Religion Archives - Page 9 of 12 - Protection of Conscience Project Library

Does Mission Matter?

Lawrence E Singer

Extract
It is apparent that Catholic health care is suffused with a religious purpose. Its creation is based upon Church interpretation of a duty to Jesus, and its facilities are required to adhere to formal prescriptions of appropriate canonical, ethical and moral behavior. As recently as twenty years ago, questions regarding a facility’s Catholicity and the implications of this calling would rarely have been asked. In part this was because of the highly visible presence of Sisters or Brothers in the facility, making the religious nature of the institution readily apparent to even the casual observer. Too, few Catholic institutions were part of health care systems, and those systems that existed were of a local or regional nature, likely well- known by the communities served.

Today, many Catholic health care facilities have joined together into larger (often multi-state) health care systems with less visible Sister presence and the development of sophisticated corporate management teams distant from day-to-day operations and local community involvement. Many of these systems enjoy significant market power. As discussed below, the heightened visibility of these organizations has led to very public questioning of institutional adherence to religious teaching (especially in the area of sterilizations and, to a lesser extent, abortion), posing a significant challenge to the Catholic mission. Other significant challenges to the mission have also arisen, as the law, the competitive environment, and even changes within the Church present their own hurdles to Catholic facilities. Section III discusses these issues, setting the stage in Part IV for a discussion of whether a religious mission is sustainable in a pluralistic society.

Singer LE. Does Mission Matter? Houston J Health Law Pol. 2006 Sep;6(2):347-377.

Foreword: The Role of Religion in Health Law and Policy

William J Winslade, Ronald A Carson

Extract
This symposium issue explores several continuing controversies at the intersection of Law, Ethics, Healthcare, Politics, Health Policy and Religion: abortion, contraception, the status of embryos, stem cell research, IVF, personal and professional autonomy, end- of-life decisions, and religiously based health care systems. The multiple values associated with each of these topics strain and threaten to usurp the effectiveness of our legal system to regulate them.

Winslade WJ, Carson RA. Foreword: The Role of Religion in Health Law and Policy. Houston Journal of Health Law & Policy. 2006 Sep;6(2):245-248.

The association of physician’s religious characteristics with their attitudes and self-reported behaviours regarding religion and spirituality in the clinical encounter

Farr A Curlin, Marshall H Chin, Sarah A Sellergen, Chad J Roach, John D Lantos

Abstract
Context: Controversy exists regarding whether and how physicians should address religion/spirituality (R/S) with patients.

Objective: This study examines the relationship between physicians’ religious characteristics and their attitudes and self-reported behaviors regarding R/S in the clinical encounter.

Methods: A cross-sectional mailed survey of a stratified random sample of 2000 practicing U.S. physicians from all specialties. Main criterion variables were self-reported practices of R/S inquiry, dialogue regarding R/S issues, and prayer with patients. Main predictor variables were intrinsic religiosity, spirituality, and religious affiliation.

Results: Response rate was 63%. Almost all physicians (91%) say it is appropriate to discuss R/S issues if the patient brings them up, and 73% say that when R/S issues comes up they often or always encourage patients’ own R/S beliefs and practices. Doctors are more divided about when it is appropriate for physicians to inquire regarding R/S (45% believe it is usually or always inappropriate), talk about their own religious beliefs or experiences (14% say never, 43% say only when the patient asks), and pray with patients (17% say never, 53% say only when the patient asks). Physicians who identify themselves as more religious and more spiritual, particularly those who are Protestants, are significantly more likely to endorse and report each of the different ways of addressing R/S in the clinical encounter.

Conclusions: Differences in physicians’ religious and spiritual characteristics are associated with differing attitudes and behaviors regarding R/S in the clinical encounter. Discussions of the appropriateness of addressing R/S matters in the clinical encounter will need to grapple with these deeply rooted differences among physicians..

Curlin FA, Chin MH, Sellergen SA, Roach CJ, Lantos JD. The association of physician’s religious characteristics with their attitudes and self-reported behaviours regarding religion and spirituality in the clinical encounter,’. Med Care. 2006;44(446-453.

(Editorial) The sacred and the secular: the life and death of Terri Schiavo

CMAJ

Extract
. . . In medical and legal opinion, Terri Schiavo’s cognizance of her self and her life ended in 1990, when she suffered a cardiac arrhythmia and massive cerebral cortical encephalopathy that left her in a persistent vegetative state. Her facial expressions, along with a seemingly “normal” sleep–wake cycle, constituted but one dimension of the cruelty of this condition. . .

. . .More than one commentator has viewed the “right- to-life” fight to prolong Schiavo’s pitiable existence as an anti-abortion campaign “by other means.” . . .

. . . there seems little doubt that, in North America, ideology and religion have begun to seriously distort the type of consensus-building that is the proper business of democratic politics . . .

Where do physicians find themselves in such debates? Medicine is a secular and scientific profession that, for all that, must still contend with the sacred matters of birth, life and death. In practice, physicians must set aside their own beliefs in deference to the moral autonomy of each patient — or else transfer that patient’s care to someone who can meet this secular ethic. . .

. . .The emotionalism and rancour that swirled around the Schiavo case underscores a wider societal duty borne by the medical and scientific community. This is to remain alert to political and legislative tendencies that impose imprecise moral generalizations on the majority, at the expense of reason, scientific understanding and, not infrequently, compassion.

CMAJ. (Editorial) The sacred and the secular: the life and death of Terri Schiavo. Can. Med. Assoc. J.. 2005 Apr 26;172(9):1151.

The Concealment of Religious Values in Judicial Decisionmaking

Scott C Idleman

Extract
Religious beliefs and values can play a significant and potentially necessary role in the judicial disposition of cases, particularly those in which the positive law is meaningfully underdeterminate. With some exceptions, however, the permissible role of such beliefs and values in various stages of the judicial process is not often appropriately addressed within public and even academic circles. To the contrary, the issue tends by most commentators to be either largely overlooked, perhaps due to its delicacy or complexity, or categorically disposed of pursuant to a debatable theory of public discourse or a distinctive reading of the Constitution’s religion clauses. The central thesis of this Essay is that the relationship between judging and religious influences, as a result of these and other circumstances, is one defined substantially by concealment, much of it unconscious, rather than by truly principled and effective regulation. The Essay’s purposes, accordingly, are to develop this thesis more fully; to examine its chief consequences, especially for the legitimacy of judicial decisionmaking; and, to the extent that these consequences are unfavorable, to suggest some modest corrective measures.

Idleman SC. The Concealment of Religious Values in Judicial Decisionmaking. Va Law Rev. 2005 Apr;91(2):515-534.

(News) Slow progress to reproductive rights

Jocalyn Clark

Extract
Religious fundamentalism and a lack of resources are the chief barriers to achieving sexual and reproductive rights for all by 2015, concluded the 2004 International Conference on Population and Development (ICPD) . . . Katherine McDonald, president of Action Canada for Population and Development, said that advocates of the Cairo consensus have been overly distracted by their efforts to isolate and shame US and conservative backlash and must reinvest in a commitment to human rights. “In-depth policy analyses of sexual, reproductive, and abortion rights are lacking,” she said.

Clark J. Slow progress to reproductive rights. Can Med Assoc J. 2004;171(8):841.

Private Conscience: Public Duty

Graham Zellick

Extract
The premise of this lecture is that there are two different sets of ethical rules, the purely private and a special set arising in the workplace which will differ from occupation to occupation. . . .

• First, I hope it is axiomatic that ethics and morals must accompany individuals at all times no matter what they are doing.

• Secondly, that the moral or ethical position of the individual may in certain circumstances have to take on board other considerations which also have a moral and ethical dimension and that the ultimate decision, though different from one that would be reached in private life by the individual, is nevertheless justifiable and ethical.

• Thirdly, that to violate these precepts, even if it is done in order to give primacy to one’s own ethical code, is not ethical: the individual should resign or seek an alternative occupation. In other words, there are times when to listen to one’s private conscience while remaining deaf to the moral demands of one’s occupation can itself be seriously unethical.

• Fourthly, that weighing these considerations in the balance is no easy task and succumbs to no formula. It calls for the exercise of keen judgment informed by a developed moral framework.

Zellick G. Private Conscience: Public Duty. European Judaism. 2003 Autumn;36(2):118-131.

When Free Exercise Exemptions Undermine Religious Liberty and the Liberty of Conscience: A Case Study of the Catholic Hospital Conflict

Brietta R Clark

Extract
Conclusion
Using this framework, I propose a more protective principle for free exercise protection than currently exists, one that requires a heightened scrutiny of all laws that burden religious liberty, even neutral laws of general applicability. This review should examine carefully the need for the government law and the possibility of an exemption or accommodation that will not undermine the purpose of the law. However, I would not go as far as some states in providing almost absolute free exercise protection from government laws serving important government interests. Rather, the principle I advocate requires a balancing of interests tipped to favor laws protecting third parties’ from harm over religious claimants’ objections. The Catholic hospital conflict demonstrates how even under this more protective free exercise principle, the rule of law and the self–limiting principle of the liberty of conscience and religious liberty operate as justifiable limits on the scope of free exercise protection. The hospitals’ free exercise interests must be balanced against the potential harm to patients who cannot access necessary reproductive health care and information, which means that in many cases exemptions for religious hospitals will be denied.

Clark BR. When Free Exercise Exemptions Undermine Religious Liberty and the Liberty of Conscience: A Case Study of the Catholic Hospital Conflict. Oregon Law Review. 2003 Fall;82(3):625-694.

Moral Diversity Among Physicians and Conscientious Refusal of Care in the Provision of Abortion Services

Karen E Adams

Journal of the American Women's Medical Association — Journal of the American Women’s Medical Association

Abstract
Physicians are independent moral agents whose values, like those of nonphysicians, are shaped by personal experience, religious beliefs, family, and lifetime mentors. Most individuals are free to exercise their moral values in the ways that they see fit within the boundaries of legality. Physicians’ moral values take on special significance, however, when considering services patients may request but that contradict that physician’s moral beliefs, such as termination of pregnancy. In this article I analyze the competing obligations to self and to patient that a conscientiously objecting physician must consider when his or her personal morality affects his or her relationship with the patient. Despite each physician’s freedom to choose his or her mode of practice and which services to provide, a physician with a moral viewpoint that would prevent even counseling on certain options should consider practicing in an area of medicine in which the patient’s right to full disclosure of options and informed consent is not compromised by the physician’s personal moral stance.

Adams KE. Moral Diversity Among Physicians and Conscientious Refusal of Care in the Provision of Abortion Services. J American Med Women’s Ass (1972). 2003;58(4):223-226.

In Good Conscience: The Legal Trend to Include Prescription Contraceptives in Employer Insurance Plans and Catholic Charities’ “Conscience Clause” Objection

Kate Spota

Extract
This Note examines Petitioner’s constitutional argument in Catholic Charities v. Superior Court as applied to a California statute drafted with a narrowly drawn “conscience clause” exemption. First, this Note describes the background for Roman Catholic opposition to contraceptives, and contrasts the reasons behind women’s rights activists’ claim for equal access to contraception as a part of reproductive freedom. Second, this Note examines the preeminent cases decided by the U.S. Supreme Court, the U.S. Court of Appeals for the Ninth Circuit, and the California Supreme Court, as well as the relevant federal statutes and administrative decisions used by the California Court of Appeal in deciding Catholic Charities. Third, this Note describes in detail the arguments advanced by the Petitioner in Catholic Charities and the court’s resulting analysis. Concluding that the Court of Appeal of California correctly decided against the Petitioner in Catholic Charities, this Note examines the possible impacts of that decision on society’s view of women and on the Catholic health care system. Finally, this Note concludes that the California Supreme Court will affirm the appellate court’s decision and hold that the mandatory inclusion of prescription contraceptives in insurance plans, even for institutions whose religious beliefs are contrary to the mandate, does not violate the Free Exercise Clause or the Establishment Clause of the U.S. or California Constitutions.

Spota K. In Good Conscience: The Legal Trend to Include Prescription Contraceptives in Employer Insurance Plans and Catholic Charities’ “Conscience Clause” Objection. Cathol U Law Rev. 2003;52(4):1081-1113.