. But even what you might consider “general” hospitals vary tremendously in the services they can offer. Lots of hospital simply don’t have certain types of doctor on staff and/or don’t perform certain types of procedures.
Is treating a broken wrist something that’s something a “typical hospital” should be able to take care of? What if there’s no orthopedic surgeon on staff at the hospital? What if someone get’s stabbed and needs lung surgery, but you don’t have a trauma or thoracic surgeon on call? Parathyroid cancer but no endocrine surgeon? Brain tumor but no neurosurgeon? Should they be shut down? Should they be forced to hire one? What if they can’t find one? This isn’t a very uncommon scenario by the way.
And what the heck does “take it over” mean? Fine, take it over. If you don’t have a ob/gyn on staff that’s willing to perform procedure x, what exactly are you going to do?
In the end, it always seems to me that all these turbo-hypotheticals of hospitals run by vegan Christians Scientists who are also Jehova’s Witnesses and also conservative Catholics and also ultra-Orthodox Jews and KKK members that only open on Saturday and are the only hospitals in 5000 miles is about abortion and irrational hatred of religion.
all the mentions of sky pixies and bronze age myths disappear when you provide abortions.