by Paul Gingras

Created on: May 19, 2008   Last Updated: May 21, 2008

The United States has always prided itself on the diversity of the people, which comprise its population (i.e., on the variety and richness of their ethnic backgrounds). But along with this richness and diversity of cultural traditions, there also comes a variety of conflicting worldviews (i.e., a multitude of religious beliefs). This can sometimes lead to conflicts between the providers of medical care and their patients, along with their associated religious belief (Champagne 1983: 95).

As medical technology becomes more complex and tenaciously spreads into the many areas of public and private life, we witness greater conflict between ideologies; that is, patients begin to challenge the state interest in the life of its citizens, especially where the patient's religious beliefs conflict with the technology used to keep him alive at all costs.

For example, the issue of consent is perhaps the most critical, as well as the most controversial, of the many issues confronting the patient-provider relationship. Court decisions have caused much confusion among providers, such that many now fear that arbitrary and burdensome standards for obtaining consent for a medical procedure have been instituted by the legal system. But this issue of consent is not new. It has its basis " in the common law enforcement of the concept of personal autonomy and self-determination" (Annas, Glantz and Katz 1981: 71).

A 1905 Illinois court stated that a free citizen who resides under a free government has a " first and greatest right which underlies all others the right to the inviolability of his person." That right forbids the physician from performing any major operation upon a patient without his prior consent (Annas, Glantz and Katz 1981: 71).

What this means for the patient is that he/she has the right to refuse medical treatment. The courts have also stated that this right to refuse treatment must be weighted against certain specific state interests which concern the life of the patient, as well as the collective lives of the citizens. These interests are (1.) to preserve life, (2.) to protect innocent third parties, (3.) to prevent suicide, and (4.) to maintain " the ethical interests of the medical profession" (Annas, Glantz and Katz 1981: 83-84).

According to the First Amendment, each American citizen has the " fundamental right to the free exercise of religion." This right, however, may interfere with the patient consenting to medical treatment.

An example of such a conflict would

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