Update on American HHS birth control mandate controversy: January, 2013

The American Center for Law and Justice (ACLJ) has filed a lawsuit against the regulation on behalf of two Ohio companies [Lifenews]. A U.S. District Judge has dismissed suits  filed by the Archdiocese of Washington and four other Catholic nonprofit groups on the grounds that the suits are premature [Bloomberg] Lawsuits filed by Colorado Christian University and Notre Dame University in Indiana have also been dismissed [The Coloradoan; First Things].  The Catholic diocese of Nashville, Tennessee and seven other groups in the state are appealing a lower court ruling against them[The Tennessean].  In Illinois, a temporary injunction has been granted against state legislation that is similar to the HHS regulation because the state’s Religious Freedom Restoration Act and Health Care Right of Conscience Act [Georgia Bulletin].  However, the U.S. federal government is appealing a decision to grant a temporary injunction against the HHS regulation to Tyndale House Publishers Inc. of Illinois [Bloomberg].A temporary injunction against the HHS regulation has been granted to a Missouri company, Sharpe Holdings Inc., the third such injunction granted in the state [St. Louis Beacon].    Virginia Attorney General Ken Cuccinelli attracted criticism because of his remarks to the effect that the nature of the HHS regulation will only become apparent if people go to jail for refusing to obey it [Reason.com]

For a map and up-to-date overview of lawsuits filed against the U.S. Department of Health and Human Services, see the Becket Fund’s HHS Information Central.

Confronting Conscientious Objection

Engaging Bioethics
The Hoya, 31 January, 2013
Reproduced with permission

Maggie Little*

Conscientious objection. . . is not something lightly invoked. Its legitimate exercise brings with it strong obligations. Objecting providers must disclose their limitations early and often to minimize patient burdens. And they must convey those restrictions with compassion and respect. . . . The very premise of protecting conscientious refusal, after all, is that deeply good and reasonable people disagree on the issue. . .  Full Text

Refusing to provide euthanasia called “abandonment”

Writing in the New England Journal of Medicine, two euthanasia advocates have characterized refusal of physicians to provide euthanasia as patient abandonment, a violation of medical ethics.  The assertion appears in their response to a suggestion that euthanasia could be provided by a state agency rather than physicians.

Angell M., Lowenstein E. Letter re: Redefining Physicians’ Role in Assisted Dying.  N Engl J Med 2013; 368:485-486 January 31, 2013 DOI: 10.1056/NEJMc1209798

The fox and the grapes:

An Anglo-Irish perspective on conscientious objection to the supply of emergency hormonal contraception without prescription

Cathal T Gallagher, Alice Holton, Lisa J McDonald, Paul J Gallagher


Emergency hormonal contraception (EHC) has been available from pharmacies in the UK without prescription for 11 years. In the Republic of Ireland this service was made available in 2011. In both jurisdictions the respective regulators have included conscience clauses  which allow pharmacists to opt out of providing EHC on religious or moral grounds providing certain criteria are met. In effect, conscientious objectors must refer patients to other providers who are willing to supply these medicines. Inclusion of such clauses leads to a cycle of cognitive dissonance on behalf of both parties.

Objectors convince themselves of the existence of a moral difference between supply of EHC and referral to another supplier, while the regulators must feign satisfaction that a form of regulation lacking universality will not lead to adverse consequences in the long term. We contend that whichever of these two parties truly believes in that which they purport to must act to end this unsatisfactory status quo. Either the regulators must compel all pharmacists to dispense emergency contraception to all suitable patients who request it, or a pharmacist must refuse either to supply EHC or to refer the patient to an alternative supplier and challenge any subsequent sanctions imposed by their regulator. [Full Text]

Obama ‘freedom to worship’ assaults First Amendment

 Freedom of religion not just for private expression

28 January, 2013
Washington Times

Jonathan Imbody*

President Obama marked Religious Freedom Day earlier this month by framing religious liberty as “the freedom to worship as we choose.” If the president had not been restricting and attacking religious freedom so egregiously, he might merit a pass for using “freedom to worship” as poor shorthand for religious liberty.

The First Amendment of our Constitution actually reads, “Congress shall make no law respecting an establishment of religion, or prohibiting the free exercise thereof.” The constitutionally guaranteed free exercise of religion in America extends well beyond the freedom to worship. It includes the freedom to live out our conscientiously held beliefs. . . [Read on]


Canary in the Coal Mine: Mounting Religious Restrictions in Europe

Religious Freedom Project
Berkley Center for Religion, Peace and World Affairs

Roger Trigg

On January 15, 2013, the European Court of Human Rights issued judgments on four cases of great significance for the cause of religious freedom. What they say could well have repercussions beyond Europe itself. . .

These four cases all came from the United Kingdom, and concerned the place of religion, and a religiously formed conscience, in modern European society. . . The point of principle at stake is how much importance should be given publically to religiously based principles, particularly in societies that are growing increasingly secular. [Read on]


The spread of conscience clause legislation

Claire Marshall

Human Rights. Jan 2013, Vol. 39 Issue 2, p15-16. 2p.


The article presents information on a proliferation in conscience clause legislation to federal and state laws in the U.S. The move is stated to be pitting individual religious autonomy against the public interest, mainly in the areas of education and health care. Right of refusal laws is closely related to abortion conscience clauses are pharmacist.[Full Text]


Medicine, Strasbourg, and conscientious objection

European Court of Human Rights decision

Julian Sheather*

. . .Conscientious objection is a live issue in medicine. . . Given the prevailing political pluralism—given the co-existence in our culture of different value systems—to what extent should medicine accommodate such objections? Should those whose consciences differ be treated differently? What forms of conscientious objection should be tolerated and on the basis of what criteria?
[Full Text]

UNFPA head promotes aggressive approach to “reproductive rights”

Dr. Babatunde Osotimehin, Executive Director of the United Nations Population Fund, has published and editorial that extols the passage of the Philippines Reproductive Health Act.  He argues that “family planning is a long established human right” and makes a claim for “reproductive rights,” and asserts that it is necessary to “tear down . . . barriers that prevent [people] from accessing information and services.”

Conscientious objections in pharmacy practice in Great Britain

Zuzana Deans

Bioethics. 2013 Jan;27(1):48-57. doi: 10.1111/j.1467-8519.2011.01918.x. Epub
2011 Jul 29. PubMed PMID: 21797914.


Pharmacists who refuse to provide certain services or treatment for reasons of conscience have been criticized for failing to fulfil their professional obligations. Currently, individual pharmacists in Great Britain can withhold services or treatment for moral or religious reasons, provided they refer the patient to an alternative source. The most high-profile cases have concerned the refusal to supply emergency hormonal contraception, which will serve as an example in this article.

I propose that the pharmacy profession’s policy on conscientious objections should be altered slightly. Building on the work of Brock and Wicclair, I argue that conscientious refusals should be acceptable provided that the patient is informed of the service, the patient is redirected to an alternative source, the refusal does not cause an unreasonable burden to the patient, and the reasons for the refusal are based on the core values of the profession. Finally, I argue that a principled categorical refusal by an individual pharmacist is not morally permissible. I claim that, contrary to current practice, a pharmacist cannot legitimately claim universal exemption from providing a standard service, even if that service is available elsewhere. [Full Text]