Conscience - Bill of Health

The Ever-Expanding Right to Refuse to Provide Healthcare

September 23, 2024October 4, 2024 The Petrie-Flom Center Staff Leave a comment

For the past decade, a blockbuster religion law case has been a feature of every Supreme Court term. The Court dramatically eased the ability of employers to claim religious exemptions. It overturned long-standing Establishment Clause precedent. And it revolutionized Free Exercise Clause doctrine to favor objectors to public health measures and antidiscrimination laws. With no religious liberty claim on the docket, the 2023-24 term promised to be the exception.

Nevertheless, in a pair of abortion cases, the Court took the opportunity to broadly interpret federal conscience law to override patients’ rights to emergency care. The first, Food and Drug Administration v. Alliance for Hippocratic Medicine (AHM), challenged the FDA’s approval of mifepristone, the abortion pill. The second, Moyle v. United States, involved the conflict between state abortion bans and the Emergency Medical Treatment and Labor Act (EMTALA), a federal law that requires life- and health-saving care, including abortion, in emergency departments. Neither seemed to implicate the Church Amendment of 1973, which allows individual providers and institutions to refuse to perform or participate in abortion for religious or moral reasons.

blue brain hovers over bright blue circle.

Is OI the New AI? Questions Surrounding “Brainoware”

March 13, 2024April 26, 2024 Adithi Iyer Leave a comment

By Adithi Iyer

The idea of artificial intelligence is just seeping into our collective consciousness, but as we watch new developments in the space, the true “new kid on the block” may be a new type of infused human-technology intelligence — one derived from a blob of cells no larger than a grain of rice. These new units of computational prowess are brain organoids, grown in-lab and capable of producing very basic, but real-time, neurological activity. Brain organoids are a specific, and arguably the most interesting, subset of organoid models that are just beginning to enter legal debates.

Abortion rights protest following the Supreme Court decision for Whole Women's Health in 2016

Book Review: Mary Ziegler’s ‘Abortion and the Law in America’

December 2, 2020December 2, 2020 James Toomey Leave a comment

By James Toomey

If you want to understand America, you must understand our politics of abortion. And if you want to understand our politics of abortion, you must read Mary Ziegler’s recent legal history, “Abortion and the Law in America: Roe v. Wade to the Present” (2020).

In comprehensive detail and in a singularly fair and thoughtful way, Ziegler tells the story of American regulation of abortion from the Supreme Court’s historic Roe v. Wade decision to the present, and looks ahead to an uncertain future. Through vignettes of activists who have dedicated their lives to one side of the debate or the other, Ziegler shows that, notwithstanding the superficial constancy of the abortion debate — one side proclaiming the constitutional, essential rights of the fetus, the other the similarly irreducible right of bodily autonomy — the character of the debate, and the kinds of arguments made, have shifted over the course of the last fifty years.

What the Study of Religion Can Teach Us About Psychedelics

November 4, 2020November 3, 2020 The Petrie-Flom Center Staff Leave a comment

By Sam S.B. Shonkoff

If there is one thing that the critical study of religion unveils, it is that every enchanting and revelatory movement in human history — without exception, no matter how luminous the auras — is nonetheless human.

Psychedelics are no exception.

These substances are making a lot of brain scientists and policymakers talk about mysticism. And how could they not? A rapidly expanding body of data confirms that historically sacramental elements can induce altered states of consciousness with significant healing powers.

In contrast to today’s more conventional psychopharmacological techniques, which require regular doses to maintain chemical changes in the body, it appears that psychedelic medicines operate precisely by means of transformative experiences, the effects of which can last for months, if not years. Scholars and psychonauts alike can hardly account for these phenomena without recourse to the lexicon of religious studies.

And yet, strangely, scholars of religion have been largely absent from this discourse.

Polar chart depicting state conscience protection laws for abortion (46 states), sterilization (17 states), contraception (16 states), or emergency contraception (5 states).

New Dataset: Conscience Protections for Providers and Patients

June 19, 2019June 19, 2019 Nadia Sawicki Leave a comment

Scholarship and public debate about law’s role in protecting health care providers’ conscience rights often focus on who should be protected, what actions should be protected, and when and whether there should be any limitations on conscience rights.

But the how of these legal protections is rarely addressed – that is, when health care providers decline to participate in medical services that violate their deeply-held beliefs, exactly what consequences do state laws protect them from? The new dataset I’ve just released on LawAtlas answers this question in the context of reproductive health conscience laws, and reveals some surprising trends.

protesters carry signs that say "refugees welcome" in

Words Matter: How Refugees of Torture Became a “Migrant Caravan”

November 9, 2018November 13, 2018 Stephen Wood Leave a comment

San Pedro Sula in Honduras was the murder capital of the world for decades, a title it lost only a few years ago to Caracas, Venezuela in 2016.

At its peak, there were an average of three murders a day, which is alarming for a city with a census population of around only 765,000. This violence is fueled by a booming drug and weapons trade, one-third of the population facing unemployment, the presence of violent gangs, and political strife that make living in Honduras a daily life or death struggle.

When framed this way, it is clear to see that the term “migrant caravan” doesn’t at all describe this group marching from Honduras, through Mexico to the United States border. Let’s not let politicos or the media brand them as anything else. Terminology is important here, and the term “migrant caravan” doesn’t even begin to describe this group.These people are victims of torture, fleeing a violent landscape to seek asylum for themselves and their families. Anything less than that is a disgraceful mischaracterization of who they actually are.

elderly person's hand clasped in young person's hands

How Would You Like to be Treated if You Had Dementia?

October 9, 2018November 1, 2018 Leslie C. Griffin Leave a comment

The New Yorker just published an article full of ethical questions about the best health care treatment for dementia patients. It should make you think about which life you would choose. Larissa MacFarquhar’s piece is titled “The Comforting Fictions of Dementia Care.” Its subtitle suggests a sad story, noting “Many facilities are using nostalgic environments as a means of soothing the misery, panic, and rage their residents experience.” The article tells numerous powerful stories of dementia patients’ good and bad experiences.

The Abortion Information Wars

March 29, 2018March 29, 2018 cnicheileachai Leave a comment

by Clíodhna Ní Chéileachair

The Supreme Court is currently considering National Institute of Family and Life Advocates (NIFLA) v. Becerra, a challenge by abortion opponents to a California law that requires unlicensed centers in the state to inform potential patients about whether the center is medically licensed or not, and that requires clinics offering pregnancy-based care to give accurate information about the availability of low cost, or free government contraceptive and abortion care. The law is an attempt to target clinics which purport to offer comprehensive pre-natal care and pregnancy counselling, while in actuality pursuing an agenda that typically discourages women from availing of abortion care through biased counselling, false descriptions of the risks of abortions and descriptions of foetal development that are inaccurate. The number of these clinics nationwide is estimated at 4,000 – far outstripping the number of actual abortion clinics in the US – and are frequently taxpayer funded. NIFLA claims that the law targets the organisation’s free speech rights and unfairly targets the political beliefs of clinic owners and operators.

Institutional Conscience, Individual Conscience

February 22, 2018February 22, 2018 cnicheileachai Leave a comment

The debate over compulsory coverage for contraception rages on, with Notre Dame changing their policy on coverage for birth control again under Trump executive order allowing them to do so. The university had initially claimed that a requirement mandating them to provide contraceptive coverage was a burden on its exercise of religion, and discontinued coverage last October, before quickly reversing course after a protracted outcry from students, faculty and staff. Over 17,000 people are currently covered by the institution’s insurance plan. The university’s current position is to cut coverage for birth control that the university considers to be inconsistent with Catholic teachings; continuing coverage for ‘simple contraception’ while discontinuing coverage for contraception that ‘kills a fertilized egg’.

The Affordable Care Act required that insurers cover the cost of contraception without any out-of-pocket costs by the claimant, with exemptions for houses of worships and closely-held for-profits, with the proviso that organisations that wished to avail of the exemption must notify the federal government, who would then contract directly with the insurer to provide unimpeded access to birth control for employees and their dependents. Under Trump administration rules, the exemption has been expanded to include non-profit organizations and for-profit companies, including public corporations, and a separate HHS rule allows similar moral objections for most institutions.

Dystopian Memes on ‘The Week in Health Law’ Podcast

January 23, 2018January 23, 2018 Nicolas P. Terry Leave a comment

By Nicolas Terry and Frank Pasquale

Subscribe to TWIHL here!

It’s a stormy healthcare landscape out there, so this show is all lightning round. We cover several areas:

Litigation: Nic provides the Ariadne’s thread through a labyrinthine pharma-tort judgment out of California. The metal on metal hip litigation has resulted in a big judgment, but medical device regulation is still fundamentally broken. Disgruntled Centene enrollees are suing the ACA insurer of last resort for ultra-narrow networks (and Washington state is not happy, either). Washington may lead the way for future narrow network regulation or consent decrees. We followed up on the duodenoscope superbug litigation saga, focusing on duties to translate foreign language emails in discovery.

Regulation: We discussed a crisis in long-term care, following up on last week’s discussion with Paul Osterman. Medicare is not making it any easier for many who qualify for help. We reviewed the new priorities of HHS’s Conscience Rights, er, Civil Rights Division (and potential responses to conscience claims). The rise of Medicaid work requirements is a hot topic, as Kentucky Governor Bevin imposed them last week. Read More

Category: Conscience