“I’ve known I wanted to go into medicine for a long time,” uttered Megan Kreft, a young Portland-area physician assistant. Kreft spoke joyfully about her love for being able to manage and treat patients in a variety of medical specialties — a perk for physician assistants. She wanted to be able to work with patients in an authentically Catholic way.

Kreft was born and raised in the Portland metro area. She studied at the University of Portland and attended Oregon Health and Science University for her physician assistant training.

Kreft noticed in graduate school that some elements have seeped into medicine, elements that are contrary to the Catholic faith. She was granted accommodations by OHSU to be excused from participating in patient care that involved abortions, assisted suicide and gender transitioning. Kreft persevered. She was cautious about pursuing work in women’s health and primary care, knowing that so many of the ethical dilemmas she would face would be in those fields. Still, Providence Medical Group in Sherwood impressed her.

“I was blown away by the clinic, the support, the staff and their enthusiasm for great patient care,” said Kreft, adding that Providence appealed to her because of its Catholic identity. She was offered a position in January 2019.

Kreft aimed to be open to God’s word, and as she signed the employment documents for her new role at Providence, she felt at peace. Among the documents she was asked to sign was one requiring adherence to the U.S. Conference of Catholic Bishops’ Ethical and Religious Directives for Catholic Health Care Services. The 43-page document lays out how Catholic health care providers in the U.S. should provide care. It includes sections on beginning-of-life care and end-of-life care.

“My husband and I felt this was where God was calling us,” she said. The feeling, however, was short-lived.

Refusing to refer

Before Kreft was hired, an administrator at her clinic reached out asking which services she’d perform. On the list were vasectomies and inserting intrauterine devices, as well as prescribing hormonal contraception and emergency contraception.

“I told my manager these service violated my religious beliefs and conscience,” said Kreft.

When it became clear to Kreft that she was expected to provide these services or refer patients to another of the clinic’s providers for them, her opinion of the clinic changed. She refused to refer patients for the controversial services. Soon, she was told she would no longer be allowed to see female patients of child-bearing age.

“I’m trained to care for patients from birth to death,” said Kreft. “It was a significant population in size and also a population that I, as a woman, care about.”

The final incident for Kreft occurred when a female patient that had already been on Kreft’s schedule came in to see her for another issue. During the visit, the patient asked for an emergency contraception. Kreft told the patient she couldn’t prescribe that.

As she stepped out of the room to file paperwork, she realized that another of the clinic’s providers was prescribing the contraception to Kreft’s patient.

A few weeks later, she was invited to a meeting with the regional medical director and the clinic’s medical director. Kreft says she was told that she’d traumatized the patient and broke the Hippocratic Oath. Not long after, Kreft was invited to another meeting where she says she was told to either sign a form indicating she would refer patients to other clinic providers for services she refused to offer or she would be fired.

Kreft tried to negotiate, offering other ways to continue care for patients while still respecting her beliefs. Kreft said leadership refused to negotiate and she was fired Oct. 4. Since her dismissal, she has filed a civil rights complaint with the Office of Civil Rights of the Department of Health and Human Services.

Kreft says she was also prohibited from practicing medicine as a faithful Catholic, but she hopes her story can help others struggling to practice their faith in their medical fields.

Providence officials said that to respect an agreement with Kreft, they could not discuss the personnel matter.