Abstract Contemporary bioethics generally stipulates that public moral deliberation must avoid allowing religious beliefs to influence or justify health policy and law. Secular premises and arguments are assumed to maintain the neutral, common ground required for moral deliberation in the public square of a pluralistic society. However, a careful examination of non-theistic arguments used to justify euthanasia (regarding contested notions of human dignity, individual autonomy, and death as annihilation) reveals a dependence on metaethical and metaphysical beliefs that are not universally accepted in a pluralistic society. Such beliefs function in non-theistic arguments in the same way that foundational beliefs justify moral convictions in religious frameworks of belief. This parallel is apparent when religious belief is defined broadly (a la John Reeder) as ‘the search for the good in light of the limits and possibilities of the real.’ Seen through this interpretive lens, frameworks comprising Secular foundational commitments function, in ethically relevant respects, like the guiding beliefs found in the comprehensive frameworks of traditional religions. When conscientious practice in healthcare is reconsidered in light of this foundational similarity between the religious and the secular, it is clear that those who object to the foundational beliefs underpinning Secular arguments for euthanasia should not be required to provide, participate in, or refer patients for euthanasia (or other ethically controversial practices similarly dependent on contested frameworks of belief) in pluralistic societies that prize moral freedom as a primary human good.
Rachel Kogan, Katherine L Kraschel, Claudia E Haupt
Abstract This article canvasses laws protecting clinicians’ conscience and focuses on dilemmas that occur when a clinician refuses to perform a procedure consistent with the standard of care. In particular, the article focuses on patients’ experience with a conscientiously objecting clinician at a secular institution, where patients are least likely to expect conscience-based care restrictions. After reviewing existing laws that protect clinicians’ conscience, the article discusses limited legal remedies available to patients.
Extract We must return to our Pythagorean roots and not substitute a secular group conscience to replace individual conscience, and thereby protect the rights of all parties. My hope is that our specialty will uphold the right of individual clinicians to practise according to their consciences and we will continue to welcome Hippocratic clinicians into our ranks.
Lexis Nexis Summary Pharmacists who have subscribed to this movement assert that they have a “right” to refuse to fill valid patient prescriptions whenever doing so might violate their own religious or moral beliefs. … The governments of Arkansas, Florida, and South Dakota sought to both endorse and shield from liability instances of religiously motivated pharmacist refusal to dispense family planning products. … Such expectations, as demonstrated in the policy positions set forth by organizations like the American Pharmacists Association (APhA) and Pharmacists for Life, harm the profession by undermining its credibility while underscoring the need to preserve the regulating power of liability as a tool to protect patient interests. … These factors, compounded with the profession’s own struggle for professional legitimacy and insistence on recognition of the practitioners’ “clinical role” in the provision of medication to patients indicate that a defense against alleged malpractice based on a free exercise theory would not succeed both based on the secular nature of the profession and as a matter of existing free exercise jurisprudence. … South Dakota’s legislature has already demonstrated as much by including a provision in its pharmacist refusal clause permitting pharmacists to refuse to dispense palliative drugs that might be used to hasten death, clearly a measure that can affect women and men alike
Abstract As a science and practice transcending metaphysical and ethical disagreements, ‘secular’ medicine should not exist. ‘Secularity’ should be understood in an Augustinian sense, not a secularist one: not as a space that is universally rational because it is religion-free, but as a forum for the negotiation of rival reasonings. Religion deserves a place here, because it is not simply or uniquely irrational. However, in assuming his rightful place, the religious believer commits himself to eschewing sheer appeals to religious authorities, and to adopting reasonable means of persuasion. This can come quite naturally. For example, Christianity (theo)logically obliges liberal manners in negotiating ethical controversies in medicine. It also offers reasoned views of human being and ethics that bear upon medicine and are not universally held – for example, a humanist view of human dignity, the bounding of individual autonomy by social obligation, and a special concern for the weak.
Abstract Only when it is recognized that not all ‘faiths’ are religious and that all citizens operate out of some sort of faith commitments can we be properly in a position to evaluate nonreligious faiths alongside religiously informed ones. This re-adjustment of the usual way of examining matters then should lead, Professor Benson argues, to a more accurate way of viewing current education and politics (and their areas of avoidance) as well as such things as fair access to the public square by religious believers and their communities. The long dominance of atheistic and agnostic forms of social ordering (including funding for such things as education and health care) is based, in part, on a belief that stripping religious frameworks from public sector projects is ‘neutral’ when it is not.
In addition, the focus on a rights based jurisprudence has a tendency to view rights such as the freedom of religion in individualist ways that ignore the communal importance of religion. The paper will suggest that moves to put pressure on the associational dimension of religions ignore the communal nature of certain forms of belief to the detriment of a more co-operative society and far from encouraging human freedom, actually reduce it.
In the long run, the importance of religions and their communities to the public sphere – which has been recognized by the Constitutional Court of South Africa – will be encouraged by this fresh and more accurate way of viewing belief systems and the communities that form around them. The more accurate way of understanding both the reality of and the need for more articulate public beliefs, will, Benson argues, provide a richer ground for such things as public school curriculum which often drift in the face of fears of moral imperialism and metaphobia (fear of metaphysics).
Extract Jürgen Habermas’s recent observations regarding the increasing gulf between traditional religions and contemporary secularism is correct (2002, 2008). The dominant bioethical and political ideologies of the contemporary Western world have come to be not merely secular but often passionately atheistic. Throughout Western Europe and North America, for example, there is a growing movement to undermine the salience of religious discourse, to undue its influence in the public forum, and to erase religion from the public space. Attempts to frame all of medicine within a completely secular morality, relegating religious belief and practice to the realm of private personal choice, have become ever more prominent. Here, one need only consider the current clash between the US Roman Catholic bishops and President Obama’s administration over whether Catholic employers, such as Catholic hospital systems, ought to be legally required to provide insurance coverage for artificial contraception, including abortifacients, in their employer sponsored health care plan.1 In law and public policy, there has been a profound rupture from Traditional Christianity, which secular proponents aggressively seek to place in the distant past, as if Christianity had been an unfortunate, perhaps immoral, accident of history. Habermas’s acknowledgment of the vast divide between traditional religions that approach the world and moral analysis with knowledge of a God Who commands, and secular worldviews that begin all epistemic and normative analysis with the prior assumption that God does not exist, elucidates the fundamental debates of contemporary bioethics.
Abstract Notwithstanding the notorious difficulty of defining religion and the consequent effort on the part of jurists and academics to avoid embracing any particular definition, one model of religion has dominated modern discourse: religion as conscience. Because of the dominance of this model, alternative views – which either subordinate the conscience to other supposedly more fundamental features of religion or dispense with the psychological apparatus of conscience altogether – have been largely submerged in modern political and legal discourse. Yet they will not remain suppressed. As a number of the conference papers have attest, alternatives and challenges to the dominant model have been surfacing with increasing regularity and insistence, particularly in the last decade, in part because the logic of the model seems to have exhausted or deconstructed itself, or driven itself into a corner, but also because theoretical rivals to the conception of religion as conscience have always existed, have never disappeared, and have never stopped pressing their claims.
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.
A Response to Iain T. Benson, “Living Together with Disagreement: Pluralism, the Secular and the Fair Treatment of Beliefs in Canada Today”
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.