Conscientious objection to assigned work tasks: A comment on relations of law and culture

Roger Cotterrell

Comparative Labor Law & Policy Journal
Comparative Labor Law & Policy Journal

Abstract
This paper considers how far a legal-cultural perspective may help to explain contrasts in approaches, in different jurisdictions, to a particular legal issue addressed by five national reports on which the paper comments. The issue is: how should law respond to employees’ objections, on grounds of conscience, to being required to perform particular work tasks assigned by their employers, or to being required to perform them in particular ways? The national reports discussed relate to Japan, the United States, Germany, Israel and Spain. The paper argues that cultural factors can influence not only law’s response but also the ways in which the issue of conscience is understood, contextualised and legally presented.


Cotterrell R. Conscientious objection to assigned work tasks: A comment on relations of law and culture. Queen Mary University of London, School of Law Legal Studies Research Paper No. 104/2012.  Comparative Labor Law & Policy Journal, volume 31 (2010), 511-22

Physicians’ “right of conscience”- beyond politics

Asgad Gold

The Journal of Law, Medicine & Ethics
The Journal of Law, Medicine & Ethics

Extract
Introduction:
Recently, the discussion regarding the physicians’ “Right of Conscience” (ROC) has been on the rise. This issue is often confined to the “reproductive health” arena (abortions, birth control, morning-after pills, fertility treatments, etc.) within the political context. The recent dispute of the Bush-Obama administrations regarding the legal protections of health workers who refuse to provide care that violates their personal beliefs is an example of the political aspects of this dispute.


Gold A. Physicians’ “right of conscience”- beyond politics. J Law Med Ethics. 2010 Spring;38(1):134-42. PubMed PMID: 20446991.

Access to Prescription Drugs: A Normative Economic Approach to Pharmacist Conscience Clause Legislation

Joanna K Sax

Maine Law Review
Maine Law Review

Abstract
Legal scholarship in this area debates the fairness of conscience clauses. The debate appears to be at an impasse and is, in any event, unsatisfying. This Article proposes the application of welfare economics as the guiding principle in policy determinations and presents an alternative approach to the current debate surrounding pharmacist conscience clauses. The theoretical application of welfare economics demonstrates that pharmacist conscience clause legislation may not maximize individuals’ well-being. A common law approach, whereby a pharmacist may be held liable for refusing to fill a prescription for a non-medical reason, most likely can reach the appropriate balance to minimize total social costs. If however, states refuse to repeal pharmacist conscience clause legislation or states continue to pass pharmacist conscience clause legislation, duty-to-fill legislation, which places a statutory duty on pharmacies or pharmacists to fill valid prescriptions, may be needed. If this is the case, duty-to-fill legislation should include a provision that pharmacies cannot refuse to carry any FDA approved medication due to any religious or personal objections. Importantly, duty-to-fill legislation does not alter any of the professional responsibilities and gatekeeper functions of a pharmacist. The pharmacist’s job to ensure the prescription is valid and legal remains. The expertise required for drug allergies or interactions is still a critical component of the profession. Interesting to note in this debate is that the word science is within the word conscience.


Sax JK. Access to Prescription Drugs: A Normative Economic Approach to Pharmacist Conscience Clause Legislation. Maine Law Review. 2010 Feb 17;63(1):90-129.

Medical Conscience and the Policing of Parenthood

Richard F Storrow

William & Mary Journal of Women and the Law
William & Mary Journal of Women and the Law

Abstract
As state and local anti-discrimination provisions become more and more comprehensive, physicians who refuse to treat patients for reasons of sexual orientation or marital status are beginning to face legal liability. Increasingly, physicians are invoking codes of medical ethics alongside more familiar constitutional law claims in support of their claim to insulation from legal liability. This Article explores what medical ethics has to say about physicians who, for sincerely held religious reasons, refuse to treat patients for reasons of sexual orientation or marital status. The issue is explored through the lens of a case recently decided by the California Supreme Court in which infertility physicians refused to help a lesbian couple have a child with the aid of artificial insemination. Through a close examination of the provisions of medical ethics codes and the arguments based on those codes raised in the California case, this Article concludes that medical societies should not support carving out an exception from anti-discrimination laws for physicians who, for reasons of religious conscience, want to express their class-based biases in the clinic.


Storrow RF. Medical Conscience and the Policing of Parenthood. William & Mary J Women Law. 2010;16(2):369-393.

(Thesis) Triangulation of Rights, Balancing of Interests: Exploring the Tensions between Freedom of Conscience and Freedom of Religion in Comparative Constitutional Law

Dia Dabby

Theses
Thesis

Abstract
Freedom of religion, often recognised as “first freedom” in numerous legal traditions, also reflects the different conceptions of the place of the individual and the collectivity in society. Our study will analyse the Canadian, American and European constitutional models of freedom of religion and conscience. In a first chapter, we will examine the theoretical conceptions of religion in the social sciences as well as from the perspectives of legal approaches in order to discern the manner in which religion is conceived and to better understand its various influences. In this way, we hope to enhance our understanding of both identity and to a greater extent, culture, both in and out of law. In the second and third chapters, we will attempt to characterise the relationship between freedom of conscience and freedom of religion in Canada, as well as identify unresolved issues. In the final chapter, we will observe how freedom of conscience has been interpreted in the American legal setting as well as in the European Union, by way of the European Court of Human Rights (ECtHR). We hypothesise that a better understanding of the relationship between the freedoms of conscience and religion can be arrived at by clarifying the theoretical conceptions of religion and conscience in comparative constitutional law.


Dabby D. (Thesis) Triangulation of Rights, Balancing of Interests: Exploring the Tensions between Freedom of Conscience and Freedom of Religion in Comparative Constitutional Law. University of Montreal. 2010.

Cooperation with Securities Fraud

Ronald J Colombo

Alabama Law Review
Alabama Law Review

Abstract
Although “proximity” is itself an indefinite concept, we are not without tools in deciphering it. For we have at our disposal a well-developed, longtested method of analyzing proximity with an eye toward the just imposition of culpability: moral philosophy’s “principles of cooperation.” By turning to these principles, we have at our fingertips a ready-made set of factors to consider in assessing whether one’s conduct should be deemed proximate versus remote to another’s fraud. The principles of cooperation also provide a framework around which we can organize securities fraud jurisprudence in general. For the insights gleaned from the principles regarding moral culpability in many respects parallel the conclusions reached by courts and commentators construing liability under the securities laws. Perhaps, in addition to the assistance it provides us in resolving the difficult issue of proximity, this framework could serve as a useful aid in resolving other, and future, securities fraud questions..


Colombo RJ. Cooperation with Securities Fraud. Alabama University Law Review. 2009 Dec;61(1)-66.

Where conscience meets desire: refusal of health care providers to honor health care proxies for sexual minorities

Shawna S Baker

Women's Rights Law Reporter
Women’s Rights Law Reporter

Baker SS. Where conscience meets desire: refusal of health care providers to honor health care proxies for sexual minorities. Women’s Rights Law Reporter. 2009-2010;31(1):1-41.

When Two Fundamental Rights Collide at the Pharmacy: The Struggle to Balance the Consumer’s Right to Access Contraception and the Pharmacist’s Right of Conscience

Suzanne Davis, Paul Lansing

DePaul Journal of Health Care Law
DePaul Journal of Health Care Law

Extract
Conclusion

In conclusion, we think that the marketplace of ideas should be allowed to function on this issue. So long as consumers have access to distribution channels for emergency contraception and to information regarding where the drug is available, there is no reason why the market would fail to reconcile this dilemma. However, if Wilson is correct that governments will not be able to fight the urge to take an active role in this dispute, then freedom of conscience should be the paramount fundamental right. This determination is necessary to provide the proper balance of rights because placing an affirmative duty on pharmacists to dispense a drug negates the basic premises on which our nation is built and only avoids a slight inconvenience to consumers who desire emergency contraception. Finally, it is important for governments to recognize that there are sound arguments on both sides of this legal debate and that an in depth analysis of the ethical and public policy ramifications of regulation on this issue is absolutely necessary.


Davis S, Lansing P. When Two Fundamental Rights Collide at the Pharmacy: The Struggle to Balance the Consumer’s Right to Access Contraception and the Pharmacist’s Right of Conscience. 12 Depaul J. Health Care L. 67, 89-91 (2009)

Invoking conscientious objection in reproductive health care: evolving issues in Peru, Mexico and Chile

Lidia Casas

Reproductive Health Matters
Reproductive Health Matters

Abstract
As Latin American countries seek to guarantee sexual and reproductive health and rights, opponents of women’s rights and reproductive choice have become more strident in their opposition, and are increasingly claiming conscientious objection to providing these services. Conscientious objection must be seen in the context of the rights and interests at stake, including women’s health needs and right to self-determination. An analysis of law and policy on conscientious objection in Peru, Mexico and Chile shows that it is being used to erode women’s rights, especially where it is construed to have no limits, as in Peru. Conscientious objection must be distinguished from politically-motivated attempts to undermine the law; otherwise, the still fragile re-democratisation processes underway in Latin America may be placed at risk. True conscientious objection requires that a balance be struck between the rights of the objector and the health rights of patients, in this case women. Health care providers are entitled to their beliefs and to have those beliefs accommodated, but it is neither viable nor ethically acceptable for conscientious objectors to exercise this right without regard for the right to health care of others, or for policy and services to be rendered ineffectual because of individual objectors.

Keywords:

Casas L. Invoking conscientious objection in reproductive health care: evolving issues in Peru, Mexico and Chile. Reprod Health Matter. 2009 Nov;17(34):78-87.

Unethical Protection of Conscience: Defending the Powerful against the Weak

Bernard M Dickens

American Medical Association Journal of Ethics
American Medical Association Journal of Ethics

Extract
In protecting and privileging health care professionals who withhold information that their patients depend upon, the provisions reduce health care professionals to the status of self-serving traders in an unequal market who may take advantage of those obliged or unwise enough to trust them and rely on their integrity. The provisions underscore the challenge that conscientious objection poses to health care professionalism [8]. To allow physicians to deny or frustrate a patient’s rights of conscience by enforcing their own through nonreferral, as the new regulations do, is unethical. It is ethically justifiable to be intolerant of religious or other fundamentalist intolerance.


Dickens BM. Unethical Protection of Conscience: Defending the Powerful against the Weak. Am Med Ass J Ethics. 2009;11(9):725-729.