California Supremes: No religious exception to civil rights in medicine

The California Supreme Court said today:

Do the rights of religious freedom and free speech, as guaranteed in both the federal and the California Constitutions, exempt a medical clinic’s physicians from complying with the California Unruh Civil Rights Act’s prohibition against discrimination based on a person’s sexual orientation? Our answer is no.

The unanimous decision, ten years in the making, came in Benitez v. North Coast Women's Care Medical Group (PDF). Lupita Benitez was stalled, given unnecessary treatments, and finally turned away when North Coast made clear it would not provide artificial insemination to a lesbian. Benitez ultimately got the services elsewhere and is now a mother of three, but fought to the state's highest court to make sure that facilities like North Coast can't use religious beliefs as an excuse to discriminate in the provision of health care.

Background on religious exemptions

North Coast's religious freedom defense won't be going before the U.S. Supreme Court: the Court has interpreted the federal constitution as not requiring religious exemptions from "neutral laws of general applicability." Employment Division v. Smith (1990). Nevertheless, state constitutions may and often do provide more robust protections for individual rights than does the federal constitution, so religious objectors have continued to argue for religious exemptions from various laws in the state courts. The California Supreme Court rejected such an argument in 2004 in the Catholic Charities case (PDF), which involved the California Women’s Contraception Equity Act. There, the court declined to set out a specific test for religious exemption claims, concluding that under even a strict standard -- i.e., the most protective for religious objectors - there wouldn't be an exception for Catholic Charities.

Reasoning of the decision

The court draws the same conclusion today in Benitez. Specifically, it says that the state's antidiscrimination law furthers a compelling state interest in social equality, and there is no way for the state to advance that interest without some burden on the religious exercise of medical providers. The court notes, however, that if North Coast specifically objects to providing artificial insemination to lesbians, it stay true to its religious beliefs by choosing not to offer that service to anyone.

North Coast made the intriguing argument that the text of the California constitution mandates an unprecedented, almost total protection for religious objectors to state laws. The constitution says religious liberty is "guaranteed," but "does not excuse acts that are licentious or inconsistent with the peace or safety of the State." North Coast therefore argued that combating "licentiousness" or protecting "the peace and safety of the State" are the only permissible grounds for laws that do not allow religious exemptions. The court rejected this approach. Concluding, the court made clear that North Coast can seek to prove that it denied services to Benitez on some other ground, but can't simply claim liberty of conscience.

Impact of the decision

As was much discussed after Marriage Cases, the California Supreme Court is the most-cited state supreme court in the nation. The decision in Benitez is likely to be followed in other states' courts. The decision's implications go far beyond the field of infertility care or even health care more generally: it means that there is no general religious-belief exception to the civil rights laws in the provision of commercial services and public accommodations.

This decision is correct. There are, of course, areas antidiscrimination laws can't reach because of the right to privacy and the freedom of association. But so far as they go, these laws should not be subject to a carve-out for those who claim a religious obligation to discriminate.