As we are now all too familiar, Kim Davis recently refused to provide marriage licenses because of her religious beliefs. Regardless of one’s view of her particular decision, her case raises a really important question about the role of religion in a society where more than a single religion is practiced.
In medicine, this question has come up regarding treatments for pregnant women. After the Roe v. Wade decision in 1973, many states passed conscientious objection laws allowing physicians (and hospitals) to refuse to provide abortions as a matter of conscience. In addition the American Medical Association’s (AMA) Code of Medical Ethics allows physicians to refuse care to patients if that care would violate a physician’s “personal, religious, or moral belief.” Both the AMA and the government seem to agree—physicians should be allowed a right-of-refusal for reasons of conscience.
The AMA, however, puts an important limit on the right of refusal. Specifically, a physician should be allowed conscientiously object unless the patient is in a life-threatening situation. If the physician is the only physician around, the only one who has accepted this role, then they have a responsibility to provide for the patient the care that’s needed, regardless of conscience.
What I like about the AMA’s position is the recognition that context matters. When a procedure violates a physician’s conscience and another physician can fill the role, conscientious objection should be respected. But, if this is the only physician in a position to treat, if they are uniquely situated to provide the service, they have accepted a role that includes certain responsibilities even when doing so may violate their conscience.
A similar issue is now in question in California. As you may have heard, California’s legislature recently passed a right-to-die law. The law now sits on the desk of Gov. Jerry Brown, who has not stated publicly whether he will sign the law. Some suggest that he may not because the law would legalize activities that pretty clearly violate Catholic dogma and Gov. Brown is Catholic.
So I wonder if we want our legally allowed options in health care to be determined by the religious beliefs of elected officials? If we lived in a Catholic nation, then the use of Catholic dogma to determine laws would make sense. But living in a pluralistic nation with Christians, Muslims, Jews, Sikhs, Hindus, atheists, and others, laws that work for the freedom of all people cannot rest on the dogma of any particular religious perspective.
In short, Gov. Brown should decide whether or not to sign the law based on what’s in the interests of all of his constituents, regardless of his religious beliefs. It makes perfect sense for him to say something like, “As a Catholic, I would never take advantage of what this law allows, but as governor, I believe its best for my state and my constituents.”
Whether or not similar reasoning should apply to Kim Davis, I’ll leave to others to debate. I abhor the media circus that opportunists and other ne’er-do-wells have created, but I sympathize with Kim Davis’ desire to have her closely held beliefs respected. Moreover, if we applied the AMA standards of conscientious objection, there may be reasons to let her off the hook. In Kentucky, marriage licenses can be procured from any county, regardless of residence or marriage ceremony location. Much as the AMA and state legislators have protected the freedom of physicians to base their practice on their religious beliefs so long as care can be acquired elsewhere, consistent application of this principle might grant Kim Davis a similar protection for her conscientious objection.
Abraham Schwab is an associate professor of philosophy and a medical ethicist at IPFW.
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