Her mind was reeling.
Instead, he had thrown her onto his bed and assaulted her.
“I’m done with you,” he’d tonelessly told her afterward.
Boyer had grabbed her clothes and dashed for her car in the freezing predawn darkness.
Bruised and in pain, she grimaced through the pelvic exam.
“I’ll need the morning-after pill,” she told him.
Dr. Gish looked up.
He was a trim, middle-aged man with graying hair and, Boyer thought, an aloof manner.
“No,” Boyer says he replied abruptly.
“I can’t do that.”
He turned back to his writing.
Emergency contraception is most effective within a short time frame, ideally 72 hours.
Dr. Gish simply shook his head.
“It’s against my religion,” he said, according to Boyer.
(When contacted, the doctor declined to comment for this article.)
Boyer left the emergency room empty-handed.
“I was so vulnerable,” she says.
“I felt victimized all over again.
First the rape, and then the doctor making me feel powerless.”
Later that day, her rape counselor found Boyer a physician who would prescribe her EC.
“Doctors swear an oath to serve their patients.
But instead, they are allowing their religious beliefs to compromise patient care.
And too often, the victims of this practice are women.”
Patients denied treatment rarely complainthe situation tends to feel so humiliatingly personal.
And when patients do make noise, the case is usually resolved quietly.
Harnish, 21, was shocked by the way the doctor treated her.
“He turned me away when I needed medical help.
That’s not what a doctor is supposed to do.”
Then she called the newspaper.
Despite the attention the story attracted, Dr. Gish continues to work at Good Samaritan Hospital.
In many cases, women don’t even know a doctor is withholding treatment.
But unfortunately, now we can’t even trust doctors to tell us what we need to know."
To many doctors, however, the issue represents a genuine ethical dilemma.
“I know that life begins at conception, and that each person has inherent value.
That includes the life of the unborn.”
“Doctors are people, too,” she adds.
“We have to be able to leave the hospital and live with ourselves.
The law also favors medical professionals.
Now many states have gone further.
(See “The State of Doctor Refusals,” right.)
“We’re not trying to deny anybody access to treatment,” Manion adds.
“We’re saying, ‘Don’t make your choice my choice.
Dotts, who was single, had recently moved to Birmingham, Alabama, and was seeing an M.D.
recommended by a coworker.
The visit was unremarkable until she asked for a refill of her birth control prescription.
That’s when the doctor informed her that he was Catholic and the pills were against his religion.
“The look he gave me actually made me feel ashamed,” Dotts says.
“Like I had this wild and crazy sex life.
Like he was trying to protect me from myself.”
Her bewilderment quickly turned to anger"I thought, Wait, what in the world?
“especially when she remembered that her insurance covered only one annual gynecology checkup.
Dotts, who’d majored in religion in college, got tough with the doctor.
“I’m glad for you that you’re faithful,” she told him.
“But don’t push it on me.
I’m here for my treatment, and I expect you to give it to me.”
Dotts grabbed the prescription and left, resolving to find herself a new gynecologist.
“I don’t make that assumption now.
I ask a million questions and advocate for myself.”
A federal version of the bill is under consideration by a House subcommittee.
But such efforts have been more than matched by those of conscience-clause activists.
Since 2005, 27 states introduced bills to widen refusal clauses.
“Doctors shouldn’t be forced to provide services, but they can’t just abandon patients.”
But Morrison warns women not to be fooled.
“I ask you, what belief would keep someone from fitting a patient with a prosthetic limb?”
“What they’re really after is limiting access to women’s health care.
And if women come to fear their doctors’ judgments, a new set of problems can develop.
“Any way you look at it, it’s dangerous for women.”
“I’m not married,” Bray told him.
“You’re not?”
He calmly put down his pen.
“Then I’m not comfortable continuing this exam.”
“Such religious beliefs are a fundamental right guaranteed by the Constitution of the United States.”
Bray sobbed in her parked car for another 45 minutes before she could collect herself for the drive home.
“I had a lot of pent-up emotions,” she remembers.
I really felt put through the ringer, and the doctor compounded that feeling.”
It’s true that several lawsuits have favored health providers who refuse services based on their principles.
And in a recent case in San Diego, an appeals court ruled against 35-year-old Guadalupe Benitez.
Their reasoning is in dispute: Benitez has claimed both doctors told her they objected to her sexual orientation.
Carlo Coppo, a lawyer for the doctors, says they refused because she was unmarried.
We don’t serve your kind here.”
So one could see doctor refusals as a mere inconvenience.
But those cases are so rare.”
Access to reproductive health care, however, is already a challenge in some areas.
“Lower-income people who are refused health care are trapped,” Brooks says.
“They can’t pay out of pocket for these services.
And they may not have transportation to go elsewhere.
So they really don’t have options.”
But in a world guided by religious directives, even this can be a slippery proposition.
She was only 14 weeks pregnant, but her water had broken.
Hutchins would likely miscarry in a matter of weeks.
Dr. Goldner says his devastated patient chose to get an abortion at local Elliot Hospital.
But there was a problem.
Elliot had recently merged with nearby Catholic Medical Centerand as a result, the hospital forbade abortions.
They were asking me to do something other than the standard of care.
They wanted me to put her health in jeopardy.”
Ultimately, Dr. Goldner paid a taxi to drive her the hour and a half to the procedure.
(The hospital merger has since dissolved, and Elliot is secular once again.)
“Unfortunately, her story is the tip of the iceberg,” Dr. Goldner says.
Baptist and Seventh Day Adventist hospitals may also restrict abortions.
You wouldn’t necessarily know a hospital’s affiliation upon your arrival.
“The community is often in the dark that changes have taken place at all.”
Either way, says Morrison, “it requires you to be an extremely educated consumer.”
“They assured us that patient care would be unaffected,” Dr. Stulberg says.
“But then I got to see the reality.”
The doctor was struck by the hoops women had to jump through to get basic care.
“When I saw her not long afterward, she was pregnant with unwanted twins.”
And in emergency scenarios, Dr. Stulberg says, the newly merged hospital did not offer standard-of-care treatments.
The more invasive way to treat an ectopic is to surgically remove the tube.
An alternative, generally less risky way is to administer methotrexate, a drug also used for cancer.
It dissolves the pregnancy but spares the tube, preserving the women’s fertility.
“The doctor thought the noninvasive treatment was best,” Dr. Stulberg recounts.
Turns out, the definition ofemergencydepends on whom you ask.
“But the reality is, the vast majority of abortions are elective.
There are very, very few instances where the mother’s life is truly in jeopardy.”
“That was a legitimate situation,” Dr. Christiansen says.
But in general, “it’s a pure judgment call.
A doctor would have to be in the situation and decide whether it constitutes a life-threatening emergency or not.
“Raise your hand if you’d like to be the test case.
Photo Credit: Plamen Petkov
