How the New Healthcare Law Endangers Conscience

by Helen Alvaré
June 29, 2010

The new healthcare law has endangered longstanding protections on conscience. We must act to address them or risk creating a dangerous precedent.

A great deal of attention has been paid to the quandary that nearly prevented the passage of the Patient Protection and Affordable Care Act (PPACA): federally subsidized abortion. Very little attention, however, has been focused on the status of conscience protection following passage of this lengthy, complicated piece of legislation, despite its being chock-full of new mandates that implicate the consciences of private and institutional providers, patients, and health insurance companies alike. A rare exception was Rob Stein’s piece in the Washington Post, yet even this article spared readers too many important details.

Why is the conscience issue so neglected? One possible reason is that conscience violations are less tangible than the destruction of a living human being. Furthermore, the area of conscience protection has many moving parts, which can be hard to monitor. Conscience protection laws can shield both the religious and moral objector or just the former; they might cover many different forms of involvement (providing, referring, etc.) in one or more services (abortion, euthanasia, birth control, etc.); they could cover one or more sets of actors in the healthcare field (individual providers, hospitals, insurance companies, etc.) against discrimination by one or more authorities (government entities, employers, health plans, etc.). the rest

There are also various theological and philosophical grounds for different conscience claims; these might range from an objection to killing (easy to grasp) to an objection to impairing the normal functioning of the human reproductive system (more difficult for many to grasp in a world awash in birth control). Finally, there is the seemingly insoluble dilemma posed when the demand for legal conscience protection is characterized as a contest between “your right to refuse” and “my right to have.”