Religious Freedom Archives - Page 9 of 10 - Protection of Conscience Project Library

The scope and limits of conscientious objection

Bernard M Dickens, Rebecca J Cook

International Journal of Gynecology & Obstetrics

Abstract
Principles of religious freedom protect physicians, nurses and others who refuse participation in medical procedures to which they hold conscientious objections. However, they cannot decline participation in procedures to save life or continuing health. Physicians who refuse to perform procedures on religious grounds must refer their patients to non-objecting practitioners. When physicians refuse to accept applicants as patients for procedures to which they object, governmental healthcare administrators must ensure that non-objecting providers are reasonably accessible. Nurses’ conscientious objections to participate directly in procedures they find religiously offensive should be accommodated, but nurses cannot object to giving patients indirect aid. Medical and nursing students cannot object to be educated about procedures in which they would not participate, but may object to having to perform them under supervision. Hospitals cannot usually claim an institutional conscientious objection, nor discriminate against potential staff applicants who would not object to participation in particular procedures.

Dickens BM, Cook RJ. The scope and limits of conscientious objection. Int J Gyn Ob. 2000;71(1):71-77.

Informed Consent for Emergency Contraception: Variability in Hospital Care of Rape Victims

Steven S Smugar, Bernadette J Spina, Jon F Merz

Abstract
There is growing concern that rape victims are not provided with emergency contraceptives in many hospital emergency rooms, particularly in Catholic hospitals. In a small pilot study, we examined policies and practices relating to providing information, prescriptions, and pregnancy prophylaxis in emergency rooms. We held structured telephone interviews with emergency department personnel in 5K large urban hospitals, including 28 Catholic hospitals from across the United States. Our results showed that some Catholic hospitals have policies that prohibit the discussion of emergency contraceptives with rape victims, and in some of these hospitals, a victim would learn about the treatment only by asking. Such policies and practices are contrary to Catholic teaching. More seriously, they undermine a victim’s right to information about her treatment options and jeopardize physicians’ fiduciary responsibility to act in their patients’ best interests. We suggest that institutions must reevaluate their restrictive policies. If they fail to do so, we believe that state legislation requirng hospitals to meet the standard of care for treatment of rape victims is appropriate.

Smugar SS, Bernadette J Spina BA, Jon F Merz JD. Informed Consent for Emergency Contraception: Variability in Hospital Care of Rape Victims. Am J Public Health. 2000 Sep;90(9):1372-1376.

(News) Matters of principle; AMA favors reproductive rights access but says providers can’t be forced to violate conscience

Deanna Bellandi,Elizabeth Thompson

Extract
After Roman Catholic leaders issued strong criticism about its trampling of religious freedom, the American Medical Association approved a watered-down measure supporting continued community access to a full range of reproductive services following hospital consolidations. The AMA’s amended resolution stopped short of saying Catholic hospitals should have to perform all reproductive health procedures. . . The AMA instead upheld its policy that physicians and hospitals not be forced to perform services that violate their moral principles. . .

Bellandi D, Thompson E. Matters of principle; AMA favors reproductive rights access but says providers can’t be forced to violate conscience. Mod Healthcare 2000 Jun 19; 30(25): 6,14.

Crisis of Conscience: Reconciling Religious Health Care Providers’ Beliefs and Patients’ Rights

Katherine A White

Abstract
In this note, Katherine A. White explores the conflict between religious health care providers who provide care in accordance with their religious beliefs and the patients who want access to medical care that these religious providers find objectionable. Specifically, she examines Roman Catholic health care institutions and HMOs that follow the Ethical and Religious Directives for Catholic Health Care Services and considers other religious providers with similar beliefs. In accordance with the Directives, these institutions maintain policies that restrict access to “sensitive” services like abortion, family planning , HIV counseling, infertility treatment, and termination of life-support. White explains how most state laws protecting providers’ right to refuse treatments in conflict with religious principles do not cover this wide range of services. Furthermore, many state and federal laws and some court decisions guarantee patients the right to receive this care. The constitutional complication inherent in this provider-patient conflict emerges in White’s analysis of the interaction of the Free Exercise and Establishment Clauses of the First Amendment and patients’ right to privacy. White concludes her note by exploring the success of both provider-initiated and legislatively mandated compromise strategies. She first describes the strategies adopted by four different religious HMOs which vary in how they increase or restrict access to sensitive services. She then turns her focus to state and federal “bypass” legislation, ultimately concluding that increased state supervision might help these laws become more viable solutions to provider-patient conflicts.

White KA. Crisis of Conscience: Reconciling Religious Health Care Providers’ Beliefs and Patients’ Rights. Stanford Law Rev. 1999 Jul;51(6)1703-1749.

(Thesis) Conscientious objectors to a medical treatment: What are the rules?

Andre Carebonneau

Abstract
Patients who refuse a specific medical treatment for religious reasons must often overcome strongly entrenched presumptions held by physicians and judges, presumptions frequently based on personal values. A case in point is the refusal of blood transfusion therapy by Jehovah’s Witnesses. This paper rests on the following theory: The sanctity of life principle is not necessarily violated by respecting the autonomous decision of a patient who, for religious or moral reasons, chooses one therapy over another that may be favored by the treating physician. Where a patient has decided for conscientious reasons against a certain treatment in any given medical situation, the need to be informed will shift from the patient to the physician. The physician must understand the nature of the religious or moral conviction as well as his own moral and legal obligation to respect the patient’s wishes by providing the best Medical care under the circumstances.

Carebonneau A. (Thesis) Conscientious objectors to a medical treatment: What are the rules [masters thesis]. [Montreal, PQ]: McGill Univesity; 1999 Jul. 122 p.

Selective conscientious objection in the United States

Joseph E Capizzi

Extract
It is this author’s position that the concerns of the selective conscientious objector ought to be legally recognized, not because an exemption is granted to the pacifist, but because it is the right thing to do in a democratic society that is respectful of its members’ religious commitments. This is not proposed as yet another right to add to the ever-growing list of individual rights in our society. The point of this essay is not to argue implicitly in defense of liberalism by arguing explicitly for a right deriving therefrom. Rather, it is proposed that the recognition of selective conscientious objection is necessary due to the presence of two existent legal concepts: the free exercise of religion, already extended to pacifists, and the right to confessional neutrality. “Compelling state interests” simply do not, in point of fact, override confessional neutrality. The government’s arguments about the feasibility of determining sincere selective objectors, about the drain of manpower that it claims would occur, and that the selective objector is merely a “political” dissenter and as such should not be granted this privilege, are not convincing.

Capizzi JE. Selective conscientious objection in the United States. J Church State. 1996 Spring;38(2):339-363.

Abortion (Policy Statement)

Canadian Medical Association

Abstract
The Canadian Medical Association (CMA) recognizes that there is justification for abortion on medical and nonmedical socioeconomic grounds and that such an elective surgical procedure should be decided upon by the patient and the physician(s) concerned. Ideally, the service should be available to all women on an equitable basis across Canada. CMA has recommended the removal of all references to hospital therapeutic abortion committees as outlined in the Criminal Code of Canada. The Criminal Code would then apply only to the performance of abortion by persons other than qualified physicians or in facilities other than approved or accredited hospitals. The Canadian Medical Association is opposed to abortion on demand or its use as a birth control method, emphasizing the importance of counselling services, family planning facilities and services, and access to contraceptive information. . . the association also supports the position that no hospital, physician or other health care worker should be compelled to participate in the provision of abortion services if it is contrary to their beliefs or wishes. CMA also recommended that a patient should be informed of physicians’ moral or religious views restricting their recommendation for a particular form of therapy.

Canadian_Medical_Association. Abortion (Policy Statement). Can Med Assoc J. 1985 Aug 15;133(4):318.

A question of conscience

Robert L Walley

British Medical Journal, BMJ — British Medical Journal

Extract
It was indeed a surprise to be informed by an eminent professor, after a hospital interview, that as a Roman Catholic gynaecologist “there is no place for you to practise within the National Health Service.” One had always assumed, quite naively it seems, that the British “system” is based on fair play and, above all, respect for the individual conscience. It soon became quite obvious that in order to stay in the specialty in Britain I would have had to change a conscientiously held abhorrence to the direct taking of human life. I chose to leave country, home, and family in order to practise medicine in full freedom of conscience.

Walley R. A question of conscience. Br. Med. J.. 1976;1(6023):1456-1458.

Abortion Conscience Clauses

Marc D Stern

Columbia Journal of Law & Social Problems

Extract
Despite the rulings in Roe and Doe, physicians, nurses, and denominational hospitals opposed to abortions have continued to refuse to perform them. They have argued that Roe and Doe, as judicial interpretations of the fourteenth amendment, do not apply to private activity, and that in any event the free exercise clause protects those who, for religious or moral reasons, object to abortion. These claims are not without difficulties. . . . Since Roe and Doe, Congress and many state legislatures have enacted laws to protect both institutions and individuals who refuse to participate in abortions for religious or moral reasons. These so-called “conscience clauses” limit the power of the courts to compel the performance of abortion where a refusal to participate is religiously or morally based. This article will explore the problems these statutes raise. The conclusion reached is that, for the most part, well-drafted conscience amendments are constitutional.

Stern MD. Abortion Conscience Clauses. Columbia J Law Soc Probl. 1975 Summer;11(4):571-627.

Abortion and Conscience Clause: Current Status

Dennis J Horan

Abstract
The abortion controversy is currently in the coercive stage. The hard core proponents of legalized abortion are now busy opposing abortion legislation that keeps abortion in the criminal code, or that seeks to regulate abortion other than through the medical practice act. Their aim is the psychological satisfaction of making abortion not only legal, but morally acceptable to all but the cranky Catholics. Part of the plan includes opposition of conscience clauses. Obviously this latter stance smacks of a betrayal of their promise that their wish was only freedom now, and thus they are somewhat at a disadvantage before the courts, at least as far as the conscience clause is concerned.

Horan DJ. Abortion and Conscience Clause: Current Status. Catholic Lawyer. 1974;20(4):289-302.