Doctor of homophobia: some states may allow health care providers to refuse treatment to anyone, on moral grounds. Gays are a prime target.

Imagine going to see a doctor to treat a sexually transmitted disease such as herpes and having the doctor refuse to treat you because you caught the virus through gay sex, arguing that he or she has a "religious objection" to gay sexual relations.

While that scenario may sound like a shirking of medical responsibility to "do no harm," a number of bills being floated in state legislatures across the country would make such a situation reality.

Measures have been introduced in Arkansas, Michigan, Rhode Island, South Dakota, Texas, Vermont, and West Virginia that would allow pharmacists and other health care providers to refuse treatment or medication to anyone by citing ethical, moral, or religious grounds. In Georgia the law already states that "it shall not be considered unprofessional conduct for any pharmacist to refuse to fill a prescription based on his or her ethical or moral beliefs."

"This gives them a license to discriminate against LGBT people," says Joel Ginsberg, interim executive director of the Gay and Lesbian Medical Association in San Francisco.

The issue was brought to the forefront last year when the Michigan house of representatives passed just such a bill.

The measure had languished in the legislature for six years, but picked up steam when Michigan's Democratic and pro-choice governor, Jennifer Granholm, told a pro-life group that she could support a measure that would allow health care workers to refuse to provide women with RU-486, the so-called abortion pill, based on moral objections.

According to Sean Kosofsky, director of policy for the Detroit-based GLBT rights group Triangle Foundation, the Michigan house then rushed to pass a bill. The problem was that the bill was not narrowly tailored, as Granholm had suggested. And in fact, notes Kosofsky, "Michigan already has a refusal clause" that allows health care workers to refuse to perform or assist in abortions and pharmacists to refuse to dispense morning-after birth control pills.

Following an outcry from gay groups and others in Michigan last year, the bill went nowhere in the senate. "What killed this antiabortion measure was that they were sloppy about it," says Kosofsky. But backers of the bill seemed to have learned their lesson, to a point.

They filed two bills this year. The first measure would allow health care providers to claim "conscientious objector" status, except for such issues as sexual orientation, marital status, and "participation in high-risk activities." But the second measure allows "health care facilities"--a term encompassing everything from hospitals to private doctors' offices--to claim the same status and does not protect patients from discrimination on those bases.

"Once they pass the law, what's to stop lawmakers from amending it to remove the sexual orientation exemption?" asks Kosofsky. "This is really a wedge issue. [The bill's supporters] thought that by exempting all the minorities, and leaving only the abortion issue, that they would only have to take on the abortion rights lobby. Well, we're not going to let that happen."

The foundation is working with Planned Parenthood on this issue. "Even with the sexual orientation exemption, we are still firmly opposed to these bills," says Sarah Scranton, executive director of Planned Parenthood Affiliates of Michigan, noting that there are no exemptions for gender identity or gender expression in the bills.

Liz Boyd, press secretary to Governor Granholm, says the governor "has major concerns" about the bills. Although she said it was premature to talk about a possible veto, she reiterated that the bills, as they are currently written, are "very broad."

The issue goes beyond this kind of legislation. In California, for example, courts are currently mulling a lawsuit filed by Lambda Legal on behalf of a San Diego woman who was allegedly refused fertility care because she is a lesbian. Guadalupe Benitez claims that her obstetricians not only cited their fundamentalist Christian beliefs but also asserted their religious beliefs exempt them from California's antidiscrimination law.

The California Medical Association has since filed a court brief in support of the doctors.

Ginsberg of the GLMA calls the desire of doctors to refuse treatment based on morals or religion "a reconceptualization of what it means to be a health care provider, which is to heal people and not be judgmental. This seeks to make health care more about the morality of the provider rather than where it should be, which is on the health of the patient."

Kuhr is editor at large of the Boston-based GLBT newspaper In Newsweekly.