I completely gave up coffee (quelle horreur!) when I found out I was pregnant late last year. Later I was told by my wonderful doctor that I could have up to 300 mg or so of caffeine a day. I promptly left her office and went to the nearest coffee shop. Over the months of pregnancy, a fascinating thing has happened to me. While no one has begrudged me an occasional sip of wine or my husband's beer -- no disapproving looks, even -- I have had tremendous trouble ordering coffee. This is a phenomenon I've experienced solely with baristas from African countries, although I'm not sure if correlation is causation. It happens even at places like Starbucks. I've been asked to reconsider. I've been refused service. I've ordered a regular cup of coffee, only to be served decaffeinated. It's amazing. Coffee, while important to me, is not so important that I would cause a stink about not being served. In fact, if it troubles someone to serve me, I wouldn't want to force them to do so.

All this to say that refusal of service is a very contentious issue and one that is being highlighted in recent medical cases. We're all familiar with pharmacists getting in trouble for refusing to provide the so-called "morning after" pill. Frequently these pharmacists explain that it would violate their religious conscience to provide it to patients.

USA Today's Laura Parker had a very interesting article about the issue. She writes that doctors are also refusing to artificially inseminate patients, use fetal tissues or prescribe Viagra:

No doctor is required to perform particular treatments.

The collision between religious freedom and rules against discrimination occurs when physicians perform procedures selectively, offering them to some patients but withholding them from others, says Jill Morrison, legal counsel to the National Women's Law Center.

This year in a case generating wide interest, the California Supreme Court will hear a first-of-its-kind lawsuit: fertility treatment denied to a lesbian.

In Washington state, a gay man recently settled out of court with a doctor who refused to prescribe him Viagra.

"He told me he had prescribed certain drugs for married people, but he wasn't going to do that for me," Jonathan Shuffield says. "It was very painful having the trust broken between my doctor and me."

Patrick Gillen, legal counsel for the Thomas More Law Center, a Michigan-based public interest law firm that defends religious freedom, says the political clout of gays and lesbians has led to a situation that "is ripe for conflict." Gillen says no doctors should be required to perform procedures that violate their religious faith, especially "if the patients can get the treatment elsewhere."

It's a very brief and well-written story about the issue. In a separate piece, the same reporter looks at the lesbian artificial insemination case in greater detail. She begins by asking when the freedom to practice religion becomes discrimination. Apparently the answer is more complicated than my knee-jerk response of "Frequently. Which right -- to practice religion or be free from discrimination -- is given more legal weight?"

Parker explains that the California Supreme Court is being asked to decide how to accommodate a physician's religious views without violating California's anti-discrimination laws. He declined to offer in-vitro fertilization to Guadalupe Benitez, an unmarried woman, who is also a lesbian. The story ends with this fantasticly ironic quote:

Benitez, meanwhile, received treatment at another facility and has given birth to a son, now 5, and twin daughters, now 2.

"People ask me, 'Why are you doing this? You have your kids,'" she says. "I want to make a difference. These doctors are not God. They cannot manipulate who can have children and who cannot."

. . . once again reminding me that there are always religious ghosts in these stories about reproduction.