Whose Freedom of Conscience?

madisonwHaving recently finished reading James Madison’s WRITINGS with the high value he puts on the conscience of the individual as versus the demands of the majority, I found Stanley Fish’s opinion piece Conscience vs. Conscience   from the 12 April 2009 NEW YORK TIMES to be both an interesting topic and important discussion.

Fish wrote about the so-called “conscience clause,” the Provider Refusal Rule, which “allows health care providers to refuse to participate in procedures they find objectionable for moral or religious reasons.”  I had previously written about this in my blog Freedom of Conscience and Health Care Workers and voiced support for allowing health care workers the opportunity to exercise their own consciences and refuse to do some procedures for moral or religious reasons.

Fish raises another level of concern which is worth considering: the freedom of the individual’s conscience as versus the right of a democratic society to decide that some procedures are health rights for all.

Citing the English philosopher Thomas Hobbes, Fish writes:

Hobbes’s larger point — the point he is always making — is that if one gets to prefer one’s own internal judgments to the judgments of authorized external bodies (legislatures, courts, professional associations), the result will be the undermining of public order and the substitution of personal whim for general decorums: “. . . because the Law is the public Conscience . . . in such diversity as there is of private Consciences, which are but private opinions, the Commonwealth must needs be distracted, and no man dare to obey the Sovereign Power farther than it shall seem good in his own eyes.”

billrightsFish argues that the values of the Enlightenment which have served religious diverse cultures well is that individuals may believe what they want but when operating in the public domain the rule of law trumps personal beliefs.  He says this is a cornerstone of multicultural democracies.  It is also the complete compartmentalization of religion which is a hallmark of secularism. 

Referring to a U.S. court case from 1878 which has been upheld more recently by the courts, Fish writes that the courts have not viewed favorably actions taken by individuals which follow one’s religion but which are opposed to “generally applicable laws” because “To permit this would be to make the professed doctrines of religious belief superior to the law of the land, and in effect to permit every citizen to become a law unto himself.”

In other words the court has defended the right of society to promulgate laws the promote the social order at the expense of individual beliefs.   The court thus defends “society” as a legitimate legal entity which also has “rights.”  Thus the courts do not accept the rights of the individual to be unlimited and inviolably sacrosanct.   There are legal and social limits to what any one individual can do even in the name of their conscience or religion.

The issue in regard to health care workers being allowed to exercise their own consciences and to refuse to participate in medical procedures which are legal could open a Pandora’s Box as these workers declare their conscientious objection to blood transfusions, organ donations, vasectomies, vaccinations, reproductive technologies, biracial or “illegitimate” babies, STD patients, AIDs patients or any other number of medical issues which have moral implications to some.

Will patients walk into health care facilities not knowing whether they will be given legal and available treatments because one or more workers have moral or conscientious objections to doing the medical procedures?  How will health facilities or the police for that matter monitor or enforce such rules? 

Though the Hippocratic Oath to do no harm is not always given nor always required, do health care professionals have any obligation to perform legal medical procedures which a patient requests or needs?  Whose conscience rules when there is a clash of consciences and cultures?  These are indeed the difficult questions an individualistic and diverse society has to wrestle with.

soldier_kevinAmerica has a conscientious objector right when it comes to military service which allows citizens to refuse to engage in actions that are morally reprehensible to them (see also my blog Soldiers of Conscience).  This has also been part of Christian tradition, but I do not think the Quran allows for conscientious objection to war.   So we do have precedence for allowing some to opt out of certain professions or “procedures” based on their own consciences.  How this can work in the complicated world of health care is perhaps not as clear.

Soldiers of Conscience

I wanted to do something different tonight, and so plopped myself down in front of the TV and began flipping channels.  I have been feeling tired of many things and in need of time off – something I know the importance of – the Sabbath rest which God had built into His week, but which I ignore.  I rarely watch TV as it usually causes me to fall asleep.  But tonight I wanted to do something mindless, to kill time.

I flipped through the channels and came to the PBS station which was airing the POV show Soldiers of Conscience.  I was immediately drawn into the show.  I was watching soldiers talk about their own conscience – some who remained faithful to their sworn oath of duty to the military and defending our country and some who became conscientious objectors to war while serving in the Iraq war.

I have since high school found the military to be terrifying.  I have not thought myself able to kill.  During the Vietnam War I was sickened by the thought of going to war and found strength in the anti-war movement.  My draft number was 13 at a time when deferrals had become a thing of the past.  But then stunningly Nixon stopped the draft and I didn’t have to report to the Cleveland induction center.  I never had to face what I was going to do if put into the military.

Watching SOLDIERS OF CONSCIENCE brought back all those memories, and why I find war so horrifying.  I realized from watching the show that I would not be good soldier material.  I don’t know that I could ever have become the reflex shooter that the military now trains people to be.  The one West Point professor explains how studies in WWII showed how few soldiers were willing to pull the trigger in combat and kill the enemy.  The modern army has virtually perfected their training to make sure that the soldiers don’t think, that they just act on reflex and training.  The military today wants to make sure that the soldier’s conscience is only awakened after the battle, but then the military instructor admitted they never train the soldiers for what to do when the conscience awakens – after you have killed the enemy, or a civilian.   Shoot first, reflect on it later. 

The West Point instructor has specialized in studying the morality of war.  He asked the most difficult question about the Christ’s Parable of the Good Samaritan.    What if you are walking by the victim, not after he has been beaten to a pulp, but while he is being beaten?   Is it “Christian” to wait until the robbery and beating is over and then come to his aid?   Do you have a moral obligation as a Christian to try to intervene and risk your life and stop the beating?  What if lethal force is the only way to stop the beating and robbery?  What is your moral duty?

His take was that the military is not the Good Samaritan who arrives on the scene after the felonious assault takes place, but the military is simply those who walk the path while the assault occurs or while it it being threatened.  The military takes the moral viewpoint that it is better to stop the beating than to be a Good Samaritan.

Then there was the soldier who in his court martial was found guilty and sent to prison for refusing to serve another tour of duty in Iraq because he could no longer bring himself to kill anyone.  He commented that humanity had figured out that human sacrifice was unacceptable and had outlawed the practice.  And humans had figured out that slavery was inhumane and banned the practice.  Maybe the time has come for humans to figure out that war is no more moral than human sacrifice and slavery.

I do not know that this documentary can change anyone’s mind about the morality of war, or of the goodness of the war in Iraq, but I did find it most engaging and challenging.  Not at all the mindless TV that I had begun flipping the channels to find.  Think TV would not give me the peace I wanted for the evening.

Killing time turned into facing up to killing people.  And my pacifist nature was challenged by the realities of the world.  “There is no peace for the wicked,” says the Lord (Isaiah 48:22, 57:21).

If you want to think hard about the morality of war, and the effects of war on some men who served in Iraq, I would recommend watching POV’s  SOLDIERS OF CONSCIENCE.  For each, whether continuing to obey orders and fight, or choosing to lay down their arms and not kill again, was using the conscience God has given us as human beings.