Notes Toward an Understanding of Freedom of Conscience

Abstract

Commentators wrestling with conflicts between claims of conscience made by health care workers and demands for morally controversial services have offered a variety of responses. Despite these efforts, controversy about freedom of conscience in health care continues. It subsides from time to time, only to erupt again with renewed force when tectonic political and social forces collide. Discussion has not gone deep enough to address underlying disagreements about the nature of the human person that shape disputes about freedom of conscience. Proposals to limit freedom of conscience must first take into account the distinction between its perfective and preservative forms. Limiting perfective freedom of conscience prevents people from doing the good that they wish to do, and may (if no alternatives are available) prevent them from perfecting themselves, fulfilling their personal aspirations or achieving some social goals. This may do them some wrong. But if it does them some wrong, it does not necessarily do them an injury. In contrast, to force people to do something they believe to be wrong is always an assault on their personal dignity and essential humanity, even if they are objectively in error; it is always harmful to the individual, and it always has negative implications for society. This does not mean that no limit can ever be placed on preservative freedom of conscience. It does mean, however, that even the strict approach taken to limiting other fundamental rights and freedoms is not sufficiently refined to be safely applied to limit freedom of conscience in its preservative form. The stakes are far too high. Like the use of potentially deadly force, if the restriction of preservative freedom of conscience can be justified at all, it will only be as a last resort, and only in the most exceptional circumstances.