Jehovah’s Witness wins transplant case
By BRAD COOPER | The Kansas City Star
TOPEKA | The state of Kansas violated a Jehovah’s Witness’ constitutional right to exercise her religious faith when it denied her request for an out-of-state liver transplant, a state appeals court ruled this morning.
A three-judge appeals court panel overturned a lower-court ruling and ordered the Kansas Health Policy Authority to grant Mary Stinemetz’s request to undergo a Medicaid-funded liver transplant in Nebraska.
“We are very happy,” said Corinne Petrik, the lawyer representing Stinemetz.
Stinemetz, of Hill City, Kan., had refused to undergo a liver transplant at the University of Kansas Hospital because she would need a blood transfusion – something she could not accept as a Jehovah’s Witness.
She had asked the state to approve a live transplant in Nebraska where she could undergo a “bloodless transplant,” but her request was rejected because the procedure would be done out of state.
She is not currently on a waiting list for an organ and her eligibility for a transplant hasn’t been evaluated.
While the appeals court found that state Medicaid rules didn’t target Stinemetz’s faith, it did note that state regulations did allow for exceptions to the general rule barring Medicaid funding for out-of-state services.
Because the rules allow for exceptions, the state under the 1st Amendment could not deny Stinemetz’s request unless it had a compelling reason – something that judges had trouble pinpointing during oral arguments.
The state “has failed to suggest any state interest, much less a compelling interest for denying Stinemetz’s request for prior authorization for the out-of-state liver transplant,” Appeals Court Judge Thomas E. Malone wrote for the court.
The court noted that cost was not an issue in denying Stinemetz’s claim, finding that the bloodless procedure costs less than one that requires a blood transfusion.
“There is no question that the (state) would authorize a bloodless liver transplant if a medical facility was available in Kansas to perform the technique,” Malone wrote in the 40-page opinion.
Given that the bloodless procedure is less costly, state is “unable to argue that the agency is being fiscally responsible as the steward of Kansas’ tax dollars” by rejecting Stinemetz’s request.
Religious freedom aside, the court found that the state’s action seemed arbitrary since state regulations allow for exemptions to the out-of-state policy on a case-by-case basis.
Efforts to reach the Kansas Health Policy Authority were unsuccessful this morning.
The case pitted two U.S. Supreme Court cases 30 years apart against each other.
Stinemetz’s case was based partly on a 1963 case involving a Seventh Day Adventist who was let go from her job because she wouldn’t work on Saturday – the Sabbath of her faith
She was denied state unemployment benefits when she couldn’t find a job because of her unwillingness to work on Saturdays.
The U.S. Supreme Court ruled in favor of the Seventh Day Adventist, finding that state was imposing too much of a burden on her right to exercise her religion.
The Kansas Health Policy Authority, meanwhile, contended the case involving the Seventh Day Adventist didn’t apply any more.
They agency, instead, relied on a 1990 Supreme Court case involving two workers in Oregon who were fired for ingesting peyote for sacramental purposes and were denied unemployment compensation.
The Supreme Court eventually upheld the denial of benefits, saying that government can uniformly enforce laws that might impinge on someone’s religion as long the law doesn’t target their faith.
But the Kansas Court of Appeals distinguished between the two cases, noting that that Oregon case involved illegal activity and the case with the Seventh Day Adventist related to unemployment benefits.
In the Oregon case, the Supreme Court ruled that in situations where the state might have a system of exemptions in place, it must have a compelling reason not to extend those exemptions in cases of religious hardship, the appeals court noted in its opinion.
And in this case, Kansas provided exceptions to its rules, which meant it had to have a compelling reason to deny Stinemetz’s request, the court found. The court never found the compelling interest.