This is a new angle on the right of patients to demand treatment and when doctors can say no. This time it involves a religious objection to providing artificial insemination for a lesbian.

The doctor believed it was immoral to help a homosexual get pregnant and refused to participate, but referred her to someone else for the services. The new doctor was not covered by health insurance. The woman in question sued the original doctor and the California Supreme Court ruled unanimously that anti discrimination laws trump religious objections. From the story:

The ruling, based on a state law prohibiting businesses from discriminating against customers because of their sexual orientation, comes three months after the court struck down California’s ban on same-sex marriage. “This isn’t just a win for me personally and for other lesbian women,” said the plaintiff, Guadalupe Benitez. “Anyone could be the next target if doctors are allowed to pick and choose their patients based on religious views about other groups of people.”

The ruling is the first in the nation to address doctors’ religious objections to treating gay or lesbian patients and should make health care more accessible, said Benitez’s lawyer, Jennifer Pizer, of the Lambda Legal Defense and Education Fund.

Lawyers for the clinic and two of its doctors said they were considering an appeal to the U.S. Supreme Court. One supporter of the physicians called the ruling a strike against religious freedom. “This court is allowing two lesbians to force these individuals to choose between being doctors in the state of California or being able to practice their faith,” said attorney Brad Dacus of the conservative Pacific Justice Institute, which filed arguments backing the doctors…The law “furthers California’s compelling interest in ensuring full and equal access to medical treatment irrespective of sexual orientation,” said Justice Joyce Kennard.

So this seems to be the state of the situation in law and as I perceive the mainstream view within bioethics:

- Doctors refusing to sustain lives based on quality of life determinations, still to be determined in the courts, explicitly legal in Texas and perhaps in other states, generally although not unanimously, supported in bioethics.
- Doctors and pharmacists refusing to supply contraception services based on conscience, under concerted attack throughout the nation in legislatures and courts, bioethicists almost all against permitting conscience to control in this circumstance.
- Doctor refusing elective fertility treatment based on religious views, outlawed in California, a ruling I suspect will be received happily within mainstream bioethics.

None of this is consistent if the actual issue is the consciences of doctors and other medical professionals. But that isn’t what is really going on. Rather, these and other bioethical issues, at least partially, serve as a canvas for broader cultural struggles that are roiling society.

Looked at it that way, and the consistency becomes clear. The ethics of medicine and health care come about as close as we get to expressing the general core values of a society. The current societal trend is to subsume actual or deemed to be religiously-based views to secular values and tolerance of individual choices in the public sphere–a trend moving swiftly into the ethics of medicine. But individual or professional values actually or perceived to be based primarily on secular or “rational” analyses, such as in medical futility, are more likely to be honored in the courts and among public intellectuals, and individual conscience of patients or professionals required to take a back seat.

How these play out as we go along will thus tell us a lot about where we are as a society and where we are going.

Stem cell and cloning guru Robert Lanza has battled the Catholic Church, the White House, and violent protesters. (DISCOVER)

Two closely watched companies that offer consumers information about their genes have received licenses that will allow them to continue to do business in California, a state official said Tuesday. (New York Times)

Scientists say they’ve found an efficient way to make red blood cells from human embryonic stem cells, a possible step toward making transfusion supplies in the laboratory. The promise of a virtually limitless supply is tantalizing because of blood donor shortages and disappointments in creating blood substitutes. (AP)

A mental patient died after workers at a North Carolina hospital left him in a chair for 22 hours without feeding him or helping him use the bathroom, said federal officials who have threatened to cut off the facility’s funding. (MSNBC)

Stem cells derived from human menstrual blood have, in mice, prevented limbs with restricted blood flow from withering. Trials in humans facing amputations are expected to start next year. (New Scientist)