Health Promotion Practice
July 2018 Vol. 19, No. (4) 542–549
DOI: 10.1177/1524839917738974
© 2017 Society for Public Health Education
542
Understanding Stakeholder Perspectives
The purpose of this study is to explore the ways that
some health care providers perceive the intersectional-
ity of their autonomy, religious faith, and their medical
practice, specifically when it comes to providing care
for the LGBT+ (lesbian, gay, bisexual, transgender,
queer, intersex, and asexual) community. Physicians
(n = 25) and medical residents (n = 17) located in the
southeast completed a qualitative survey regarding
their views of working with LGBT+ patients. Five main
themes resulted from the analysis: adequate education,
communication, discrimination, duty versus physician
autonomy, and religious exemption. In this analysis,
we focus specifically on duty versus physician auton-
omy and religious exemption since the other themes
have been addressed in literature. The physicians and
medical residents in this sample were divided among
groups on the right to refuse treatment. Although there
was not a question specific to religion, participants
discussed religion in their responses to whether they
believe in the right to refuse treatment. This division
supports the need to decrease the current gap in knowl-
edge regarding how religious views can affect physician
treatment of LGBT+ patients and research effective
ways to bridge the gap between physician autonomy
and the duty to provide treatment.
Keywords: access to health care; LGBT; minority
health; public health laws/policies
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INTRODUCTION
In today’s politically charged climate, religious free-
dom and conscience clauses have become the focus of
action by judicial and legislative bodies in the United
States. Conscience clauses allow individuals to deny
services to others citing moral or religious freedom.
Conscience clauses became prevalent following Roe v.
Wade and gained more traction with the Burwell v.
Hobby Lobby Stores decision. Initially conscious
clauses allowed physicians to cite religious freedom as
a reason to deny performing medical procedures,
including contraception, sterilization, and withdraw-
ing of feeding tubes (Lin, 2006; Pellegrino, 1994). A
concern of the Hobby Lobby Stores decision, which
allowed employers to deny contraception coverage, is
that the decision would empower employers to dis-
criminate in other ways citing religious freedom (R. F.
Wilson, 2016). Recently, the discussion of conscious
clauses has been expanded to groups of people, that is,
lesbian, gay, bisexual, transgender, queer, intersex, and
asexual (LGBT+) individuals. Bakeries and photogra-
phers refuse to provide wedding services for LGBT+
couples on the grounds of religious freedom (Lupu &
Tuttle, 2010). The field of health care is no exception
(Baker, 2009; Loftus, 2001; Reibman, 2009; Röndahl,
2009; Sirota, 2013; R. F. Wilson, 2016; C. K. Wilson
et al., 2014). Yet previous research specific to religion
and discrimination in health care deals mostly with
stigmatized religions or HIV/AIDS patients being
738974HPP XX X 10.1177/1524839917738974Health Promotion PracticePrairie et al. / PHYSICIAN AUTONOMY, RELIGION, AND LGBT+ PATIENTS
research-article 2017
1
Middle Tennessee State University, Murfreesboro, TN, USA
Authors’ Note: Address correspondence to Tara M. Prairie,
Department of Health and Human Performance, Middle Tennessee
State University, 1301 East Main Street, Box 96, Murfreesboro, TN
37132, USA; e-mail: tprairie@mtmail.mtsu.edu.
Intersections of Physician Autonomy, Religion, and
Health Care When Working With LGBT+ Patients
Tara M. Prairie, MA
1
Bethany Wrye, PhD
1
Sarah Murfree, MS
1