Can hospitals refuse procedures for religious reasons?

In recent years, the intersection between religion and medicine has become an increasingly debated topic, especially when it comes to the provision of health services in religious institutions. The ethical question of whether or not hospitals should refuse procedures on the basis of religious beliefs is complex and raises a variety of opinions. 

The role of religious hospitals in contemporary society

Religious hospitals play a multifaceted and significant role in contemporary society, providing quality healthcare while also embodying ethical and moral values derived from their religious traditions. These institutions often have deep roots in their communities and can play a vital role in meeting local health needs. 

Below, we'll explore the role of these hospitals in contemporary society in more detail:

1. Providing high quality healthcare

Religious hospitals often offer high-quality medical services, modern equipment and highly qualified professionals. These institutions are often recognized for their clinical excellence and commitment to patient well-being.

2. Promoting ethical and moral values

In addition to providing medical care, religious hospitals often seek to promote ethical and moral values in their practices. This can include respect for human dignity, compassion for the less fortunate and a commitment to social justice. These values can be incorporated into all areas of medical care, from patient treatment to the institution's internal policies.

3. Integration with local communities

Religious hospitals often have a strong connection with local communities, providing not only healthcare, but also programs and services that address the specific needs of those communities. This can include preventive health programs, emotional and spiritual support, and health promotion initiatives that address specific issues faced by local populations.

4. Holistic approach to care

A distinctive feature of religious hospitals is their holistic approach to care, which recognizes the interconnection between body, mind and spirit. These institutions often value not only medical treatment, but also emotional, spiritual and social support for patients and their families during periods of illness and recovery.

5. Contribution to the diversity of the health system

Religious hospitals play an important role in diversifying the healthcare system, offering a range of options for patients and contributing to the plurality of perspectives and approaches in the field of medicine. This can be especially important in contexts where religious institutions represent a significant part of the healthcare infrastructure.

Ethical challenges in religious hospitals

Religious hospitals face a number of complex ethical challenges that arise from the intersection between religious beliefs and medical practices. These challenges often generate heated debates on issues such as patient autonomy, religious freedom and the duty of the healthcare professional to provide evidence-based care. Below, we explore some of the main ethical challenges faced by religious hospitals:

1. Conflicts between religious beliefs and patients' rights

One of the most pressing challenges faced by religious hospitals is the conflict between the institution's religious beliefs and patients' rights. In cases where religious beliefs prohibit certain medical procedures, such as abortions or assisted reproduction procedures, patients may find themselves deprived of treatment options they consider essential to their health and well-being.

2. Guaranteeing fair and non-discriminatory care

Another ethical challenge is to ensure that religious hospitals provide equitable and non-discriminatory healthcare to all patients, regardless of their religion, sexual orientation or gender identity. Refusing procedures on the basis of religious beliefs can be seen as a form of discrimination, denying patients access to essential medical services.

3. Medical autonomy versus personal beliefs

Healthcare professionals working in religious hospitals can find themselves at an ethical crossroads between their professional autonomy and their own religious beliefs. While some professionals may feel morally obliged to follow the institution's religious guidelines, others may believe that their first obligation is to the patient and the provision of the best possible care, regardless of institutional beliefs.

4. Social responsibility and obligations to the community

Religious hospitals often play a prominent role in the local community and are seen as an integral part of the healthcare infrastructure. This can raise questions about the institution's social responsibility and its obligations to the wider community. Religious hospitals must balance their religious mission with a commitment to serving the entire community, regardless of religious affiliation.

5. Protecting employees' rights

In addition to patients, religious hospitals also face ethical challenges related to the rights and beliefs of their employees. Health professionals working in these institutions can feel pressured to conform to the institution's religious beliefs, even if this conflicts with their own personal convictions.

Patients' rights and medical autonomy

Patients' rights and medical autonomy are fundamental to the ethical practice of medicine and to ensuring that patients receive the best possible care, respecting their dignity, autonomy and human rights. 

1. Patient autonomy

Patient autonomy is a central principle of medical ethics that recognizes the fundamental right of patients to make informed decisions about their own health and medical care. This principle is based on the idea that patients have the ability and right to make choices that affect their health and well-being, taking into account their own beliefs, values and preferences.

• 1.1 Importance of patient autonomy: Patient autonomy is considered a cornerstone of the doctor-patient relationship. It strengthens trust between the patient and the healthcare professional, allowing patients to be active partners in their own care. When patients have the opportunity to participate in decisions related to their health, they feel empowered and more engaged in the treatment process, which can lead to better health outcomes.
• 1.2 Informed consent: An essential aspect of patient autonomy is informed consent. This implies that patients receive clear, understandable and complete information about their medical condition, the diagnosis, the treatment options available, the risks and benefits of each option and the consequences of not receiving treatment. Informed consent allows patients to make decisions that reflect their own values and preferences.
• 1.3 Limitations on patient autonomy: Although patient autonomy is a fundamental principle, there are situations in which there may be limitations on its application. For example, in cases of medical emergency, when the patient is not in a position to make informed decisions, or when refusal of treatment could result in serious harm or death, health professionals may be authorized to act on behalf of the patient to protect their health and safety.
• 1.4 Respect for cultural and individual diversity: Patient autonomy also implies respecting cultural and individual diversity. This means recognizing and valuing differences in patients' beliefs, values and preferences and adapting the care approach to meet the specific needs of each individual. Health professionals must be sensitive to cultural differences and be open to dialog and negotiation to ensure that care decisions reflect the patient's preferences.
• 1.5 Patient empowerment: By promoting patient autonomy, healthcare professionals empower patients to be active advocates for their own health. This can include helping patients understand their treatment options, encouraging them to ask questions and actively participate in discussions about their care, and supporting them in making decisions that are in line with their personal goals and values.

2. Informed consent

Informed consent is an essential part of patient autonomy and involves ensuring that patients fully understand proposed medical procedures, including their objectives, benefits, risks and alternatives. Healthcare professionals have an ethical and legal responsibility to obtain informed consent from patients before carrying out any medical intervention or invasive procedure.

3. Respect for patients' diversity and values

Respecting patient autonomy also means respecting the diversity of patients' values, beliefs and cultures. Healthcare professionals must recognize and value patients' individual differences and adapt their care approach to meet each patient's specific needs and preferences.

4. Patients' rights in religious hospitals

In religious hospitals, where the religious beliefs of the institution may influence medical practices, it is important to ensure that patients' rights are protected and respected. This can include the right of patients to receive complete and accurate information about all available treatment options, regardless of the religious beliefs of the institution, and the right to be referred to another healthcare provider if necessary to access specific treatments.

5. Medical autonomy

Medical autonomy is the principle that defends the freedom of health professionals to make clinical decisions based on their professional judgment and the best available evidence, without undue external interference. This includes the right of doctors to refuse to carry out procedures they consider morally or ethically questionable, as long as they respect the rights and interests of patients and comply with applicable ethical and legal standards.

Religious freedom and diversity of opinion

Religious freedom is a fundamental right that guarantees everyone the right to practice their religion freely, without discrimination or coercion. This right is not only limited to the freedom to worship in private, but also encompasses the freedom to manifest and practice one's religion in public, as well as the right not to have a religion.

When it comes to the intersection of religious freedom and health, it is important to recognize that religious institutions have the right to follow the principles and values of their faith. This includes the ability to establish policies and practices that are in line with their religious beliefs, as long as they do not violate the fundamental rights of others.

Diversity of opinion is a fundamental characteristic of any democratic and pluralistic society. In a healthcare context, this means recognizing and respecting a wide range of beliefs, values and perspectives from both patients and healthcare professionals. This can include different views on ethical, moral and religious issues that can influence medical decision-making.

However, it is important to emphasize that religious freedom and diversity of opinion should not be used as a justification for discriminating against or denying proper healthcare to patients. Hospitals and healthcare professionals have an ethical and legal obligation to provide medical care based on scientific evidence and in the best interests of patients, regardless of their own beliefs or the beliefs of the religious institution with which they are affiliated.

It is therefore essential to find a balance between respecting the religious freedom of institutions and individuals and ensuring that patients' rights are protected and that they receive high-quality healthcare that is culturally sensitive and respects their personal beliefs and values.

Ethics, legality and morality

The debate over whether or not hospitals can refuse procedures for religious reasons is complex and multifaceted, involving ethical, legal and moral considerations. While patients' rights advocates argue that refusing procedures can represent a form of discrimination and violate medical autonomy, religious freedom advocates defend the right of religious institutions to follow their ethical and moral principles.

As this discussion continues, it is important to strike a balance between respecting religious beliefs and ensuring that all patients have access to quality healthcare, regardless of their religion or background. This may involve developing clear and equitable policies that protect the rights of all involved, while promoting mutual respect and diversity of opinion in an increasingly pluralistic society.

See also: Who was St. Jude Thaddeus, the protector of Flamengo?

April 3rd, 2024