Abstract
On 30 June 2021, Ohio state Governor, Mike DeWine, signed a Bill which would enact the state's budget for the next two years. In addition to its core funding imperatives, the Bill also contained an amendment significantly expanding entitlements of health care providers to conscientiously object to professional duties to provide controversial health care services. This amendment has been heavily criticised as providing the means to allow health care providers to discriminate against a wide range of persons by denying them access to often contested services such as abortion and contraception. In this paper, we examine the implications of this amendment and situate it in relation to other legislative actions intended to guarantee absolute rights to conscientious objection. In doing so, we argue that the entitlements extended to health care providers by these Bills are overly broad and ignore their potential to allow significant harm to be caused to clients. We then argue that if health care providers should have rights to conscientiously object (a question we do not try an answer here), then any legislation intended to protect such rights should be limited, specific, and parsimonious. Where it is not, the ideological liberty of HCPs treads dangerously on the physical freedom of their clients.
Highlights
On the 30th June 2021, Ohio state Governor, Mike DeWine, signed the Bill which would enact the state’s budget for the two years.[1]. In addition to its core funding imperatives, the Bill contained an amendment significantly expanding entitlements of health care providers (HCPs) to conscientiously object to professional duties to provide controversial health care services.[1]. This amendment has been heavily criticised by LGBT organisations, which have argued that it provides significant scope for health care providers to refuse service to members of the LGBT community.[2]. Simultaneously, the amendment would allow significant freedom to HCPs to refuse to provide often contested services such as abortion and contraception
We note that the exemptions granted in the USA may reasonably be seen as analogous to a deliberate strategy identified by the Guttmacher Institute, to limit access to contraception and abortion.[5]. Fourth, we show how the conscience based exemptions” (CBEs) granted by the Ohio Amendment depart from, and undermine, what Daniel Brock has called the “conventional compromise” in conscientious objection.[6] we argue that in so doing, that the concessions granted by these Bills exceed what can be reasonably justified by the concern for the personal liberty of health care providers
Conscience protection laws are not a recent phenomenon in the jurisdictions with which we are concerned in this paper, having emerged alongside, and in response to laws permitting abortion in the United States[7] and United Kingdom.[8] in recent years, the long running debate surrounding conscientious objection in health care has become increasingly heated.[9,10,11] This is partly because of the increasing number of cases in which requests for CBEs are made, and partly because of the way in which appeals to freedom of conscience are used in increasingly expansive ways that limit the rights of clients to basic health care services
Summary
West-Oram, Peter G N and Nunes, Jordanna A A (2021) Conscience absolutism via legislative amendment. ISSN 1477-7509 This version is available from Sussex Research Online: http://sro.sussex.ac.uk/id/eprint/103105/ This document is made available in accordance with publisher policies and may differ from the published version or from the version of record. Copies of full text items generally can be reproduced, displayed or performed and given to third parties in any format or medium for personal research or study, educational, or not-for-profit purposes without prior permission or charge, provided that the authors, title and full bibliographic details are credited, a hyperlink and/or URL is given for the original metadata page and the content is not changed in any way. N.B. This paper was accepted for publication in the journal Clinical Ethics on the 7th November 2021. This document is the Accepted version of the paper, before journal formatting, please do not cite this version.
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