Washington Week

Jewish World Review May 10, 2001 / 17 Iyar, 5761

Patients' Rights,
Religious Rites

By Abba Cohen

http://www.jewishworldreview.com -- 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, sperm and egg banks, genetic engineering, cloning, abortion 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.

JWR contributor Abba Cohen is Washington director and counsel for Agudath Israel, the largest grassroots Orthodox group in America. To comment, please click here.


© 2001, Abba Cohen