Religious Freedom Archives - Page 6 of 10 - Protection of Conscience Project Library

Conscientious Objection: Resisting Ethical Aggression in Medicine

Sean Murphy

Responding to Cantor, Julie D., Conscientious Objection Gone Awry – Restoring Selfless Professionalism in Medicine. N Eng J Med 360;15, 9 April, 2009

Extract
Judging from the title of her article, Professor Julie D. Cantor believes that “selfless professionalism” in medicine is being destroyed by health care workers who will not do what they believe to be wrong.

She also implies that Americans have access to health care only because health care workers are compelled to provide services that they find morally repugnant. At least, that is the inference to be drawn from her warning that health care “could grind to a halt” if a federal protection of conscience regulation were “[t]aken to its logical extreme.”

Such anxiety is inconsistent with the fact that religious believers and organizations have been providing health care in the United States for generations. If anything, this demonstrates that health care is provided to many Americans – and many of the poorest Americans – because of the commitment of health care workers to their moral convictions, not in spite of them.

Murphy S. Conscientious Objection: Resisting Ethical Aggression in Medicine [Internet]. Protection of Conscience Project (2009 Apr 17).

Conscientious Objection Gone Awry-Restoring Selfless Professionalism in Medicine

Julie D Cantor

New England Journal of Medicine, NEJM — New England Journal of Medicine

Extract
Health care providers already enjoy broad rights — perhaps too broad — to follow their guiding moral or religious tenets when it comes to sterilization and abortion. An expansion of those rights is unwarranted. . . .Physicians should support an ethic that allows for all legal options, even those they would not choose. Federal laws may make room for the rights of conscience, but health care providers — and all those whose jobs affect patient care — should cast off the cloak of conscience when patients’ needs demand it.

Cantor JD. Conscientious Objection Gone Awry-Restoring Selfless Professionalism in Medicine. N Engl J Med. 2009 Apr 09;360(15):1484-1485.

The Limits of Conscience: Moral Clashes Over Deeply Divisive Healthcare Procedures

Robin Fretwell Wilson

Extract
Refusals by individual pharmacies and pharmacists to fill prescriptions for emergency contraceptives (“EC”) have dominated news headlines. . .These refusals. . .reflect moral and religious concerns about facilitating an act that would cut-off a potential human life.

Recently, conscience-based refusals have ballooned far beyond EC. Pharmacists are refusing to fill prescriptions for birth control, and other ancillary care professionals are asserting their own conscience concerns.

Conclusion
Ultimately we must decide as a community whether we prize access more highly than religious freedom. The older healthcare conscience clauses offer us a range of methods to manage the clash between competing moral interests. If urgency for the service cannot be achieved through better information, state legislatures could make a number of choices. They could choose not to burden the professional’s choice at all—prizing religious liberty more highly than access. They could force providers to provide every service legally requested—prizing patient access more highly than moral or religious freedom. Or they could choose to allow individuals of conscience to exempt themselves up to the point that it creates a hardship for the patient or employer. In a pluralistic society, a live-and-let-live regime like this may be the most we can hope for.

Wilson RF. The Limits of Conscience: Moral Clashes Over Deeply Divisive Healthcare Procedures. Am J Law Med. 2008 Mar 01;34(1):41-63.

Conscience and Conflict (Conscience in Medicine)

Marcus P Adams

Extract
Asserting that we should encourage dialogue is one thing; showing that such dialogue is possible is another. My commentary has in no way argued against having beliefs that result from religious conscience; rather, I have argued only that religious conscience, regardless of the religion from which it develops, has no place in medical decision-making.

Adams MP. Conscience and Conflict (Conscience in Medicine). Am J Bioeth. 2007;7(12):28-29.

Conscience in America: the slippery slope of mixing morality with medicine

Georgia Chudoba

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Extract
Conscience clauses in this country are becoming dangerously broad and over-inclusive. What was once a protection for physicians who objected to performing abortions is now a tool for religious activists to obstruct a patient’s right to contraceptives, sterilization, and any other medical procedure that they feel is “morally” wrong. The Legislature must place limits on these clauses to protect patients’ rights. At the onset of new medical research on stem cells and infertility treatments, it is crucial that Congress enact legislation that will protect patients’ rights to these treatments. There needs to be a balance between the doctor’s right of conscience and the patient’s right to treatment.

Chudoba G. Conscience in America: the slippery slope of mixing morality with medicine. Southwestern University Law Review. 2007;36(1):85-106.

The Freedom of Religion in Canada: Challenges and Opportunities

Iain T Benson

Abstract
The paper covers a wide scope in an attempt to examine, in the space available, some of the central cultural and constitutional facts that form the background to recent legal decisions that touch on “religious liberty” in Canada. Important, as well, are recent insights from political theorists, particularly those who examine the nature of liberalism. . . This Article will show that in the last decade the Canadian judicial system has heard a series of important cases in which principles were raised that give a truly Canadian perspective to the relationship between church and state, and the person and the community, in ways that are not developed elsewhere. These cases may provide useful grounding to the principles of accommodation of religion in the public sphere and inclusion of religion in the public sphere, and, further, may reduce the bifurcations that obscure issues where they should elucidate.

Benson IT. The Freedom of Religion in Canada: Challenges and Opportunities. Emory International Law Review. 2007;21(111)

When to Grant Conscientious Objector Status (Conscientious Objection and Emergency Contraception)

Ronald A Lindsay

Extract
Provided the physician notifies the patient as soon as possible of any limitations on services and promptly assists the patient with referrals to other physicians, physicians should be allowed to refuse to provide some services. However, once the patient and physician have decided on a course of action, they should be able to rely on the cooperation of other healthcare workers. The last thing we need is to complicate our healthcare system even further by allowing pharmacists, nurses, and others to obstruct a person’s healthcare decisions based on their sectarian beliefs.

Lindsay RA. When to Grant Conscientious Objector Status (Conscientious Objection and Emergency Contraception). Am J Bioethcs. 2007 Jun 01 ;7(6):25-26. Available from:

Politics, Parents, and Prophylaxis — Mandating HPV Vaccination in the United States

R Alta Charo

Extract
Public health officials may have legitimate questions about the merits of HPV vaccine mandates, in light of the financial and logistic burdens these may impose on families and schools, and also may be uncertain about adverse-event rates in mass-scale programs. But given that the moral objections to requiring HPV vaccination are largely emotional, this source of resistance to mandates is difficult to justify.

Charo RA. Politics, Parents, and Prophylaxis — Mandating HPV Vaccination in the United States. N Engl J Med. 2007 May 10;356(19):1905-1908.

(Correspondence) Religion, Conscience and Controversial Clinical Practices

Nada L Stotland

Extract
It is unrealistic and unfair to expect patients to anticipate all conditions that may befall them, identify which ones might be problematic for their physicians, and agree either to reach a compromise or to seek care elsewhere.

Stotland NL. (Correspondence) Religion, Conscience and Controversial Clinical Practices. N Engl J Med.. 2007;356(18):1889-1890.

Respect for Conscience in Common Law Countries

Carl Anderson

Proceedings of the Pontifical Academy for Life

Extract
The trend toward freedom of religion and conscience has been building over the past centuries. Certainly, the last hundred years have brought a greater tolerance of religious ideas in England, with restrictions on Catholic finally lifted in the early 19 th century, and the United States has, since the late
18th century enshrined religious freedom as a preeminent right. There is thus reason to hope that we may be moving toward a situation in which the precedent will be established that provides a greater understanding and accommodation of the conscience of the individual healthcare provider. However, there is not unanimity of opinion and contradictory decisions about the freedom of conscience in this area continue. “This issue is the San Andreas Fault of our culture,” said Gene Rudd of the Christian Medical & Dental Associations. “How we decide this is going to have a long-lasting impact on our society.”

Challenges to the conscience of a health care professional certainly continue in common law countries, and the current system of dealing with such issues in these countries is far from adequate, or uniform. The problems will only grow as new unethical procedures become seen as “the norm” by some and as a “right” by others. . . . Common law countries certainly have much to do to develop more fully the ideal of a conscience clause for those in the medical field. However, the fact that in most common law countries some accommodation at least seems to be made for the conscience of those in the health care field provides hope.

Anderson C. Respect for Conscience in Common Law Countries. In: Sgreccia E, Laffitte J editors. Proceedings of the 13th General Assembly of the Pontifical Academy for Life. 2007;102-114.