Across the country, there are thousands of medical professionals, hospitals, insurance agencies, businesses, and individuals who object to being involved in certain medical interventions that raise bioethical concerns, such as abortion or assisted suicide. Unfortunately, many feel pressure from the government, employers, or even patients to act against their consciences due to concerns of legal liability or professional sanctions. Since our country’s beginning, however, conscience rights, which defend those who conscientiously object to certain actions, have been built into our nation’s legal fabric. Today, many federal and state laws exist to uphold conscience protections.
What Are Conscience Laws?
Conscience laws safeguard individuals who decline to participate in certain activities that would otherwise be required, often based upon religious, moral, or ethical grounds. Although these rights are most famously invoked by individuals opposed to warfare drafts, they also span many other areas of law ranging from capital punishment to conduct that may violate the sanctity of marriage and family. Importantly for the pro-life movement, these laws affect bioethical issues. Today, conscience rights protect individuals from being forced to participate in abortions or assisted suicides, and some offer a defense against other bioethical issues like contraception or artificial reproductive technology.
Conscientious objections are rooted in genuine, deeply held convictions. According to Black’s Law Dictionary, conscientious objections must be “something more than intellectual persuasion, amounting to a compulsive and complete aversion to particular behavior.” The Supreme Court has extended conscientious objection protections to include those based on general ethical principles, rather than those solely based on religious beliefs.
Conscience Rights Are Protected in the Constitution
The First Amendment of the United States Constitution protects conscience rights. Within it, the Free Speech Clause protects individuals from compelled speech against their convictions. The Free Exercise Clause defends individuals that want to act in accordance with their religious beliefs.
Congress has passed many anti-discrimination laws to protect the conscience rights of medical professionals, healthcare entities, insurance agencies, and individuals. These laws include:
- The Danforth Amendment, which protects individuals and groups from being required to offer or pay for abortions under Title IX’s sex-discrimination provisions;
- Section 1008 of Title X, concerning family planning and pre-pregnancy activities, which makes it clear that Title X funds may not be used to pay for abortion;
- The Coates-Snowe Amendment, which protects healthcare professionals who do not want to be trained to perform abortions;
- The Church Amendments, which prevent discrimination against healthcare professionals who refuse to perform abortions;
- The Weldon Amendment, which protects healthcare entities—including individuals, institutions, and insurance payors—that object to participating in abortion for any reason;
- The Affordable Care Act, which contains a rule preventing discrimination against healthcare providers or facilities that do not provide abortion coverage;
- Medicare and Medicaid, which include protections for those who do not wish to provide, refer for, or counsel about abortions.
Conscience Rights and the Supreme Court
In recent years, two Supreme Court cases have upheld and strengthened conscience rights. In the first case, Burwell v. Hobby Lobby Stores, the Court held that, as a closely-held for-profit organization, Hobby Lobby may conscientiously object on religious grounds to providing abortifacient contraceptives in their insurance plans. In reviewing Hobby Lobby’s conscientious objection, the Court noted that it was only required to determine if the objection is sincere, not if it is rational.
In the second case, Food and Drug Administration v. Alliance for Hippocratic Medicine the Court unanimously held that doctors could not sue in federal court over their concerns about the Food and Drug Administration’s (FDA) removal of safeguards on mifepristone since the doctors were not injured by the FDA’s action. Although the Court ultimately ruled that the doctors could not bring their lawsuit in federal court, this case was a victory for conscience rights. The Court’s reasoning rested on the fact that doctors cannot be harmed by mifepristone since they are never required to perform the abortions to which they conscientiously object. Rather, federal law robustly protects conscience rights against forced participation in abortion. The Court explained that healthcare professionals only need to state that they object to participating in abortion to be protected by federal anti-discrimination laws that safeguard conscience rights. Further, the Court highlighted that even in the emergency context, doctors cannot be forced to be involved in abortions to which they conscientiously object. Thus, the Court’s holding recognized the great extent of conscience rights within federal law.
State Constitutions Defend Conscience Rights
Beyond federal mandates, numerous states codify freedom of conscience protections in their own laws. Nearly every state constitution implicitly defends conscience rights through its protection of religious liberty. Several states even safeguard conscience rights as a distinct fundamental right. Recently, a growing number of states have passed broad anti-discrimination statutes for conscientious objectors working in healthcare.
Anti-Discrimination Laws Are Vital to Society
Conscience rights have been integral to American law since the drafting of the Constitution. Today, these anti-discrimination laws continue to play a vital role in society as they allow healthcare professionals and others to provide life-saving care to clients without fear of legal repercussions for objecting to bioethically contentious practices.
If you believe you have been discriminated against based upon your conscience right, you can submit a complaint with the Office of Civil Rights in the U.S. Department of Health and Human Services.
