ARC: Let Doctors Protect Conscience by Contract

A few days ago, I criticized efforts to force hospitals to abandon their faith-based practices, however much I disapprove of those practices. Now the snazzy new Ayn Rand Center for Individual Rights (ARC) has produced a release that aptly explains the reasons for my view. Thomas Bowden said:

[T]he law should recognize each individual’s right to deal, or refuse to deal, with others on a voluntary basis.

For example, a doctor has the right to refuse an employment offer from a Catholic hospital that forbids contraceptives and abortions. But if he takes the job, he has no right to force the hospital to abandon its religious taboos and allow him to perform abortions. Likewise, a hospital has the right to hire only those doctors willing to prescribe contraception and provide abortions. If one of those doctors refuses to perform such services on moral grounds, he must take the contractual consequences.

Patients have the same rights as doctors and hospitals to set their own terms of trade. A pregnant woman contemplating abortion has the right to seek treatment at a hospital whose doctors are unencumbered by religious superstitions about ensoulment at conception. But if that hospital denies her admission, she has no right to demand that the Catholic hospital down the street abort her fetus.

The correct path out of the “conscience controversy” over abortions and contraceptives is not to adopt new regulations creating “provider conscience rights.” The solution is for government to recognize and protect the individual rights of all participants in the health-care system. Doctors, hospitals, and patients should be allowed to deal with each other by voluntary agreement, with government’s only role to enforce contracts and prevent fraud.

However, I would again point out that implicit contractual understanding could require patient notification. If I walk into a hospital, normally I expect to be offered the full range of medical information and treatment options. If a hospital refuses to offer some information or treatment on religious grounds, I need to know that. At least a hospital has an obligation to relate its relevant policies so that patients can make informed decisions.