Protection of Conscience Project Library
Service, not Servitude
Abstract
The right to moral freedom is not only analogous to the right to religious freedom. The right to moral freedom, as I explain in this essay, represents a broadening of the right to religious freedom – a broadening that for many of us is compelling.
Perry MJ. From Religious Freedom to Moral Freedom. 47 San Diego L. Rev. 993 (2010).
Abstract
Andrew Koppelman has offered a challenge to Brian Leiter’s view that the proper public attitude toward religion is one of tolerance rather than active respect. Let us explore the nature of that challenge and offer a few observations on the topic.
Wonnell CT. Comment on Koppelman and Leiter. 47 San Diego L. Rev. 987 (2010).
Abstract
The moral discourse surrounding end-of-life (EoL) decisions is highly complex, and a comparison of Germany and Israel can highlight the impact of cultural factors. The comparison shows interesting differences in how patient’s autonomy and doctor’s duties are morally and legally related to each other with respect to the withholding and withdrawing of medical treatment in EoL situations. Taking the statements of two national expert ethics committees on EoL in Israel and Germany (and their legal outcome) as an example of this discourse, we describe the similarity of their recommendations and then focus on the differences, including the balancing of ethical principles, what is identified as a problem, what social role professionals play, and the influence of history and religion. The comparison seems to show that Israel is more restrictive in relation to Germany, in contrast with previous bioethical studies in the context of the moral and legal discourse regarding the beginning of life, in which Germany was characterized as far more restrictive. We reflect on the ambivalence of the cultural reasons for this difference and its expression in various dissenting views on passive euthanasia and advance directives, and conclude with a comment on the difficulty in classifying either stance as more or less restrictive.
Schicktanz S, Raz A, Shalev C. The cultural context of patient’s autonomy and doctor’s duty: Passive euthanasia and advance directives in Germany and Israel. Med Health Care Phil. 2010 Jul 31;13(4):363-369.
Abstract
Some US states allow pharmacists to refuse to dispense medications to which they have moral objections, and federal rules for all health care providers are in development. This study examines whether demographics such as age, religion, gender influence 668 Nevada pharmacists’ willingness to dispense or transfer five potentially controversial medications to patients 18 years and older: emergency contraception, medical abortifacients, erectile dysfunction medications, oral contraceptives, and infertility medications. Almost 6% of pharmacists indicated that they would refuse to dispense and refuse to transfer at least one of these medications. Religious affiliation significantly predicted pharmacists’ willingness to dispense emergency contraception and medical abortifacients, while age significantly predicted pharmacists’ willingness to distribute infertility medications. Evangelical Protestants, Catholics and other-religious pharmacists were significantly more likely to refuse to dispense at least one medication in comparison to non-religious pharmacists in multinomial logistic regression analyses. Awareness of the influence of religion in the provision of pharmacy services should inform health care policies that appropriately balance the rights of patients, physicians, and pharmacists alike. The results from Nevada pharmacists may suggest similar tendencies among other health care workers, who may be given latitude to consider morality and value systems when making clinical decisions about care.
Davidson LA, Pettis CT, Joiner AJ, Cook DM, Klugman CM. Religion and conscientious objection: a survey of pharmacists’ willingness to dispense medications. Soc Sci Med. 2010 Jul;71(1):161-5. Epub 2010 Apr 13. PubMed PMID: 20447746
Abstract
The Supreme Court of Canada’s decision in Chamberlain,referred to above, in how it handled the definition of “secular” and pluralism as requiring the inclusion of religion and religious viewpoints, is a model for the law and the first serious consideration of a non-atheistic/agnostic (or secularistic) “secular” in Canada. It, and the TWU decision, provide the beginning outlines of an approach to both pluralism and the secular that will be superior to the preemptively non-religious and atheistic/agnostic understandings that preceded them. The decision also correctly describes the nature of pluralism as one that encourages a diversity of beliefs and that resists the co-option of “secular” society by totalistic conceptions of liberalism that exclude diversity.
These decisions ought to lead to a reconsideration of how we view law and policies in relation to all public aspects of society, including public education. Pluralism can be and needs to be re-conceptualized within existing legal norms and the Canadian historical tradition, so as to foster a richer conception of diversity and genuine tolerance with an appropriately communitarian focus. For pluralism to be pluralism, however, it is important to rescue it from a pseudo-liberalism that hides its totalistic claims.
Benson IT, Fielding A. Living Together with Disagreement: Pluralism, the Secular, and the Fair Treatment of Beliefs in Canada Today [Internet]. Camrose, Alberta: The Ronning Centre for the Study of Religion and Public Life; 2010: 1-48.
Abstract
This response will be divided into three segments. First, it will respond to Benson’s analysis of pluralism, liberalism, and the “secular”. Second, it will advocate for a return to John Stuart Mill’s harm principle as a better way of reconciling competing claims when equality rights and religious freedoms collide. Third, it will apply the harm principle to the contemporary issues of same-sex marriage and the religious objections of marriage commissioners. The central idea is that by moving away from the vague, all-encompassing language of “Charter values” to the harm principle, we create a more pluralistic public sphere that gives reasons for religious and ethnic minorities to reciprocate such tolerance and participate actively in civil society.
Benson IT, Fielding A. Living Together with Disagreement: Pluralism, the Secular, and the Fair Treatment of Beliefs in Canada Today [Internet]. Camrose, Alberta: The Ronning Centre for the Study of Religion and Public Life; 2010: 46-60.
Abstract
The Church’s teachings are often very challenging. Those who are involved in the health-care professions and who conduct their practices in accord with Church teaching can expect misunderstanding and even rejection from their colleagues and patients. One of the most difficult teachings of the Church is its condemnation of contraception. In 1968 Pope Paul VI issued the encyclical Humanae vitae, which hit the world like a bomb. In it he affirmed the Church’s long-standing teaching on human sexuality and condemned contraception in particular. Today scientific advances such as in vitro fertilization and embryonic stem-cell research, as well as the challenges in making moral decisions about end-of-life care, make it increasingly difficult for health-care professionals to practice in accord with their deeply held moral convictions. Developing a properly formed conscience, which is the voice of God, is essential in dealing with these contemporary issues and making right choices. This essay outlines the process for properly forming the conscience. It also explains why prescribing contraception is morally wrong.
Smith JE. Conscience, Contraception, and Catholic Health-Care Professionals. Linacre Quarterly. 2010 May;77(2):204-228. Edited transcript of a talk given at the first annual symposium for health-care professionals, “Conscience and Ethical Dilemmas in Catholic Healthcare,” hosted by the Archdiocese of Baltimore Respect Life Office and Baltimore Guild of the Catholic Medical Association, Baltimore, MD, May 9, 2009. The text is more conversational than a written paper and not as closely documented as a professional piece. Much of the material was accompanied by PowerPoint slides.
Abdulaziz Sachedina A. Islamic Biomedical Ethics: Principles and Application. Oxford: University Press, 2009, 296 pp. Print ISBN-13: 9780195378504. DOI:10.1093/acprof:oso/9780195378504.001.0001
Author’s Abstract
This book undertakes to correlate practical ethical decisions in modern medical practice to principles and rules derived from Islamic juridical praxis and theological doctrines. This study links these rulings to the moral principles extracted from the normative religious texts and historically documented precedents. Western scholars of Islamic law have pointed out the importance of the historical approach in determining the rules and the juristic practices that were applied to the cases under consideration before the judicial opinions were issued within a specific social, economic, and political context. These decisions reflected aspects of intellectual as well as social history of the Muslim community engaged in making everyday life conform to the religious values. Ethical decisions are an important part of interpersonal relations in Islamic law. Practical guidance affecting all facets of individual and collective human life, have been provided under the general rules of “Public good” and “No harm, no harassment.” However, no judicial decision that claims to further public good is regarded authoritative without supporting documentation from the foundational sources, like the Qur‘an and the Sunna (the exemplary tradition of the Prophet). Hence, Muslim jurists, in order to infer fresh rulings about matters that were not covered by the existing precedents in the Qur‘an and the Sunna, undertook to develop rational stratagems to enable them to solve problems faced by the community. This intellectual activity led to the systematic formulation of the principles of Islamic jurisprudence, which has assumed unprecedented importance in connection with the distinct field of medical ethics in the Islamic world that shares the modern medical technology with the West. The book argues that there are distinct Islamic principles that can serve as sources for Muslim biomedical ethics that can engage in dialogue with both secular and other religiously oriented bioethics in the context of universal medical practice and research.
“Abdulaziz Sachedina is the leading Islamic thinker writing in Engish today. Thus, his Islamic Biomedical Ethics is a welcome addition to the already extensive literature in the field because of his great knowledge of the classical and modern Islamic legal and ethical sources, his authentic religious commitment to the truth of Islam, and his willingness to engage perspectives from other traditions in what is becoming a genuinely multicultural field of moral discourse.” David Novak, author of Jewish Social Ethics
Extract
Why am I an atheist? Why do I think it is important to speak out against the harmful consequences of religious interpretations of the world and of our place in it? In this essay, I argue not only that we have no good reason to believe that a good, all-powerful, all-knowing God exists, but also that organizations and institutions campaigning in the name of God are frequently working toward preventing desirable societal progress in a number of crucial areas affecting our daily lives.
Schuklenk U. Human Self-Determination, Biomedical Progress, and God. In: Blackford R, Schuklenk U editors. 50 Voices of Disbelief: Why We Are Atheists. Wiley-Blackwell, 2009 Oct 19; 323-331.
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.