This week the Supreme Court declared same-sex marriage legal in all 50 states of the US. A great victory for equality for sure and one that sets the stage for other legal and regulatory changes that integrate this ruling into all aspect of life including health care. It also reaffirms that in the US faith groups have the right to act on their beliefs within their communities even if they are contrary to the “law of the land”.
However, as great a victory as this is for justice and equality and as necessary as it is to set the stage for other changes, there is still a long way to go before this equality that is now mandated by law becomes practice on the ground. The literature, both anecdotal and quantitative, well documents how deep bias runs. I recently read a report on some research that suggests that skin color becomes salient for babies within the first few months of life so the oft-used parental strategy of teaching equality by pretending that differences in skin color do not exist simply will not work. Children will make attributions based on skin color no matter what we do so the way to have those attributions be that people are not better or worse based on skin color is to discuss that belief openly and early.
The examples are everywhere. Just like skin color becomes salient early, the idea that people do not marry others of their own gender is deeply ingrained in most of us. That belief does not even have to be positive or negative. It is just how we learned the world works. How often have we in health care observed a situation or participated in one where a health care provider “naturally” turned to the parents of the adult patient in the bed to ask a question about care not even considering the possibility that the other person in the room could be the patient’s spouse simply because that person was the same sex as the patient? And do we then consider how the rest of the family feels about that marriage and what that means for the patient’s coping?
As the research on the salience of skin color points out, we humans register all sorts of visual and verbal cues as keys to categorizing people. It seems to be a hard-wired part of being human. Asking us to override those cues in the name of cultural/religious/ethnic equality is a very tall order indeed. However, it is exactly these types of overrides that we are being asked to make. And we as health care providers would seem to have a special responsible to work at these changes because without them some of our patients and their family members will not receive the best or the most respectful care.
I believe that these changes can be taught. We as chaplains are taught to try to recognize the places and situations that make us uncomfortable and thus separate us from being fully present to the person we are serving. We do not do away with those discomforts- that is too tall an order. But we try to put those feelings aside so that they do not get in the way of our care. None of us are perfect at this of course but our call is to keep trying.
The Supreme Court decision simply reminds us of another place in our lives where those discomforts might appear. Denying them is not a good option. Admitting to them at least to ourselves so we can put them aside and give the best care is a strategy that can work.