Department of Foundational Medical Studies, Oakland University William Beaumont School of Medicine, 586 Pioneer Dr., Rochester, MI, 48309, USA.
Institute for Bioethics & Health Humanities, Preventive Medicine and Population Health, University of Texas, Medical Branch, 301 University Blvd., Galveston, TX, 77555, USA.
J Public Health Policy. 2021 Jun;42(2):322-330. doi: 10.1057/s41271-021-00281-2. Epub 2021 Apr 27.
Given recent legal developments in the United States, now is a critical time to draw attention to how 'conscientious objection' is sometimes used by health care providers to discriminate against the LGBTQ community. We review legal developments from 2019 and present several cases where health care providers used conscientious objection in ways that discriminate against the LGBTQ community, resulting in damaged trust by this underserved population. We then discuss two important conceptual points in this debate. The first involves the interpretation of discrimination (provider versus patient-centered views), and we argue for a patient-centered view; the second involves the use of the people versus procedure distinction to reach a compromise between LGBTQ individuals and the clinicians who do not want to treat them. We argue the distinction is problematic when applied to treatment of the LGBTQ population.
鉴于美国最近在法律方面的发展，现在是引起人们关注医疗保健提供者如何以“出于良心拒服兵役”为由歧视 LGBTQ 群体的重要时刻。我们回顾了 2019 年的法律发展，并介绍了几个医疗保健提供者以歧视 LGBTQ 群体的方式使用“出于良心拒服兵役”的案例，这导致了这个服务不足的群体对医疗保健提供者失去了信任。然后，我们讨论了这场辩论中的两个重要的概念性问题。第一个问题涉及对歧视的解释（以提供者为中心和以患者为中心的观点），我们主张以患者为中心的观点；第二个问题涉及使用人与程序的区别，在 LGBTQ 个人与不想治疗他们的临床医生之间达成妥协。我们认为，当应用于 LGBTQ 群体的治疗时，这种区别是有问题的。
