A paper published in the November issue of the American Journal of Public Health offers a perspective on balancing conscientious objection with equitable access for all citizens. Authored by faculty at Columbia University Mailman School of Public Health and colleagues, the editorial makes the case that there is a fine line drawn between support for an individual’s belief and support for the rights of others with different beliefs who are entitled to receiving services according to the U.S. Constitution. They propose an alternative to a U.S. Department of Health and Human Services’ (DHHS) recent ruling to shield those who work in health and social service receiving federal funds from consequences for refusing to provide certain medical treatments on the grounds of religious belief.
“We are a group of scholars and activists from medicine, public health, ethics, law, theology, and the social science who believe that it is possible — and necessary — to honor individual integrity and moral beliefs without harming those with different beliefs and values,” writes Dr. Wendy Chavkin, Professor Emerita Population and Family Health and Clinical Obstetrics and Gynecology and lead author.
The authors make the argument that the government is giving the go-ahead to those who invoke claims of conscience as a way to oppose social and political changes.
In particular Dr. Chavkin and colleagues cite denial of health care as depriving others of needed services and as undermining public trust in the field’. “If health care is denied by individuals or institutions, a patient suffers from lack of care. Clinicians are obligated not to give higher priority to her or his own conscience than to the patient’s needs,” writes Dr. Chavkin.
“DHHS’s proposed rule would dramatically tilt the balance toward those who object, and simultaneously widens the universe of those affected,” observed Dr. Chavkin. “We believe an exemption from consequences of refusals to fulfill legal or professional duties should be accommodated only if it is not discriminatory and does not undermine bedrock social values, such as equity, pluralism and advancement of the public health . Privileging these claims infringes on the conscience and rights of those holding different beliefs.”
Read perspective: “Balancing Freedom of Conscience and Equitable Access.”
Co-authors are Desiree Abu-Odeh, Columbia Mailman School; Catherine Clune-Taylor, Princeton University; Sara Dubow, Williams College; Michael Ferber, University of New Hampshire; and Ilan H. Meyer, UCLA School of Law.