I read Robert Card’s recent paper entitled ‘Is there no alternative? Conscientious objection by medical students’ with great interest.1 That Muslim students in America are able to conscientiously object (and this was entertained) to the cross-gender consultation is somewhat startling. I have just left the Middle East, where I worked as a medical educator for five-and-a-half years (2006–2011), and, to the best of my knowledge, even in the conservative, gender-segregated traditional Muslim culture of the United Arab Emirates, not once did a male or female student refuse to examine a patient of the opposite sex.
Several issues, many of which have been described by Padela and del Pozo,2 should be taken into consideration in relation to Muslim students’ conscientious objection to the cross-gender consultation on religious grounds. Although Islam prohibits touching or physical contact by the opposite gender, unless appropriate (eg, by a spouse), in some circumstances, the ‘prohibited becomes permissible’.3 Medicine is one such circumstance. Islam does not …
Mclean M. Conscientious objection by Muslim students startling. J Med Ethics November 2013 Vol. 39 No. 11
Freedom of Conscience and Freedom of Religion should be taken to protect two distinct sets of moral considerations. The former protects the ability of the agent to reflect critically upon the moral and political issues that arise in her society generally, and in her professional life more specifically. The latter protects the individual’s ability to achieve secure membership in a set of practices and rituals that have as a moral function to inscribe her life in a temporally extended narrative. Once these grounds are distinguished, it becomes more difficult to grant healthcare professionals’ claims to religious exemptions on the basis of the latter than it is on the basis of the former. While both sets of considerations generate ‘internal reasons’ for rights to accommodation, the relevant ‘external’ reasons present in the case of claims of moral conscience do not possess analogues in the case of claims of religious conscience. However, the argument applies only to ‘irreducibly religious’ claims, that is to claims that cannot be translated into moral vocabulary. What’s more, there may be reasons to grant the claims of religious persons to exemptions that have to do not with the nature of the claims, but with the beneficial effects that the presence of religious persons may have in the context of the healthcare institutions of multi-faith societies.
Weinstock D. Conscientious refusal and health professionals: Does religion make a difference? Bioethics. doi: 10.1111/bioe.12059
An analysis of the death of Savita Halappanavar in Ireland and similar cases
Issues arising from the death of Savita Halappanavar in Ireland in October 2012 include the question of whether it is unethical to refuse to terminate a non-viable pregnancy when the woman’s life may be at risk. In Catholic maternity services, this decision intersects with health professionals’ interpretation of Catholic health policy on treatment of miscarriage as well as the law on abortion. This paper explores how these issues came together around Savita’s death and the consequences for pregnant women and maternity services worldwide. It discusses cases not only in Ireland but also the Americas. Many of the events presented are recent, and most of the sources are media and individual reports. However, there is a very worrying common thread across countries and continents. If further research unearths more cases like Savita’s, any Catholic health professionals and/or hospitals refusing to terminate a pregnancy as emergency obstetric care should be stripped of their right to provide maternity services. In some countries these are the main or only existing maternity services. Even so, governments should refuse to fund these services, and either replace them with non-religious services or require that non-religious staff are available at all times specifically to take charge of such cases to prevent unnecessary deaths. At issue is whether a woman’s life comes first or not at all.
Berer M. Termination of pregnancy as emergency obstetric care: the interpretation of Catholic health policy and the consequences for pregnant women: An analysis of the death of Savita Halappanavar in Ireland and similar cases. Reproductive Health Matters 2013;21(41):9–17
Re-framing pluralism, liberalism and diversity
Iain T. Benson*
This paper discusses how law is increasingly being used to attack religious associations under the guise of “equality” advancement and “non-discrimination” restrictions. I explore two important insights: first that the concept of “transformation” has been distorted, to shelter approaches to law that fail to respect properly associational diversity. When misused, “transformation” seeks to change the moral viewpoints or religious beliefs of religious associations by force of law. Second, the paper discusses the expansion of law so that it becomes a threat to associations. The “goods of religion” and the “limits of law” need to be more widely recognized and understood both by religious communities and by those involved in law, politics and the media. These insights demonstrate how “equality activists” employ a rhetoric of “equality” to produce inequality, “diversity” to produce homogeneity and “non-discrimination” to discriminate against religious communities and religious beliefs. Several solutions for identifying these errors and resisting them are outlined in brief.
Benson IT. The attack on Western religions by Western law: Re-framing pluralism, liberalism and diversity. International Journal for Religious Freedom, Volume 6, Issue 1/2, 2013
Robert K. Vischer
This article provides a brief introduction to the interplay between law and religion in the health care context. First, I address the extent to which the commitments of a faith tradition may be written into laws that bind all citizens, including those who do not share those commitments. Second, I discuss the law’s accommodation of the faith commitments of individual health care providers—hardly a static inquiry, as the degree of accommodation is increasingly contested. Third, I expand the discussion to include institutional health care providers, arguing that the legal system’s resistance to accommodating the morally distinct identities of institutional providers reflects a short-sighted view of the liberty of conscience. Finally, I offer some tentative thoughts about why these dynamics become even more complicated in the context of Islamic health care providers.
Vischer RK. The uneasy (and changing) relationship of health care and religion in our legal system. Theor Med Bioeth. 2013 Apr;34(2):161-70. doi: 10.1007/s11017-013-9248-2. PubMed PMID: 23546737
New book questions preferential treatment of religious liberty
University of Chicago News Office
Brian Leiter, Why Tolerate Religion? Princeton University Press, 2012, 192 pp. ISBN: 9780691153612
The Western democratic practice of singling out religious liberty for special treatment under the law is not in sync with the world we live in today, argues University of Chicago Law School professor Brian Leiter in his new book,Why Tolerate Religion?
All people, both religious and non-religious, maintain core beliefs about what they feel they absolutely must do— a category Leiter calls “claims of conscience.” In the book, Leiter, the Karl N. Llewellyn Professor of Jurisprudence, explores whether there are good reasons for the tendency to grant legal exemptions to religious claims of conscience while largely rejecting non-religious claims.
“The current status quo is predicated on a fundamental inequality,” Leiter said. For example, he says a boy might be permitted to carry a dagger to school as part of his Sikh religion, but the same dagger would not be allowed if it were part of a family tradition.
“Namely, your claim of conscience counts if it is based in religion,” Leiter said. “My claim of conscience doesn’t count if it is not based in religion. That, it seems to me, is a pernicious and indefensible inequality in the existing legal regime.” Read more . . .
Christopher O. Tollefsen
An important good for doctors, nurses, and other health care professionals could be described as that of “professional freedom.” This is the good of being able to bring one’s professional medical knowledge and one’s commitments to the norms and values of the medical profession to bear on one’s professional judgments and actions. This is, after all, one of the important aspects of being in a profession: professionals are not merely technicians performing the same routine tasks over and over, nor are they functionaries, blindly carrying out orders from above with little or no discretion on their part. . .
Tollefson C. Protecting positive claims of conscience for employees of religious institutions threatens religious liberty. Virtual Mentor. 2013;15(3):236-239. doi: 10.1001/virtualmentor.2013.15.3.pfor2-1303.
New book documents erosion of religious freedom
Trigg R. Equality, Freedom & Religion. Oxford: University Press; 2012 Jan 13. 224 p. ISBN: 9780199576852.
Is religious freedom being curtailed in pursuit of equality, and the outlawing of discrimination? Is enough effort made to accommodate those motivated by a religious conscience? All rights matter but at times the right to put religious beliefs into practice increasingly takes second place in the law of different countries to the pursuit of other social priorities. The right to freedom of belief and to manifest belief is written into all human rights charters. In the United States religious freedom is sometimes seen as ‘the first freedom’. Yet increasingly in many jurisdictions in Europe and North America, religious freedom can all too easily be ‘trumped’ by other rights.
Roger Trigg looks at the assumptions that lie behind the subordination of religious liberty to other social concerns, especially the pursuit of equality. He gives examples from different Western countries of a steady erosion of freedom of religion. The protection of freedom of worship is often seen as sufficient, and religious practices are separated from the beliefs which inspire them. So far from religion in general, and Christianity in particular, providing a foundation for our beliefs in human dignity and human rights, religion is all too often seen as threat and a source of conflict, to be controlled at all costs. The challenge is whether any freedom can preserved for long, if the basic human right to freedom of religious belief and practice is dismissed as of little account, with no attempt to provide any reasonable accommodation. Given the central role of religion in human life, unnecessary limitations on its expression are attacks on human freedom itself.
Abstract: Does freedom of conscience, and perhaps freedom of thought generally, have religious roots? Ronald Beiner’s Three Versions of the Politics of Conscience: Hobbes, Spinoza, Locke traces the idea of conscience as a factor in Western political thought to ideas that crystallized in the seventeenth century. Beiner examines three leading seventeenth century thinkers – Hobbes, Spinoza, and Locke – to explore whether conscience, or rather the idea of freedom of conscience, was specially a religious imperative for these thinkers: whether their religious commitments or their respect for religious integrity underlay and motivated their ideas about freedom of conscience.
Schwarzschild M. Was It Science, Not Religion? 47 San Diego L. Rev. 1125 (2010).
Abstract: The organizers of this symposium have posed the question: is the idea of conscience fundamentally rooted in religious commitments? This question inevitably draws us back to the seventeenth century, for that is when the discourse of conscience ultimately originated. And when we consult the most important sources from that epoch, we get, I believe a clear answer to the question, although it may not be the answer that the organizers of the symposium anticipated when they conceived the theme of this gathering.
Beiner R. Three Versions of the Politics of Conscience: Hobbes, Spinoza, Locke. 47 San Diego L. Rev. 1107 (2010).