So, what does this all mean?

The California Supreme Court decision yesterday that doctors can't use their religious beliefs as a reason for treating same-sex couples differently than other patients is far from the last word about the controversial case.

In a unanimous decision that could play a role in the campaign to pass a ballot initiative banning same-sex marriage, the justices said the religious liberty and free speech rights of doctors do not exempt them from complying with the state's civil rights act.

Before our red meat meter started alarming, we took some deep breaths and continued through the article here.

The case involved a 36 yr. old from Oceanside who sued the North Coast Women’s Care Clinic in Vista as she contended the clinic refused to perform an artificial insemination procedure for her because the clinic’s religious beliefs prevented them from doing so for a lesbian.

This represents a pretty fascinating case on a few different levels.
Setting aside for a moment the logic that led the Supremes to dictate what procedures doctors must perform, one interesting aspect of this is that the Supremes, in this ruling, eliminate any distinction between an “elective” medical procedure and that for say, setting a broken arm or treating a cancerous growth.

Now, from a short-term, pragmatic perspective , the ruling which gives clinics the option to a) deny that particular service to all other clients/patients or b) refer the person to a clinic that will perform the procedure seems to be a pretty reasonable compromise.

However, going back to the “logic” applied that resulted in this ruling, what are the long-term or broader effects of this ruling? To wit, what are the implications for other medical practices, especially ones where medical treatment and religious views intersect such as end-of-life decisions?

Another twist: The clinic in question claims it did not deny service to the lesbian couple because of their sexual orientation but rather because the couple was not married. Is this a distinction without a difference or does the sexual orientation of the couple play into the courts decision? Look at it like this: Say a heterosexual couple that is not married is denied artificial insemination from a clinic. Does this make it to the Supreme Court and does the Supreme Court rule in a similar fashion?

Given the fact that this is the same court that invented a right for the occasion with its granting legality to same-sex marriages, we’re going the cynic route saying “yes”, we believe (especially if the clinic’s claim is true) that the Court felt it was easier to apply the “compelling interest” tag to this ruling based upon sexual orientation rather than marital status.

To put a nice neat bow on this thing, it would appear that in the near-term as narrowly applied to this case, everyone goes away happy; the clinic can still refuse to practice the elective procedure and the patient is required to receive a referral to a clinic that will.

However, the reasoning applied to the ruling could be construed as less-than-genuine and the resulting outcome leaves things wide-open for more shenanigans down the road with respect to far more ethically-challenging medical decisions.