Professor Helen Alvare has posted a blog entry, Uphold Conscience Protection: Religious Freedom’s Contribution to the American Experience and Threats to It, over at Public Discourse on the importance of conscience protections in a variety of settings. Many readers of this blog will recognize the professor from her former work as spokeswoman for Prolife Secretariat of the US Conference of Catholic Bishops or her current work as a Consultor to the Pontifical Council for the Laity.
Professor Alvare draws particular attention to the impact of the national healthcare reform act commonly known as Obamacare on the right of religiously-affiilated institutions. The new mandate that contraception (including some abortifacient forms) be included in all employer-sponsored medical insurance plans poses a particular challenge to those who are unwilling to encourage use of or assist in paying for these medications and devices.
Of course, the issue of conscience protection is growing more complex for the prolife community. There is uniform support for physicians’ ability to decline to counsel about, refer for, or perform abortions. However should a similar principle control at the other end of life?
In places like Texas, state legislatures have passed laws allowing hospitals to decline providing life-sustaining care in certain circumstances when the hospital ethics committee concludes that such care would be “futile.” These laws typically come into play when there is a dispute between family members and the physcian about continuing care. There has been some academic writing about this issue, but little consensus has emerged. Scholars such as Thomas Mayo have defended the laws, while criticis like Thaddeus Pope and Nora O’Callaghan have attacked them.
It seems if the issue of conscience protection is understood primarily in terms of the moral autonomy of the doctor (or other healthcare professional), the same rules should apply to abortion and continuation or initiation of life-sustaining care. However, if the issue is seen as dealing with the more contentious isssues of the morality of abortion and life-sustaining care, a coherent rule can be crafted to allow doctors to refuse to provide abortions, while obligating them to continue care for the terminally ill. With the graying of American and the declining protection for religious freedom, we can certainly expect increasing attention to this issue.