This is my first diary, so please bear with me. There seems to be a great deal of confusion about what is and isn't legal, the basis for the legality, and how to solve the problem encountered by the Illinois woman who found herself heading for the OR, birth plan saying that she would have a tubal in the event of a C/S in hand, only to be told that it was not possible. This was, frankly, a blue moon case, where the woman had gone to an OB for years, she had one healthy child, had had several spontaneous abortions (the medical term for a miscarriage) and had, quite reasonably, decided she'd had enough. Her OB had sold the practice to a Catholic group and had not informed the patient. The fact that she is going after the hospital rather than the doctor is strange, to say the least.
Follow me below the fold and I'll explain why.
I'm guessing that her OB was a single practitioner - a state that can only be physically maintained for a limited number of years, or you'll die of some sort of sleep deprivation induced stress. The lure of a group practice becomes irresistible, and on the night in question, it wasn't her primary who was at the hospital. The patient should have known, frankly, without being told by her unethical physician, that something had changed when she was no longer scheduled to deliver at "University Hospital" but would have to go to "St. Perpetua of Eternal Misery". It's just possible that this was all brand new and her physician didn't really understand the level of autonomy they had signed away. That's the only explanation I can think of as to why she's not suing her physician. 27 years ago, I accompanied my (Protestant) best friend to sign her contract with a group that would have moved her practice to a Catholic hospital; I asked "Can she still do tubals?" "Yes". "Can she do medically necessary abortions?" "Of course". "How about if the patient is a crazy drug addict and has no business being a mother?" "No". We got the hell out of there quick. I was a labor and delivery nurse for decades, and spent six years in the busiest L&D on the planet - Parkland in Dallas (yes, THAT Parkland, and yes, I knew some of the people who were in the ER on November 22, 1963).
In the comments in the original diary, I proposed that Medicare/Medicaid establish a rule that says that hospitals and physicians who do not disclose, well in advance (leaving the patient with sufficient time to make other arrangements) that standard of care options, like a tubal with a C/S, are not available, be denied payment from either program for anything. This is the method that the government used to get all institutions on board for examination by the Joint Commission on Accredidation of Hospitals, something that has transformed medical care, making it so much safer that it's shocking.
Many people answered me saying that M/M should just refuse payment "to all who discriminate", leading me to conclude that there is a great deal of ignorance in liberal land about the Constitution. Individuals and institutions are free to not provide elective procedures, like tubals, under the religious freedom guaranteed under the 1st Amendment. One idiot even said that it was "unethical" to allow people or institutions to refuse to do anything that a patient wanted, so long as it "wasn't something crazy like a face transplant when they already had a perfectly good face". Yowza. What these people are asking to do would shred the Conscientious Objector clause, so the next time there's a hot ground war, we'll have to lock up all the Quakers, Amish, Hutterites, Mennonitites, Hassidim, etc, of draftable age. Do you really want to go there?
Many of you seem confused between the 1st and 14th Amendments, specifically the Equal Protection Clause, which the government has used to desegregate schools, hospitals, lunch counters, etc. In Loving v Virginia, it was used to strike down laws that made interracial marriage illegal, and it was the basis for all of the gay rights decisions that have swept the land the past few years (the genius of having Edie Windsor take a tax case to the SCOTUS first is the definition of strategy). However, the Bill of Rights is NOT the Consumers Bill of Rights. Many of you seem to have replaced the ethos of shopping, where the cutomer is always right, with the real world, where others have rights that allow them to do, or not do, things with which you disagree.