Professional Integrity Example

The hospital in this example regularly allows hysterectomies to be performed on women who are not transgender. The facility claimed that performing this procedure as part of gender transition/affirmation conflicted with the religious views of the Catholic church and was in violation of the Ethical and Religious Directives (ERDs). The facility had an institutional objection to this procedure for this particular patient due to the religious affiliation of the health care institution.

The provider in this case felt that performing this procedure was in the best interest of the patient. The provider was not aware of the impact of the ERDs on her patient’s ability to receive this procedure at this facility. This example highlights the possibility that at times, a provider’s deeply held beliefs about what is morally right and in the best interest of their patient may conflict with the rules of the facility.

The term conscientious provision describes when a provider’s conscience compels them to provide legal and professionally accepted treatments that are prohibited by their health care institution.

The patient in this case felt that his right to receive treatment had been violated. A lawsuit was filed on his behalf against the Catholic health care system that owned the facility.

Medical outcome: In this case, the provider completed the procedure at a different facility, one that was not subject to the Ethical and Religious Directives.

Legal outcome: The lawsuit filed in 2017 alleged that the patient had been discriminated against due to his gender identity. In 2019, the court agreed, finding that the patient experienced discrimination when the hospital cancelled his surgery. The court also said that Dignity Health does not have a right to violate California’s nondiscrimination law.