Three months after approving same-sex marriage, the California Supreme Court gave gay rights another boost Monday by unanimously ruling that doctors can't invoke religion to refuse treating homosexual patients (pdf).
"There's a great diversity of religious beliefs in California, and they're all protected," Jennifer Pizer, senior counsel in the Lambda Legal Defense and Education Fund's Los Angeles office, said in a prepared statement. "But not to the point where laws are violated and other people are hurt."
Coming on the heels of the marriage ruling in May, the opinion continued the California court's tradition of being sensitive to gay issues. In recent years, the justices have approved second-parent adoptions; strengthened non-biological parents' claims to parenthood in same-sex relationships; prevented businesses from discriminating against registered domestic partners; and approved municipal policies against doing business with groups that discriminate against gays.
Monday's case began in 2001 when Oceanside, Calif., lesbian Guadalupe Benitez sued Drs. Christine Brody and Douglas Fenton, who claimed their Christian faith prevented them from providing intrauterine insemination in some circumstances. The doctors, who worked at the North Coast Women's Care Medical Group in Vista, Calif., argued that they couldn't provide fertility treatments to Benitez because she wasn't married, but Benitez said they refused because of her sexual orientation.
Monday's ruling reversed San Diego's 4th District Court of Appeal, which held in 2006 that Brody and Fenton should have been able to use their religious objections as an affirmative defense at trial.
The Supreme Court's opinion, authored by Justice Joyce Kennard, said the doctors' actions violated the state's Unruh Civil Rights Act, which prohibits businesses from discriminating based on sex, race, color, religion, ancestry, national origin, disability, medical condition or sexual orientation.
Kennard also pointed out that the U.S. Supreme Court has never exempted individuals expressing religious objections from following "neutral and valid" laws of general applicability.
"The First Amendment's right to the free exercise of religion," she wrote, "does not exempt defendant physicians here from conforming their conduct to the [Unruh] act's anti-discrimination requirements even if compliance poses an incidental conflict with defendants' religious beliefs."
The opinion, however, wasn't all bad news for the doctors. While denying them an affirmative defense, the ruling held that the physicians are still free to voice their religious beliefs, including any objections they have to the Unruh Act's prohibition against sexual orientation discrimination. The doctors are also free to rebut the allegation that their treatment qualms had anything to do with the patient's sexual orientation.
"The trial court's ruling left defendant physicians free to later offer evidence at trial that their religious objections were to participating in the medical insemination of an unmarried woman and were not based on plaintiff's sexual orientation," Kennard wrote. "The trial court's ruling simply narrowed the issues in this case by disposing of defendants' contention that their constitutional rights to free speech and the free exercise of religion exempt them from complying with the Unruh Civil Rights Act's prohibition against sexual orientation discrimination."
Kennard also said that Brody and Fenton could easily avoid future complications by referring patients to other physicians within their clinic who don't have religious objections -- as long as the patients are ensured "full and equal access to medical treatment."
The ruling sends the case back to the San Diego County Superior Court for trial.
Kenneth Pedroza, a partner with Pasadena, Calif.'s Cole Pedroza who represented the doctors, said he felt as if the high court hadn't provided a "full analysis" on the California constitutional issues. But he said he was pleased that the justices allowed the doctors to explain at trial why they didn't want to treat Benitez and said physicians could refer to other professionals if they felt doing a procedure would violate their religious beliefs.
"To the extent that Justice Kennard has effectively laid out a test at trial," he said, of the process by which doctors can refer patients to other doctors, "this is a test our doctors have met."
Pedroza said there are also some First Amendment issues that might make the case amenable for appeal to the U.S. Supreme Court.
The ruling is North Coast Women's Care Medical Group Inc. v. Superior Court (Benitez), 08 C.D.O.S. 10825.
