Article: Is the Conscience Respected?
NEW YORK, MARCH 17, 2007 (Zenit.org).- Here is a text by Carl Anderson,
vice president of the John Paul II Institute for Studies on Marriage
and the Family, regarding the respect for conscience in life issues.
* * *
THE CHRISTIAN CONSCIENCE IN SUPPORT OF THE RIGHT TO LIFE
Respect for Conscience in Common Law Countries
Carl Anderson
Vice President, John Paul II Institute for Studies on Marriage and
Family
Supreme Knight, Knight of Columbus
Pontifical Academy for Life XIII General Assembly February 24, 2007
St. Thomas More is recognized in our time as one of the great defenders
of human dignity and the rights of human conscience. We are all
familiar with the famous lines from "A Man for All Seasons" regarding the role
of conscience: In his refusal to sign the oath, More says "what matters
to me is not whether it's true or not but that I believe it to be true,
or rather, not that I believe it to be true, but that I believe it."[1]
St. Thomas More is also rightly regarded as the model Catholic
government official when he says earlier in the play, "when statesmen forsake
their own private conscience for the sake of their public duties …
they lead their country by a short route to chaos."[2]
And how simply, yet profoundly, he set the standard for all those of
the Christian faith who serve in government when he said at the end,
"Tell the King, I die the King's loyal servant, but God's first."
Perhaps we might do well to regard Thomas More as a sure guide for
politicians, reminding them of his approach to government service. As "A
Man for all Seasons" recounts More as saying of his work as chancellor of
England, "I wish no man harm, I speak no man harm, I do no man harm and
if this be not good enough then … "
We might also regard St. Thomas More as a patron of husbands and
fathers. We may recall the way in which More is depicted at the end of his
trial in "A Man for All Seasons." He declares to the court which has just
condemned him that "It was not for the oath but because I would not
consent to the marriage."
Everything we know about St. Thomas More tells us that he cared deeply
for his family and that one of the reasons why he sought so desperately
to avoid a confrontation with the king was to protect his family. Yet,
finally, More was to sacrifice both his life and his family's security
for a principle that gave an eternal meaning and an eternal unity to
his family; that is, the sacramental nature of marriage.
Unquestionably, in agreeing to the dissolution of the king's marriage
there was also an implicit acceding to the possible dissolution of any
marriage. This was a point that could not have been lost on the
chancellor of England and a lawyer of the brilliance of Thomas More. Thus, one
of history's great statesman and men of conscience went to his death
for a principled defense of the sacramental unity of marriage.
Having said this we should remember the observation of Clarence Miller,
one of several editors of the "Complete Works of St. Thomas More." He
enumerates what scholars give as the various "grounds for More's
martyrdom: the integrity of the self as witnessed by an oath, the irreducible
freedom of the individual conscience in the face of an authoritarian
state, papal supremacy as a sign of the supra-national unity of Western
Christendom, past and present."
Then Miller writes, "All of these are true as far as they go. But in
the last analysis More did not die for any principle, or idea, or
tradition, or even doctrine, but for a person, for Christ. As Bolt himself
made More say in the play: "Well … finally … it isn't a matter of
reason; finally it's a matter of love."[3]
And so, I think it is entirely appropriate to remember St. Thomas More
as we explore the richness of the encyclical "Evangelium Vitae" and its
call to the Catholic people to build a culture of life and a
civilization of love. We should begin with recognition that "Evangelium Vitae"
rests, to a considerable extent, upon the foundation provided by John
Paul II's great encyclical on the "Splendor of Truth" and the moral
conscience.
"Veritatis Splendor" takes up the question of the obligations which
truth imposes on Catholics in democratic societies. It observes that the
demands of universal and unchanging moral laws may seem to contradict
"the uniqueness and individuality of the person" and even "represent a
threat to his freedom and dignity" (No. 85). The encyclical also admits
that "in a widely de-Christianized culture, the criteria employed by
believers themselves in making judgments and decisions often appear
extraneous or even contrary to those of the Gospel" (No. 88).
But then John Paul II writes what could have come from the thought or,
perhaps more accurately, from the spirituality of Thomas More. He
states, "It is urgent to rediscover and to set forth once more the authentic
reality of the Christian faith, which is not simply a set of
propositions to be accepted with intellectual assent. Rather, faith is a lived
knowledge of Christ, a living remembrance of his commandments, and a
truth to be lived out. … It is an encounter, a dialogue, a communion of
love and of life between the believer and Jesus Christ … (No. 88).
Or as More had put it, "finally it's a matter of love."
After so many years it is perhaps too easy to view the English Catholic
martyrs of the 16th century as having a sort of determination or even a
certain eagerness for their fate. But the following passage on the
subject of martyrdom written by More while he was in the tower poignantly
reveals something very different.
More wrote in "De Tristitia Christi" of the martyr's encounter with
Christ who says this to his follower: "You are afraid, you are sad, you
are stricken with weariness and dread of the torment with which you have
been cruelly threatened. Trust me. I conquered the world, and yet I
suffered immeasurably more from fear. I was sadder, more afflicted with
weariness, more horrified at the prospect of such cruel suffering drawing
eagerly nearer and nearer.
"Let the brave man have his high-spirited martyrs, let him rejoice in
imitating of them. But you, my timorous and feeble little sheep, be
content to have me alone as your shepherd, follow my leadership; if you do
not trust yourself, place your trust in me. See, I am walking ahead of
you along this fearful road."[4]
Few in the Church have more poignantly depicted the call to holiness
and spiritual perfection than More in this brief description of the
"sequela Christi" to martyrdom.
But the ultimate lesson which More gives us is that for the Catholic,
government service opens a horizon to a type of personal martyrdom.
Certainly, this was the case in More's life and throughout much of the 16th
century. It was equally true throughout much of the 20th century. And
it is also true in the beginning of the third millennium as we
increasingly face a new culture of death.
Politics which too often today has been the arena of personal
self-promotion and egocentrism should be understood rather by the Catholic as a
following of Christ which is open to martyrdom, if not of the bloody
martyrdom suffered by More, than a martyrdom of career and reputation. To
think otherwise is a disservice to the Catholic community and to be
dishonest with one's self.
We might say that John Paul II has a similar vision of the Catholic's
struggle in the face of an increasingly hostile culture when he wrote in
"Evangelium Vitae" the following: "Faced with the countless grave
threats to life present in the modern world, one could feel overwhelmed by
sheer powerlessness: Good can never be powerful enough to triumph over
evil!
"At such times the people of God, and this includes every believer, is
called to profess with humility and courage faith in Jesus Christ, 'the
Word of Life.' The gospel of life is not simply a reflection, however
new and profound, on human life. Nor is it merely a commandment aimed at
raising awareness and bringing about significant changes in society.
Still less is it an illusory promise of a better future. The Gospel of
Life is something concrete and personal, for it consists in the
proclamation of the very person of Jesus" (No. 29).
Thus, what Thomas More had suggested was the sure hope of those
suffering for the truth of the Catholic faith, John Paul II sees as the
guiding star of Catholics in the pro-life movement.
We see also in the life of Thomas More the truth recognized by the
Second Vatican Council when it observed in Gaudium et Spes that, "In the
depths of his conscience man detects a law which he does not impose on
himself, but which holds him to obedience" (No. 16).
In commenting on this reality of the moral life, John Paul II writes in
"Veritatis Splendor" that this law "serve[s] to protect the personal
dignity and inviolability of man, on whose face is reflected the splendor
of God" (No. 90).
As John Paul II continues, this "splendor" of God "is confirmed in a
particularly eloquent way by Christian martyrdom" (No. 90) which when
"accepted as an affirmation of the inviolability of the moral order, bears
splendid witness both to the holiness of God's law and to the
inviolability of the personal dignity of man, created in God's image and
likeness" (No. 92).
Thus, the martyr provides an invaluable and, one might even say,
irreplaceable contribution to the good of society "by reawakening its moral
sense" (No. 93). The moral sense to which the martyrdom of Thomas More
pointed is stated precisely in "Veritatis Splendor": "Only by obedience
to universal moral norms does man find full confirmation of his
personal uniqueness and the possibility of authentic moral growth" (No. 96).
The seeming contradiction between individual freedom and the moral law
is reconciled by the martyr with a beautiful transparency which reveals
the integrity of the human conscience to society.
"Evangelium Vitae" suggests that the encounter between the Christian
and society centers around several key "concepts" which go to the heart
of the Catholic citizen's life in a pluralistic, democratic society. The
Holy Father makes clear that what is at stake in the public debate
regarding abortion and euthanasia, for example, is not simply a
disagreement over "choices" within a pluralistic society, but is instead a grave
threat to the very survival of democracy (Nos. 18-20).
It has become a tenet of popular culture that the Western liberal
democratic ideal has now emerged triumphant in it great struggle with
totalitarian ideologies.[5] In his address to the United Nations, John Paul
II stated, "we are witnessing an extraordinary global acceleration of
that quest for freedom which is one of the great dynamics of human
history."[6]
However, for this pope, history does not represent some inevitable
evolutionary process toward the realization of democracy. Instead, the
present moment is "a turning point" which presents not only an opportunity
to realize the "universal longing for freedom" but also an enormous
threat to freedom. "Evangelium Vitae" (No. 18) points out that this threat
to freedom consists in a great contradiction lurking at the center of
democracy: abortion.
John Paul II begins his analysis of what he terms this "surprising
contradiction" with a deeply pastoral appreciation of the "tragic
situations of profound suffering" which can give rise to "decisions that go
against life" (No. 18).
The Pope takes note of the "suffering, loneliness, [and] total lack of
economic prospects, depression and anxiety about the future" which can
influence decisions regarding abortion, euthanasia and suicide. He
emphasizes that such circumstances can mitigate even to a notable degree
subjective responsibility and the consequent culpability of those who
make these choices which in themselves are evil."[7]
The personal tragedies which lead to decisions concerning abortion, for
example, do not represent the most profound threat to democracy,
however. Such acts are called "tragic" precisely because we recognize them to
be wrongful and we know that the actor has submitted in desperation to
circumstances which he or she felt unable to overcome. These tragedies,
in themselves, do not constitute a threat to the foundation of
democratic society because their "tragic" character testifies to the objective
evil of what is done.
Instead, John Paul II observes democratic society is imperiled by the
insistence that such objectively disordered acts, however subjectively
mitigated, must be transformed from crimes to "legitimate expressions of
individual freedom … and protected as actual rights (No. 18).
It is this inversion of "wrong" actions into "right" actions that John
Paul II insists constitutes "a direct threat to the entire culture of
human rights" (No. 18). This inversion is a direct threat to the future
of democracy because it establishes "a perverse idea of freedom" at the
very heart of democracy.
John Paul II describes this disordered freedom as one which "carries
the concept of subjectivity to an extreme" (No. 19). It is a concept of
freedom which "exalts the isolated individual in an absolute way, and
gives no place to solidarity, to openness to others and service of them"
(No. 19). In short, this concept of freedom ultimately makes democratic
communities impossible and destroys the foundation of democratic
structures because it erodes public consensus regarding the common good.
"Evangelium Vitae" thus moves the engagement between the Catholic and
contemporary society on questions of abortion and euthanasia to a more
dramatic and profound level. Rights advocates often claim that a true
regard for pluralism and democracy requires acceptance of abortion and
euthanasia. They argue that the social divisiveness surrounding these
issues can only be appropriately resolved by their "privatization" or
"deregulation."
In response, John Paul II maintains that the concept of freedom
implicit in abortion and euthanasia "rights" makes true respect for pluralism
and enduring democratic structures impossible. He observes in
"Evangelium Vitae" that such an accommodation is in reality an invitation for
whole communities or classes of people to be "rejected, marginalized,
uprooted and oppressed" (No. 18).
Thus, the abortion freedom, which presents itself as essential to the
realization of human freedom, instead becomes the vehicle by which the
rights of many are denied.
John Paul II traces the cause of this contradiction to the negation of
authentic freedom -- when a concept of freedom is proposed which "no
longer recognizes and respects its essential line with the truth" (No.
19). This separation of truth from freedom creates a culture in which
"any reference to common values and to a truth absolutely binding on
everyone is lost" (No. 20).
The inevitable consequence of this separation of freedom from truth is
to institutionalize a destabilizing form of conflict in communities. As
John Paul II writes, "If the promotion of the self is understood in
terms of absolute autonomy, people inevitably reach the point of rejecting
one another [and] society becomes a mass of individuals placed side by
side, but without any mutual bonds" (No. 20). The impossibility of
moral consensus within community ultimately makes impossible the common
life of communities and the realization of the common good.
The separation of freedom from truth also has implications for the role
of reason in public discourse. The greatest of these implications is
the marginalization of reason as the foundation of society. Thus,
"Evangelium Vitae" observes the community is increasingly unable to maintain
itself "as a community in which the 'reasons of force' are replaced by
the 'force of reason'" (No. 19). The result is that society is
increasingly unable to achieve consensus on important moral questions.
Too often this cultural transformation is hidden when the
abortion/euthanasia debate is seen as simply a contest between the freedom of the
individual and the imposition of morality by the state. "Evangelium
Vitae" re-focuses this discourse by opening up a more fundamental issue. The
encyclical views the abortion debate as not primarily an argument over
morality or even over the question of when human life begins or ends.
Instead, the most basic issue is a fundamental conflict over the nature
and the dignity of the human person. In reformulating the discussion in
this way, "Evangelium Vitae" underscores the fact that contemporary
man, for the first time, finds his freedom unhinged not only from the
truth of an objective, external moral order, but also from the moral truth
of his own nature and dignity.
This distortion at the center of the human person has diminished the
possibility of authentic human communion and community. It has left the
human person increasingly defenseless to accelerating threats from the
anti-life culture of nihilism and death.[8]
This anti-life culture threatens not only the life of the human person;
it threatens the life of the human conscience. Indeed, this anti-life
society, in the name of freedom of choice, threatens human life
precisely because it distorts and diminishes the human conscience. Thus, the
encounter between the culture of life and the culture of death takes
place primarily within the human conscience.
The culture of death has made Thomas More not just "a man for all
seasons," but a "man for all Catholics." The culture of death challenges all
of us to bear witness to the splendor of the Catholic conscience.
We should not be surprised that "Evangelium Vitae" calls for "a general
mobilization of consciences and a united ethical effort to activate a
great campaign in support of life" (No. 95). This mobilization of
consciences in defense of life by "the people of life and the people for
life" (No. 6) is at the center of the encyclical's vision of
evangelization.
It is also the foundation of John Paul II's approach to social justice
and the law. In this way, "Evangelium Vitae" provides an extraordinary
response to the "demoralization" of conscience brought about by the
widespread practice of abortion and euthanasia.
However, "Evangelium Vitae" was not the first time the Holy Father
proposed such a role for conscience in the transformation of society. In
reviewing the reasons for the collapse of Marxism throughout Eastern
Europe, John Paul II wrote in "Centesimus Annus" that "the fundamental
error of socialism is anthropological in nature," since socialism rejected
"the concept of the person as the autonomous subject of moral decision"
(No. 13).
"Centesimus Annus" makes clear the confrontation between the Church and
any political order which systematically denies human rights must be
focused within the conscience of each person. Like "Evangelium Vitae,"
this earlier encyclical asserts that the mission of the Church in
confronting such a culture is "to increase the sensitivity of consciences"
(No. 52).
"Centesimus Annus" observed that the collapse of communism behind the
Iron Curtain occurred because "the consciences of workers have
re-emerged in a demand for justice" (No. 26).
For example, in Poland in 1980, Father Jozef Tischner defined the
Solidarity movement as inherently linked to a "human dignity that is based
on the conscience of human beings." In a series of sermons given in
Krakow to the leaders of Solidarity, Father Tischner explained that "the
deepest solidarity is the solidarity of consciences."[9]
The "solidarity of consciences." which "Centesimus Annus" understood
was capable of bringing down the anti-life culture of Marxist
totalitarianism, is now proposed in "Evangelium Vitae" as capable of bringing down
the culture of death.
If, as it has been said, truth is the first victim of violence, then
the culture of death is also, and inescapably, a culture at war with the
truth. In fact, the culture of death can only continue in existence by
hiding the truth regarding the nature and dignity of the human person.
One of the most obvious falsehoods undergirding the culture of death is
it refusal to recognize the humanity of the child before birth.
Supreme Court Justice Harry Blackmun gave legal standing to this
masking of the truth when he wrote in Roe v. Wade -- the case which legalized
abortion throughout pregnancy -- that "We need not resolve the
difficult question of when life begins. When those trained in the respective
disciplines of medicine, philosophy and theology are unable to arrive at
any consensus …"[10]
When the culture of death is expressed in a legal system in this way it
surrounds the citizen and his conscience with a social environment
which separates him from the truth about who he is as a person. Thus, the
legal acceptance of abortion destroys not only the child but, in some
sense, every person.
Writing in 1978, Vaclav Havel provided a deep insight into this
phenomena. In "The Power of the Powerless" Havel wrote, "The profound crisis
of human identity brought on by living within a lie, a crisis which in
turn makes such a life possible, certainly possesses a moral dimension
as well; it appears, among other things, as a deep moral crisis in
society.
"A person who has been seduced by the consumer value system, whose
identity is dissolved in an amalgam of the accoutrements of mass
civilization, and who has no roots in the order of being, no sense of
responsibility for anything higher than his or her own personal survival, is a
demoralized person. The system depends on this demoralization, deepens it,
is in fact a projection of it into society."[11]
The person described by Havel as one "seduced by the consumer value
system": and one whose personality is "dissolved" into mass civilization
does not exist only in Marxist societies. A similar process of
"demoralizing" the human person is underway in the new culture of death within
Western democracies.
Havel's response is worthy of deep reflection precisely because it was
a response which sought to return to the politics of his native
Czechoslovakia a sense of morality in order that people might once again "be
able to live within the truth."[12] The rehabilitation of the
"demoralized" man requires precisely the rehabilitation of his conscience through
the restoration of the relationship between freedom and truth.
Writing during the Second World War, Jacques Maritain explored the
Christian foundations of democratic political structures. He found that in
the Western democracies Christianity had not been able to supplant the
secular conscience but that, instead, Christianity had been able to
achieve what he termed the "evangelical inspiration" of the secular
conscience.[13]
In "Christianity and Democracy," Maritain concluded that "what has been
gained for the secular conscience, if it does not veer to barbarism, is
faith in the brotherhood of man, a sense of the social duty of
compassion for mankind in the person of the weak and the suffering, the
conviction that the political work par excellence is that of rendering common
life better and more brotherly and of working so as to make of the
structure of laws, institutions and customs of this life a house for
brothers to live in."[14]
In short, Maritain proposed that there was an "evangelical inspiration"
of democratic principles which has made democracy possible. Reduced to
its essential character, this Christian "inspiration" of democracy
achieved a political consensus that "Machiavellianism and the politics of
domination" were to be rejected. In their place was established the idea
that "politics depends upon morality because its aim is the human good
of the community."[15]
Thus, Maritain saw a vital and irreplaceable role for the Christian to
engage democratic society at all levels of the political process. But
an "evangelically inspired" secular conscience is not the same as a
Catholic conscience or even a Christian conscience.
The difficulty all too often today is that the Catholic politician
possesses not a Catholic conscience, but a secular conscience with little
or no evidence of any evangelical inspiration. How often do we hear a
Catholic politician stating a political philosophy or guiding principles
that reflect or move beyond those values Maritain concluded had been
accomplished by the "evangelical inspiration" of the secular conscience?
We must expect more from a Catholic politician than a secular
conscience.
Yet, this obligation brings with it a dilemma. Joseph Cardinal
Ratzinger described it when he asked, how is it possible "to allow faith to
become effective as a political force without transforming it into yet
another element of power?"[16]
Cardinal Ratzinger also put the question in a slightly different way
when he asked, "How can Christianity become a positive force for the
political world without being turned into a political instrument and
without on the other hand grabbing the political world for itself?"[17]
To choose the wrong answer, of course, opens up the prospect of what
Jacques Maritain so aptly described as "the pharisaically Christian
state" -- the state which manipulates both faith and political power in
order to preserve existing power structures.
The answer of "Evangelium Vitae" goes in an entirely different
direction. It is a response which seeks to defend both the Christian and
secular conscience. In doing so, it responds within the context articulated
by the Second Vatican Council: "the civil authority must see to it that
the equality of the citizens before the law, which is itself an element
of the common good society, is never violated either openly or covertly
for religious reasons and that there is no discrimination among
citizens."[18]
"Evangelium Vitae" embraced the democratic ideal and seeks to
evangelize it through a community of believers transformed into a new "people of
life and people for life." Thus, the encyclical attempts to
rehabilitate the secular conscience in regard to the true principles of the
democratic ideal.
What "Evangelium Vitae" brings to this discourse (Nos. 18-24) is a new
awakening of moral sensitivity, the rehabilitation of the concept of
freedom, and the presentation of the role and dignity of conscience. This
threefold approach offers the only enduring opportunity for avoiding an
unprecedented abuse of human rights of the weak, handicapped and
defenseless now being foreshadowed by the culture of death.
This "inspiration" of the secular conscience is possible because, as
John Paul II has observed, "there is a moral logic which is built into
human life and which makes possible dialogue between individuals. … The
universal moral law written on the human heart is precisely that kind
of 'grammar.'"[19]
But we must ask ourselves what is the language which speaks this
"grammar"? It has been argued that the abortion "freedom means that women
must be free to choose self or to choose selfishly. … There is no easy
way to deny the powerful argument that a woman's equality in society
must give her some irreducible rights unique to her biology, including the
right to take the life within her life."[20]
What is surprising here is not so much the ideological basis of the
rhetoric of the abortion "freedom" but its explicit identification with
the culture of death.
But this is not all. If the "right" to abortion may not be limited by
the combined weight of an innocent human being's "right" to life and the
state's interest in the protection of human life, how is it to be
supposed that the "right" to abortion may be limited by a "right" of
conscience?
In contrast to this view of freedom, "Evangelium Vitae" rejects any
"notion of freedom which exalts the isolated individual in an absolute
way" (No. 19). John Paul II's insistence that freedom must have an
"essential link with the truth" is a claim that truth is linked first and
foremost not with some external moral code, but with the true identity and
the true dignity of the human person -- and this must include a
recognition of the inviolability of conscience.
As John Paul II reminded us at the United Nations, "Reference to the
truth about the human person is, in fact, the guarantor of freedom's
future."[21] It is only when the dignity of the human person is recognized
and respected in the public order that it is possible for men and women
to live not only in freedom but in truth.
Common law today is the basis for the legal systems of England and many
other countries formerly under British rule including the United
States, Canada and Australia, among others. England, the land of St. Thomas
More, is also the birthplace of common law. Common law was originally
derived from Natural Law and was seen as above and independent of the
state.[22] Many civil rights -- even those found in the U.S. Constitution
-- are attributed at least in part to the common law system.
"Common law emphasizes assent rather than domination, the community
rather than the state, moral authority rather than physical power."[23]
The system also recognized the value of precedent. However, as St. Thomas
More discovered, even English common law -- the independent tradition
of right and wrong within a community -- was unable to grant him an
exclusion from taking the Oath of Supremacy based on conscience, nor did it
save him from the block.
However, Thomas More held true to his beliefs -- and interestingly --
to common law as well. In his discourse on common law, William
Blackstone, one of its most famous commentator's and a man to whom the
foundational documents of the United States owe a great debt[24] wrote: "Nay, if
any human law should allow or enjoin us to commit it [an act contrary
to divine or natural law], we are bound to transgress that human law, or
else we must offend both the natural and the divine."[25]
Thomas More certainly held fast to this principle, as "the king's good
servant, but God's first," however, King Henry made no allowance for a
man's conscience.
Thankfully, England and other common law countries grew more tolerant
of conscience in the years that followed, but to this day there is no
absolute standard in common law countries with reference to exemptions on
behalf of conscience for medical or pharmacy personnel confronted with
issues of conscience, and common law countries struggle to balance the
rights of conscience with perceived "rights" to various medical
procedures.
However, common law countries generally seem to be moving in the
direction of accepting at least some conscience claims, though there are
troubling exceptions. To follow their conscience, providers of health
services have sometimes had to pursue legal action, however, in many cases
the right to conscience seems to have prevailed in common law countries
and thus, in many instances, doctors, other medical staff and
pharmacists such countries can make successful moral objections to performing
certain procedures such as abortions -- or dispensing certain drugs, such
as so-called emergency contraception.
[I have limited this commentary to abortion and the dispensing of
abortifacients since they are the most likely to cause grave moral concern
among health care providers. Moreover, the apparent trend toward
allowing conscience exceptions for health care providers in this area may well
set a precedent in other (newer) areas of medicine fraught with ethical
dilemmas].
The trend toward freedom of religion and conscience has been building
over the past centuries. Certainly, the last hundred years have brought
a greater tolerance of religious ideas in England, with restrictions on
Catholic finally lifted in the early 19th century, and the United
States has, since the late 18th century enshrined religious freedom as a
preeminent right.
There is thus reason to hope that we may be moving toward a situation
in which the precedent will be established that provides a greater
understanding and accommodation of the conscience of the individual health
care provider. However, there is not unanimity of opinion and
contradictory decisions about the freedom of conscience in this area continue.
"'This issue is the San Andreas Fault of our culture,' said Gene Rudd of
the Christian Medical & Dental Associations. 'How we decide this is
going to have a long-lasting impact on our society.'"[26]
While many jurisdictions have moved to incorporate some element of a
conscience exemption into the law, especially in the areas of abortion
and contraception, the absolute right to such an exemption is not yet
universally accepted -- and is the subject of widespread debate and
lobbying by abortion advocates, who often seek to force those in the medical
profession to perform immoral procedures.[27]
Too common are opinions like that of philosophy professor Ken Kipnis:
"If your religious orientation is such that you can't discharge your
professional responsibilities, then you shouldn't take on those
responsibilities in the first place […] You should find other work."[28]
Fortunately the law has often been more generous to healthcare
professionals. With respect to abortion, an early example of a conscience
clause occurs in England. Section 4(1) of the Abortion Act of 1967, states:
"No person shall be under any duty, whether by contract or by any
statutory or other legal requirement, to participate in any treatment
authorised (sic) by this Act to which he has conscientious objection
[…]."[29]
While the burden of proof of the conscientious objection rests with the
person making the claim, a statement under oath that the person indeed
has such an objection "shall be sufficient evidence for the purpose of
discharging the burden of proof."[30]
"Section 4(1) of the 1967 Act … was not in the original bill, but was
introduced in response to concerns that doctors would be under pressure
to perform terminations against their beliefs. Interestingly, one
amendment that didn't make the final act proposed that, "no person [shall
be] … deprived of, or be disqualified from, any promotion or other
advantages by reason of the fact that he has such conscientious
objection."[31]
So it would seem, the protection, while better than nothing, is
limited.
Pharmacists in England also appear to enjoy the benefit of certain
conscience exemptions. The Royal Pharmaceutical Society allows some freedom
of conscience for pharmacists: "The Code of Ethics, Part 2A1(k) states
"that before accepting employment pharmacists must disclose any factors
which may affect their ability to provide services. Where pharmacists'
religious beliefs or personal convictions prevent them from providing a
service they must not condemn or criticise (sic) the patient and they
or a member of staff must advise the patient of alternative sources for
the service requested."[32]
However, because the guidelines do stipulate that a pharmacist must
"advise the patient of alternative sources for the service requested,"
pharmacists objecting to providing a particular prescription may find
themselves in the awkward position of having to be if not actors, at least
accomplices. Some have evidently refused to refer their patients, and
the legal consequences of such actions are, as of now, unclear.[33] In
fact, the issue of referral has become a sticking point in many common
law countries as health care professionals refuse to be involved in
immoral treatment in any way.
It seems that many common law countries have followed England in
allowing physicians and pharmacists to decline to dispense medical services
that they find morally unacceptable -- at least under certain
conditions.
In Canada, a 2002 article in the BC Catholic noted: "They remain
anxious, but Canadian nurses seem to have their right to conscientious
objection worked out, for the most part. The nurses' code of ethics and their
collective agreements recognize their right to withdraw from giving
care that offends their morality as long as the patients they tend are
placed in others' care …
"However, a recent contract cancellation at B.C. Women's Hospital, as
well as developments in other provinces, raises doubt as to whether
nurses do in fact enjoy unfettered freedoms of conscience and
religion."[34]
The article cites several examples of nurses whose hospitals were
forced to participate in abortions, though, in most of the cases, the
results -- sometimes after years of struggle --favored those who held to
their conscientious objection.
The Canadian Medical Association discourages any discrimination
stating: "No discrimination should be directed against doctors who do not
perform or assist at induced abortions. Respect for the right of personal
decision in this area must be stressed, particularly for doctors
training in obstetrics and gynecology, and anesthesia."[35]
"Pharmacists across Canada have the right to refuse to sell the
contraceptive as a 'matter of conscience' as long as they refer customers to
someone who will," the Daily Herald Tribune in Grande Prairie, Alberta,
reported earlier this year.[36]
Both in Canada and in Australia, things seem to be improving for
conscientious objectors. Many legal battles and debates over conscience were
seen over the past 20-30 years, with a shift in favor of conscience as
the norm.
Australia generally allows for conscience exclusions for doctors and
pharmacies. For example, in 2002, along with passage of a liberal
abortion law in Canberra, a conscientious objection amendment allowed doctors
to opt out of the procedure.[37] In many areas of the country including
the Australian Capital Territory, South Australia, Tasmania and
Victoria the law allows medical personnel to opt out of performing
abortions.[38]
The Age in Australia reported in 2003 that "[p]harmacists who are
morally opposed to selling emergency contraception can refuse to dispense
the drug but may leave themselves open to legal action."[39] In 2004 CNS
News reported that a pharmacist "who has moral objections is not
obliged to supply a product, but is expected to refer the customer to an
alternative source." The story went on to report that some pharmacists are
refusing "to refer customers to other suppliers."[40]
As recently as last year the debate continued in Australia: "Health
Minister Tony Abbott believed individual pharmacists had the right to
choose whether they supplied the morning-after pill. But the federal
opposition maintained pharmacists were obliged to offer a full range of
products, particularly in one-chemist towns."[41]
There is some gray area, to be sure, but overall, the idea of a
conscience-exemption for those morally opposed to procedures such as abortion
seems to be making headway in Australia.
In the United States, both the federal government and many states have
provided some conscience exemptions for doctors who are morally opposed
to abortion: "The dispute over abortion access began almost as soon as
the U.S. Supreme Court legalized the procedure in 1973. Six months
later, Congress carved out exceptions for doctors and hospitals with moral
objections to abortion. Forty-seven states passed similar laws.
Louisiana's, one of the most restrictive in the nation, says no one should be
forced to 'recommend or counsel' an abortion, either."[42]
More recently, Congress took steps to protect health care workers
whose consciences prevent them from performing abortions. The Weldon
Amendment became Federal Law in 2004 and gave "federal protection for health
care providers, including hospitals and insurers, who choose not to
participate in abortion."[43]
The amendment stated: "(1) None of the funds made available in this Act
[the federal Health and Human Services appropriations bill for Fiscal
Year 2005] may be made available to a federal agency or program, or to a
state or local government, if such agency, program, or government
subjects any institutional or individual health care entity to
discrimination on the basis that the health care entity does not provide, pay for,
provide coverage of, or refer for abortions.
"(2) In this subsection, the term 'health care entity' includes an
individual physician or other health care professional, a hospital, a
provider-sponsored organization, a health maintenance organization, a health
insurance plan, or any other kind of health care facility,
organization, or plan."[44]
The amendment was not universally accepted. California' Attorney
General Bill Lockyer quickly filed suit to block the Amendment from taking
effect. [The case is still pending]. For pharmacists in the United
States, the laws vary according to state.
As of Aug. 1 of this year: "Four states -- Arkansas, Georgia,
Mississippi, and South Dakota -- have passed laws allowing a pharmacist to
refuse to dispense 'emergency contraception' drugs.
"Illinois passed an emergency rule that requires a pharmacist to
dispense FDA-approved contraception.
"Colorado, Florida, Maine, and Tennessee have broad refusal clauses
that don't specifically reference pharmacists, while California
pharmacists have a duty to dispense prescriptions and only can refuse when their
employer approves the refusal and the patient can still access the
prescription in a timely manner."[45]
Unresolved and troublesome issues remain, however. While pharmacists
and medical personnel can often have recourse to a conscience exclusion,
hospitals -- including Catholic hospitals -- are increasingly under
attack by laws requiring them to provide so-called emergency contraception
to rape victims.
"Connecticut is part of a growing number of states that are considering
or have passed legislation requiring hospitals to dispense Plan B or at
least provide information about the emergency contraception to rape
victims.
"According to advocacy groups, Massachusetts, California, New Jersey,
New Mexico, New York, South Carolina and Washington require hospitals to
dispense the drug. Catholic hospitals are not exempted from those laws,
yet the laws in New Jersey and New York include provisions to appease
the church that prevent the pill from being given if a woman is already
pregnant.
"Similar bills are pending this session in 12 states, including
Connecticut."[46]
The Connecticut bill was defeated, but the trend toward forcing
hospitals to provide unethical treatment is troubling. Also troubling is the
fact that abortion can be made nearly mandatory for physicians in
training, with career consequences if they opt out.
Such is already the case in New York City: "In July 2002 the 11 public
hospitals in New York City imposed mandatory abortion training for all
medical residents. Amid the bad news, an encouraging sign has been
reported. Some 25% (or 38 of the approximately 150 doctors in residency
training) have opted out of the abortion program, though doing so could
compromise their medical careers."[47]
Challenges to the conscience of a health care professional certainly
continue in common law countries, and the current system of dealing with
such issues in these countries is far from adequate, or uniform. The
problems will only grow as new unethical procedures become seen as "the
norm" by some and as a "right" by others.
A good overview of the situation in the United States, at least
occurred in 2002 when the United States Conference of Catholic Bishops
submitted a statement to Congress, which included the following: "While the
principle of protection for conscience rights is widely acknowledged, its
implementation has been far from perfect, creating a need for more
comprehensive and forward-looking legislation. Most federal conscience
protections apply only to specific federal programs or are tied to the
receipt of federal funds (5).
"Their scope is limited by this fact, and by the narrow range of
procedures covered. Though the majority of states acknowledge and protect
rights of conscience, their laws suffer from similar inadequacies. Most of
these laws are limited to abortion. Only a few states protect health
care providers from being forced to perform sterilizations. Few existing
laws protect the full range of individuals and institutions that may be
involved in providing health care in our increasingly complex health
care system.
"Many states do not protect the rights of conscience with respect to
newly created technologies such as cloning or embryonic research, or even
current misuses of older technology such as 'surrogate' motherhood.
States have also not addressed the need to protect providers with respect
to new threats to human life at the end of life, such as
physician-assisted suicide and euthanasia.
"As noted by one commentator: 'As the range of medical technologies
continues to expand ... the number of medical services involving
potentially serious conflicts of conscience is certain to increase.'(6)
"Finally, with new organized threats to conscience on the horizon, it
is especially important for states to expand and strengthen their
existing protections now. These threats have become especially apparent in
recent years in the fields of abortion and contraception, as reviewed
below."[48]
Common law countries certainly have much to do to develop more fully
the ideal of a conscience clause for those in the medical field. However,
the fact that in most common law countries some accommodation at least
seems to be made for the conscience of those in the health care field
provides hope. It may also provide a precedent upon which we can work to
build a society that does not require any protector of life with moral
objections to unethical medical procedures to actively participate in a
culture of death.
It may seem that the discussion of the role of conscience of a Catholic
politician and of a Catholic health care provider are two distinct,
unrelated issues. However, if it is true that much of the difficulty for
Catholic politicians concerns the failure to adequately form a Catholic
conscience or to properly understand the implications of the demands of
conscience on one's public responsibilities, then it is difficult to
see how it will be possible in the future to fashion laws -- either by
legislative or judicial action -- that respect the rights of a properly
formed conscience.
Once again we are reminded of a scene from "A Man for All Seasons,"
this time of the conversation between More and his friend, the Duke of
Norfolk. It is clear that More's stand on conscience is really
incomprehensible to the duke since he asks More to join the other members of the
nobility in agreeing to the demands of the king for the sake of
friendship.
When More asks the duke whether after he has done what has been asked
whether the duke will then follow More into hell for violating his
conscience for friendship's sake, the duke complains of More's obstinacy. In
short, how can we expect those who have failed to take due care of
their own conscience to properly care for the consciences of others?
John Paul II has elevated the role of Catholics by insisting in
"Veritatis Splendor" and "Evangelium Vitae" that any moral consensus within
society must be one which recognizes the three fundamental principles of
the culture of life.
The first is the incomparable value and dignity of every human being
regardless of age, condition or race. This is especially true in the case
of the poor, the weak and the defenseless. And this is also true for
the dignity of the human conscience.
The second is that it is always a violation of human dignity to treat
anyone as an instrument or means to an end. Instead, every person must
be seen as good in himself or herself and never as an object to be
manipulated.
The third principle is that the intentional killing of an innocent
human being, whatever the circumstances and particularly in cases of
abortion and euthanasia, can never be morally justified.
In these moral principles we can see that the Church's mission in
building the culture of life is inseparable from the legacy of the Second
Vatican Council. This is especially the case in regard to the teaching of
the council on conscience, freedom and human dignity.
By insisting that the Catholic people must be "a people of life and for
life" (No. 6), John Paul II has outlined the mission of the Catholic
people in the conversion of culture. In this mission, "Evangelium Vitae"
presents a blueprint for Catholic identity in the third millennium in
which "the dignity of the person and the Gospel of life are a single and
indivisible Gospel" (No. 2).
In becoming "a people of life and for life" Catholics will bear witness
most truly to the truth, to conscience and to the possibility of
building a culture of life. But "a people of life and a people for life" can
only be so if it is at the same time "a community of consciences for
life" or what John Paul II might have called "a great solidarity of
consciences for life."
A Catholic people must have a Catholic conscience and that conscience,
to be Catholic, must be for life.
---------------------
ENDNOTES
1. Robert Bolt, "A Man for All Seasons" (New York: Random House, 1960),
p. 91.
2. Ibid., p. 22.
3. "Complete Works of St. Thomas More", ed. Clarence Miller (New Haven:
Yale University Press, 1976), vol. 14, pt. 2, p. 775.
4. Thomas More, "De Tristitia Christi", "Complete Works of St. Thomas
More," ed. Clarence Miller (New Haven: Yale University Press, 1976) vol.
14, pt. 1, pp. 3-4.
5. F. Fukuyama, "The End of History and the Last Man" (The Free Press,
New York 1992).
6. John Paul II, Address to the General Assembly of the United Nations,
October 5, 1995; L'Osservatore Romano (English edition, October 11,
1995) p. 8.
7. John Paul II's recognition in No. 18 of the suffering and sense of
hopelessness which often pervades these decisions against life and his
sensitivity in No. 99 in discussing pastoral responses to women who have
had abortions reflect the depth of commitment to "solidarity" which
runs through the encyclical.
8. Carl Anderson, "'Evangelium Vitae' e cultura post-moderna" in
Evangelium Vitae: Enciclica e Commenti (Libreria Editrice Vaticana, Citta del
Vaticano 1995) also printed in L'Osservatore Romano 28 April 1995.
9. Jozef Tischner, "The Spirit of Solidarity" (Harper and Row
Publishers, San Francisco 1984) p. 4.
10. Roe v. Wade, 410 U.S. 113 (1973).
11. Reprinted in Vaclav Havel, "Living in Truth" (Faber and Faber,
London 1986), p. 62.
12. Ibid., p. 63.
13. Jacques Maritain, "Christianity and Democracy" (Ignatius Press, San
Francisco 1986) (first edition French 1943).
14. Ibid., p. 46.
15. Ibid., pp. 42-43. Certainly not all of Maritain's contemporaries
were as sanguine regarding the influence of Christianity in the modern
democracies. For example, Christopher Dawson wrote in 1938, "It may, I
think, even be argued that Communism in Russia, National Socialism in
Germany, and Capitalism and Liberal Democracy in the Western countries are
really three forms of the same thing, and that they are all moving by
different but parallel paths to the same goal, which is the
mechanization of human life and the complete subordination of the individual to the
state and to the economic process. Of course, I do not mean to say that
they are all absolutely equivalent, and that we have no right to prefer
one to another." See, Christopher Dawson, "Religion and the Modern
State" (Sheed and Ward, New York 1938), p. XV.
16. Joseph Ratzinger, "Church, Ecumenism and Politics: New Essays in
Ecclesiology" (St. Paul Publications, New York 1988) (first edition
German 1987), p. 173.
17. Ibid., p. 216.
18. Second Vatican Ecumenical Council, Declaration on Religious Liberty
Dignitatis Humanae, 6 (1965).
19. Address to the General Assembly of the United Nations, October 5,
1995, op. cit.
20. Naomi Wolf, "Our Bodies, Our Souls", The New Republic, October 16,
1995, p. 33.
21. Address to the General Assembly of the United Nations, October 5,
1995, op. cit.
22. Robert Clinton, "God and Man in the Law: The Foundations of
Anglo-American Constitutionalism." (Lawrence: Univ. of Kansas Press, 1997)
102-103.
23. James Stoner, Jr., "Common-Law Liberty: Rethinking American
Constitutionalism." (Lawrence: Univ. of Kansas Press, 1999) 5.
24. Wayne House, "A Tale of Two Kingdoms: Can There be Peaceful
Coexistence of Religion with the Secular State?" BYU Journal of Public Law.
(vol. 13, 1999) 221.
25. Quoted in Wayne House, "A Tale of Two Kingdoms: Can There be
Peaceful Coexistence of Religion with the Secular State?" BYU Journal of
Public Law. (vol. 13, 1999) 235.
26. Rob Stein, A Medical Crisis of Conscience in The Washington Post
July 16, 2006, A1, (online).
27. Feminist Majority Foundation, Feminist Daily Newswire Sept. 24,
2002
http://www.feminist.org/news/newsbyte/uswirestory.asp?id=6910
28. Stein.
29. Abortion Act of 1967 quoted in
www.consciencelaws.org/Conscience-laws-United-Kingdom/LawUK01.htm
30. Ibid.
31. Jacky Engel, Abortion Law Reform and Conscientious Objection in the
United Kingdom in Nucleus October 2004.
http://www.consciencelaws.org/Conscience-Archive/Documents/Abortion%
20Law%20Reform%20UK.html#13.
32. The Royal Pharmaceutical Society of Great Britain, Fitness to
Practise and Legal Affairs Directorate: Fact Sheet: Thirteen, Employing a
Locum/Working as a Locum. November 2005.
http://www.rpsgb.org/pdfs/factsheet13.pdf
33. Terry Sanderson, Nothing for the Weekend, in The New Humanist. May
3, 2005
34. Greg Edwards, Accommodating Conscience in The BC Catholic, Oct.
2002
http://www.consciencelaws.org/Examining-Conscience-Background/
Abortion/ BackAbortion29.html
35. http://www.cma.ca/index.cfm/ci_id/3218/la_id/1.htm
36. Pharmacists in Religious Community Balking at Plan B Pill in The
Daily Herald Tribune, Jan. 31, 2006, p. 7. (Lexis)
37. David McLennan, It's not over say abortion adversaries Canberra
Times. Aug. 24, 2002, C3. (Lexis)
38. http://www.childrenbychoice.org.au/nwww/auslawprac.htm
39. Miranda Wood Morning-after Pill Available over the Counter in The
Age Dec. 28, 2003
40. Patrick Goodenough, Objecting Pharmacists Refuse to Sell
'Morning-After-Pill' Cybercast News Service Jan. 6, 2004
41. Danielle Cronin, Morning After Pill Refused: 'Battleground' over
Contraceptives Supply in Canberra Times. April 2, 2005 A9. (Lexis)
42. Bill Walsh, Wording Bolsters Foes of Abortion: Women in Senate are
Ready to Fight It in Times Picayune Nov. 29, 2004, National 1, (Lexis).
43. http://www.nrlc.org/federal/ANDA/HydeWeldonwebnrlnews.html
44. Ibid.
45. States look at pharmacist 'conscience' laws regarding EC in
DrugFormulary Review Aug. 1, 2006, (Lexis).
46. Susan Haigh, Connecticut Bishops Pursuing Stricter Interpretation
of Abortion, Associated Press, March 12, 2006, (Lexis).
47. http://www.projectreach.org/nycDoctors.shtml
48. http://www.nccbuscc.org/prolife/issues/abortion/kansas202.htm
[Text adapted]
vice president of the John Paul II Institute for Studies on Marriage
and the Family, regarding the respect for conscience in life issues.
* * *
THE CHRISTIAN CONSCIENCE IN SUPPORT OF THE RIGHT TO LIFE
Respect for Conscience in Common Law Countries
Carl Anderson
Vice President, John Paul II Institute for Studies on Marriage and
Family
Supreme Knight, Knight of Columbus
Pontifical Academy for Life XIII General Assembly February 24, 2007
St. Thomas More is recognized in our time as one of the great defenders
of human dignity and the rights of human conscience. We are all
familiar with the famous lines from "A Man for All Seasons" regarding the role
of conscience: In his refusal to sign the oath, More says "what matters
to me is not whether it's true or not but that I believe it to be true,
or rather, not that I believe it to be true, but that I believe it."[1]
St. Thomas More is also rightly regarded as the model Catholic
government official when he says earlier in the play, "when statesmen forsake
their own private conscience for the sake of their public duties …
they lead their country by a short route to chaos."[2]
And how simply, yet profoundly, he set the standard for all those of
the Christian faith who serve in government when he said at the end,
"Tell the King, I die the King's loyal servant, but God's first."
Perhaps we might do well to regard Thomas More as a sure guide for
politicians, reminding them of his approach to government service. As "A
Man for all Seasons" recounts More as saying of his work as chancellor of
England, "I wish no man harm, I speak no man harm, I do no man harm and
if this be not good enough then … "
We might also regard St. Thomas More as a patron of husbands and
fathers. We may recall the way in which More is depicted at the end of his
trial in "A Man for All Seasons." He declares to the court which has just
condemned him that "It was not for the oath but because I would not
consent to the marriage."
Everything we know about St. Thomas More tells us that he cared deeply
for his family and that one of the reasons why he sought so desperately
to avoid a confrontation with the king was to protect his family. Yet,
finally, More was to sacrifice both his life and his family's security
for a principle that gave an eternal meaning and an eternal unity to
his family; that is, the sacramental nature of marriage.
Unquestionably, in agreeing to the dissolution of the king's marriage
there was also an implicit acceding to the possible dissolution of any
marriage. This was a point that could not have been lost on the
chancellor of England and a lawyer of the brilliance of Thomas More. Thus, one
of history's great statesman and men of conscience went to his death
for a principled defense of the sacramental unity of marriage.
Having said this we should remember the observation of Clarence Miller,
one of several editors of the "Complete Works of St. Thomas More." He
enumerates what scholars give as the various "grounds for More's
martyrdom: the integrity of the self as witnessed by an oath, the irreducible
freedom of the individual conscience in the face of an authoritarian
state, papal supremacy as a sign of the supra-national unity of Western
Christendom, past and present."
Then Miller writes, "All of these are true as far as they go. But in
the last analysis More did not die for any principle, or idea, or
tradition, or even doctrine, but for a person, for Christ. As Bolt himself
made More say in the play: "Well … finally … it isn't a matter of
reason; finally it's a matter of love."[3]
And so, I think it is entirely appropriate to remember St. Thomas More
as we explore the richness of the encyclical "Evangelium Vitae" and its
call to the Catholic people to build a culture of life and a
civilization of love. We should begin with recognition that "Evangelium Vitae"
rests, to a considerable extent, upon the foundation provided by John
Paul II's great encyclical on the "Splendor of Truth" and the moral
conscience.
"Veritatis Splendor" takes up the question of the obligations which
truth imposes on Catholics in democratic societies. It observes that the
demands of universal and unchanging moral laws may seem to contradict
"the uniqueness and individuality of the person" and even "represent a
threat to his freedom and dignity" (No. 85). The encyclical also admits
that "in a widely de-Christianized culture, the criteria employed by
believers themselves in making judgments and decisions often appear
extraneous or even contrary to those of the Gospel" (No. 88).
But then John Paul II writes what could have come from the thought or,
perhaps more accurately, from the spirituality of Thomas More. He
states, "It is urgent to rediscover and to set forth once more the authentic
reality of the Christian faith, which is not simply a set of
propositions to be accepted with intellectual assent. Rather, faith is a lived
knowledge of Christ, a living remembrance of his commandments, and a
truth to be lived out. … It is an encounter, a dialogue, a communion of
love and of life between the believer and Jesus Christ … (No. 88).
Or as More had put it, "finally it's a matter of love."
After so many years it is perhaps too easy to view the English Catholic
martyrs of the 16th century as having a sort of determination or even a
certain eagerness for their fate. But the following passage on the
subject of martyrdom written by More while he was in the tower poignantly
reveals something very different.
More wrote in "De Tristitia Christi" of the martyr's encounter with
Christ who says this to his follower: "You are afraid, you are sad, you
are stricken with weariness and dread of the torment with which you have
been cruelly threatened. Trust me. I conquered the world, and yet I
suffered immeasurably more from fear. I was sadder, more afflicted with
weariness, more horrified at the prospect of such cruel suffering drawing
eagerly nearer and nearer.
"Let the brave man have his high-spirited martyrs, let him rejoice in
imitating of them. But you, my timorous and feeble little sheep, be
content to have me alone as your shepherd, follow my leadership; if you do
not trust yourself, place your trust in me. See, I am walking ahead of
you along this fearful road."[4]
Few in the Church have more poignantly depicted the call to holiness
and spiritual perfection than More in this brief description of the
"sequela Christi" to martyrdom.
But the ultimate lesson which More gives us is that for the Catholic,
government service opens a horizon to a type of personal martyrdom.
Certainly, this was the case in More's life and throughout much of the 16th
century. It was equally true throughout much of the 20th century. And
it is also true in the beginning of the third millennium as we
increasingly face a new culture of death.
Politics which too often today has been the arena of personal
self-promotion and egocentrism should be understood rather by the Catholic as a
following of Christ which is open to martyrdom, if not of the bloody
martyrdom suffered by More, than a martyrdom of career and reputation. To
think otherwise is a disservice to the Catholic community and to be
dishonest with one's self.
We might say that John Paul II has a similar vision of the Catholic's
struggle in the face of an increasingly hostile culture when he wrote in
"Evangelium Vitae" the following: "Faced with the countless grave
threats to life present in the modern world, one could feel overwhelmed by
sheer powerlessness: Good can never be powerful enough to triumph over
evil!
"At such times the people of God, and this includes every believer, is
called to profess with humility and courage faith in Jesus Christ, 'the
Word of Life.' The gospel of life is not simply a reflection, however
new and profound, on human life. Nor is it merely a commandment aimed at
raising awareness and bringing about significant changes in society.
Still less is it an illusory promise of a better future. The Gospel of
Life is something concrete and personal, for it consists in the
proclamation of the very person of Jesus" (No. 29).
Thus, what Thomas More had suggested was the sure hope of those
suffering for the truth of the Catholic faith, John Paul II sees as the
guiding star of Catholics in the pro-life movement.
We see also in the life of Thomas More the truth recognized by the
Second Vatican Council when it observed in Gaudium et Spes that, "In the
depths of his conscience man detects a law which he does not impose on
himself, but which holds him to obedience" (No. 16).
In commenting on this reality of the moral life, John Paul II writes in
"Veritatis Splendor" that this law "serve[s] to protect the personal
dignity and inviolability of man, on whose face is reflected the splendor
of God" (No. 90).
As John Paul II continues, this "splendor" of God "is confirmed in a
particularly eloquent way by Christian martyrdom" (No. 90) which when
"accepted as an affirmation of the inviolability of the moral order, bears
splendid witness both to the holiness of God's law and to the
inviolability of the personal dignity of man, created in God's image and
likeness" (No. 92).
Thus, the martyr provides an invaluable and, one might even say,
irreplaceable contribution to the good of society "by reawakening its moral
sense" (No. 93). The moral sense to which the martyrdom of Thomas More
pointed is stated precisely in "Veritatis Splendor": "Only by obedience
to universal moral norms does man find full confirmation of his
personal uniqueness and the possibility of authentic moral growth" (No. 96).
The seeming contradiction between individual freedom and the moral law
is reconciled by the martyr with a beautiful transparency which reveals
the integrity of the human conscience to society.
"Evangelium Vitae" suggests that the encounter between the Christian
and society centers around several key "concepts" which go to the heart
of the Catholic citizen's life in a pluralistic, democratic society. The
Holy Father makes clear that what is at stake in the public debate
regarding abortion and euthanasia, for example, is not simply a
disagreement over "choices" within a pluralistic society, but is instead a grave
threat to the very survival of democracy (Nos. 18-20).
It has become a tenet of popular culture that the Western liberal
democratic ideal has now emerged triumphant in it great struggle with
totalitarian ideologies.[5] In his address to the United Nations, John Paul
II stated, "we are witnessing an extraordinary global acceleration of
that quest for freedom which is one of the great dynamics of human
history."[6]
However, for this pope, history does not represent some inevitable
evolutionary process toward the realization of democracy. Instead, the
present moment is "a turning point" which presents not only an opportunity
to realize the "universal longing for freedom" but also an enormous
threat to freedom. "Evangelium Vitae" (No. 18) points out that this threat
to freedom consists in a great contradiction lurking at the center of
democracy: abortion.
John Paul II begins his analysis of what he terms this "surprising
contradiction" with a deeply pastoral appreciation of the "tragic
situations of profound suffering" which can give rise to "decisions that go
against life" (No. 18).
The Pope takes note of the "suffering, loneliness, [and] total lack of
economic prospects, depression and anxiety about the future" which can
influence decisions regarding abortion, euthanasia and suicide. He
emphasizes that such circumstances can mitigate even to a notable degree
subjective responsibility and the consequent culpability of those who
make these choices which in themselves are evil."[7]
The personal tragedies which lead to decisions concerning abortion, for
example, do not represent the most profound threat to democracy,
however. Such acts are called "tragic" precisely because we recognize them to
be wrongful and we know that the actor has submitted in desperation to
circumstances which he or she felt unable to overcome. These tragedies,
in themselves, do not constitute a threat to the foundation of
democratic society because their "tragic" character testifies to the objective
evil of what is done.
Instead, John Paul II observes democratic society is imperiled by the
insistence that such objectively disordered acts, however subjectively
mitigated, must be transformed from crimes to "legitimate expressions of
individual freedom … and protected as actual rights (No. 18).
It is this inversion of "wrong" actions into "right" actions that John
Paul II insists constitutes "a direct threat to the entire culture of
human rights" (No. 18). This inversion is a direct threat to the future
of democracy because it establishes "a perverse idea of freedom" at the
very heart of democracy.
John Paul II describes this disordered freedom as one which "carries
the concept of subjectivity to an extreme" (No. 19). It is a concept of
freedom which "exalts the isolated individual in an absolute way, and
gives no place to solidarity, to openness to others and service of them"
(No. 19). In short, this concept of freedom ultimately makes democratic
communities impossible and destroys the foundation of democratic
structures because it erodes public consensus regarding the common good.
"Evangelium Vitae" thus moves the engagement between the Catholic and
contemporary society on questions of abortion and euthanasia to a more
dramatic and profound level. Rights advocates often claim that a true
regard for pluralism and democracy requires acceptance of abortion and
euthanasia. They argue that the social divisiveness surrounding these
issues can only be appropriately resolved by their "privatization" or
"deregulation."
In response, John Paul II maintains that the concept of freedom
implicit in abortion and euthanasia "rights" makes true respect for pluralism
and enduring democratic structures impossible. He observes in
"Evangelium Vitae" that such an accommodation is in reality an invitation for
whole communities or classes of people to be "rejected, marginalized,
uprooted and oppressed" (No. 18).
Thus, the abortion freedom, which presents itself as essential to the
realization of human freedom, instead becomes the vehicle by which the
rights of many are denied.
John Paul II traces the cause of this contradiction to the negation of
authentic freedom -- when a concept of freedom is proposed which "no
longer recognizes and respects its essential line with the truth" (No.
19). This separation of truth from freedom creates a culture in which
"any reference to common values and to a truth absolutely binding on
everyone is lost" (No. 20).
The inevitable consequence of this separation of freedom from truth is
to institutionalize a destabilizing form of conflict in communities. As
John Paul II writes, "If the promotion of the self is understood in
terms of absolute autonomy, people inevitably reach the point of rejecting
one another [and] society becomes a mass of individuals placed side by
side, but without any mutual bonds" (No. 20). The impossibility of
moral consensus within community ultimately makes impossible the common
life of communities and the realization of the common good.
The separation of freedom from truth also has implications for the role
of reason in public discourse. The greatest of these implications is
the marginalization of reason as the foundation of society. Thus,
"Evangelium Vitae" observes the community is increasingly unable to maintain
itself "as a community in which the 'reasons of force' are replaced by
the 'force of reason'" (No. 19). The result is that society is
increasingly unable to achieve consensus on important moral questions.
Too often this cultural transformation is hidden when the
abortion/euthanasia debate is seen as simply a contest between the freedom of the
individual and the imposition of morality by the state. "Evangelium
Vitae" re-focuses this discourse by opening up a more fundamental issue. The
encyclical views the abortion debate as not primarily an argument over
morality or even over the question of when human life begins or ends.
Instead, the most basic issue is a fundamental conflict over the nature
and the dignity of the human person. In reformulating the discussion in
this way, "Evangelium Vitae" underscores the fact that contemporary
man, for the first time, finds his freedom unhinged not only from the
truth of an objective, external moral order, but also from the moral truth
of his own nature and dignity.
This distortion at the center of the human person has diminished the
possibility of authentic human communion and community. It has left the
human person increasingly defenseless to accelerating threats from the
anti-life culture of nihilism and death.[8]
This anti-life culture threatens not only the life of the human person;
it threatens the life of the human conscience. Indeed, this anti-life
society, in the name of freedom of choice, threatens human life
precisely because it distorts and diminishes the human conscience. Thus, the
encounter between the culture of life and the culture of death takes
place primarily within the human conscience.
The culture of death has made Thomas More not just "a man for all
seasons," but a "man for all Catholics." The culture of death challenges all
of us to bear witness to the splendor of the Catholic conscience.
We should not be surprised that "Evangelium Vitae" calls for "a general
mobilization of consciences and a united ethical effort to activate a
great campaign in support of life" (No. 95). This mobilization of
consciences in defense of life by "the people of life and the people for
life" (No. 6) is at the center of the encyclical's vision of
evangelization.
It is also the foundation of John Paul II's approach to social justice
and the law. In this way, "Evangelium Vitae" provides an extraordinary
response to the "demoralization" of conscience brought about by the
widespread practice of abortion and euthanasia.
However, "Evangelium Vitae" was not the first time the Holy Father
proposed such a role for conscience in the transformation of society. In
reviewing the reasons for the collapse of Marxism throughout Eastern
Europe, John Paul II wrote in "Centesimus Annus" that "the fundamental
error of socialism is anthropological in nature," since socialism rejected
"the concept of the person as the autonomous subject of moral decision"
(No. 13).
"Centesimus Annus" makes clear the confrontation between the Church and
any political order which systematically denies human rights must be
focused within the conscience of each person. Like "Evangelium Vitae,"
this earlier encyclical asserts that the mission of the Church in
confronting such a culture is "to increase the sensitivity of consciences"
(No. 52).
"Centesimus Annus" observed that the collapse of communism behind the
Iron Curtain occurred because "the consciences of workers have
re-emerged in a demand for justice" (No. 26).
For example, in Poland in 1980, Father Jozef Tischner defined the
Solidarity movement as inherently linked to a "human dignity that is based
on the conscience of human beings." In a series of sermons given in
Krakow to the leaders of Solidarity, Father Tischner explained that "the
deepest solidarity is the solidarity of consciences."[9]
The "solidarity of consciences." which "Centesimus Annus" understood
was capable of bringing down the anti-life culture of Marxist
totalitarianism, is now proposed in "Evangelium Vitae" as capable of bringing down
the culture of death.
If, as it has been said, truth is the first victim of violence, then
the culture of death is also, and inescapably, a culture at war with the
truth. In fact, the culture of death can only continue in existence by
hiding the truth regarding the nature and dignity of the human person.
One of the most obvious falsehoods undergirding the culture of death is
it refusal to recognize the humanity of the child before birth.
Supreme Court Justice Harry Blackmun gave legal standing to this
masking of the truth when he wrote in Roe v. Wade -- the case which legalized
abortion throughout pregnancy -- that "We need not resolve the
difficult question of when life begins. When those trained in the respective
disciplines of medicine, philosophy and theology are unable to arrive at
any consensus …"[10]
When the culture of death is expressed in a legal system in this way it
surrounds the citizen and his conscience with a social environment
which separates him from the truth about who he is as a person. Thus, the
legal acceptance of abortion destroys not only the child but, in some
sense, every person.
Writing in 1978, Vaclav Havel provided a deep insight into this
phenomena. In "The Power of the Powerless" Havel wrote, "The profound crisis
of human identity brought on by living within a lie, a crisis which in
turn makes such a life possible, certainly possesses a moral dimension
as well; it appears, among other things, as a deep moral crisis in
society.
"A person who has been seduced by the consumer value system, whose
identity is dissolved in an amalgam of the accoutrements of mass
civilization, and who has no roots in the order of being, no sense of
responsibility for anything higher than his or her own personal survival, is a
demoralized person. The system depends on this demoralization, deepens it,
is in fact a projection of it into society."[11]
The person described by Havel as one "seduced by the consumer value
system": and one whose personality is "dissolved" into mass civilization
does not exist only in Marxist societies. A similar process of
"demoralizing" the human person is underway in the new culture of death within
Western democracies.
Havel's response is worthy of deep reflection precisely because it was
a response which sought to return to the politics of his native
Czechoslovakia a sense of morality in order that people might once again "be
able to live within the truth."[12] The rehabilitation of the
"demoralized" man requires precisely the rehabilitation of his conscience through
the restoration of the relationship between freedom and truth.
Writing during the Second World War, Jacques Maritain explored the
Christian foundations of democratic political structures. He found that in
the Western democracies Christianity had not been able to supplant the
secular conscience but that, instead, Christianity had been able to
achieve what he termed the "evangelical inspiration" of the secular
conscience.[13]
In "Christianity and Democracy," Maritain concluded that "what has been
gained for the secular conscience, if it does not veer to barbarism, is
faith in the brotherhood of man, a sense of the social duty of
compassion for mankind in the person of the weak and the suffering, the
conviction that the political work par excellence is that of rendering common
life better and more brotherly and of working so as to make of the
structure of laws, institutions and customs of this life a house for
brothers to live in."[14]
In short, Maritain proposed that there was an "evangelical inspiration"
of democratic principles which has made democracy possible. Reduced to
its essential character, this Christian "inspiration" of democracy
achieved a political consensus that "Machiavellianism and the politics of
domination" were to be rejected. In their place was established the idea
that "politics depends upon morality because its aim is the human good
of the community."[15]
Thus, Maritain saw a vital and irreplaceable role for the Christian to
engage democratic society at all levels of the political process. But
an "evangelically inspired" secular conscience is not the same as a
Catholic conscience or even a Christian conscience.
The difficulty all too often today is that the Catholic politician
possesses not a Catholic conscience, but a secular conscience with little
or no evidence of any evangelical inspiration. How often do we hear a
Catholic politician stating a political philosophy or guiding principles
that reflect or move beyond those values Maritain concluded had been
accomplished by the "evangelical inspiration" of the secular conscience?
We must expect more from a Catholic politician than a secular
conscience.
Yet, this obligation brings with it a dilemma. Joseph Cardinal
Ratzinger described it when he asked, how is it possible "to allow faith to
become effective as a political force without transforming it into yet
another element of power?"[16]
Cardinal Ratzinger also put the question in a slightly different way
when he asked, "How can Christianity become a positive force for the
political world without being turned into a political instrument and
without on the other hand grabbing the political world for itself?"[17]
To choose the wrong answer, of course, opens up the prospect of what
Jacques Maritain so aptly described as "the pharisaically Christian
state" -- the state which manipulates both faith and political power in
order to preserve existing power structures.
The answer of "Evangelium Vitae" goes in an entirely different
direction. It is a response which seeks to defend both the Christian and
secular conscience. In doing so, it responds within the context articulated
by the Second Vatican Council: "the civil authority must see to it that
the equality of the citizens before the law, which is itself an element
of the common good society, is never violated either openly or covertly
for religious reasons and that there is no discrimination among
citizens."[18]
"Evangelium Vitae" embraced the democratic ideal and seeks to
evangelize it through a community of believers transformed into a new "people of
life and people for life." Thus, the encyclical attempts to
rehabilitate the secular conscience in regard to the true principles of the
democratic ideal.
What "Evangelium Vitae" brings to this discourse (Nos. 18-24) is a new
awakening of moral sensitivity, the rehabilitation of the concept of
freedom, and the presentation of the role and dignity of conscience. This
threefold approach offers the only enduring opportunity for avoiding an
unprecedented abuse of human rights of the weak, handicapped and
defenseless now being foreshadowed by the culture of death.
This "inspiration" of the secular conscience is possible because, as
John Paul II has observed, "there is a moral logic which is built into
human life and which makes possible dialogue between individuals. … The
universal moral law written on the human heart is precisely that kind
of 'grammar.'"[19]
But we must ask ourselves what is the language which speaks this
"grammar"? It has been argued that the abortion "freedom means that women
must be free to choose self or to choose selfishly. … There is no easy
way to deny the powerful argument that a woman's equality in society
must give her some irreducible rights unique to her biology, including the
right to take the life within her life."[20]
What is surprising here is not so much the ideological basis of the
rhetoric of the abortion "freedom" but its explicit identification with
the culture of death.
But this is not all. If the "right" to abortion may not be limited by
the combined weight of an innocent human being's "right" to life and the
state's interest in the protection of human life, how is it to be
supposed that the "right" to abortion may be limited by a "right" of
conscience?
In contrast to this view of freedom, "Evangelium Vitae" rejects any
"notion of freedom which exalts the isolated individual in an absolute
way" (No. 19). John Paul II's insistence that freedom must have an
"essential link with the truth" is a claim that truth is linked first and
foremost not with some external moral code, but with the true identity and
the true dignity of the human person -- and this must include a
recognition of the inviolability of conscience.
As John Paul II reminded us at the United Nations, "Reference to the
truth about the human person is, in fact, the guarantor of freedom's
future."[21] It is only when the dignity of the human person is recognized
and respected in the public order that it is possible for men and women
to live not only in freedom but in truth.
Common law today is the basis for the legal systems of England and many
other countries formerly under British rule including the United
States, Canada and Australia, among others. England, the land of St. Thomas
More, is also the birthplace of common law. Common law was originally
derived from Natural Law and was seen as above and independent of the
state.[22] Many civil rights -- even those found in the U.S. Constitution
-- are attributed at least in part to the common law system.
"Common law emphasizes assent rather than domination, the community
rather than the state, moral authority rather than physical power."[23]
The system also recognized the value of precedent. However, as St. Thomas
More discovered, even English common law -- the independent tradition
of right and wrong within a community -- was unable to grant him an
exclusion from taking the Oath of Supremacy based on conscience, nor did it
save him from the block.
However, Thomas More held true to his beliefs -- and interestingly --
to common law as well. In his discourse on common law, William
Blackstone, one of its most famous commentator's and a man to whom the
foundational documents of the United States owe a great debt[24] wrote: "Nay, if
any human law should allow or enjoin us to commit it [an act contrary
to divine or natural law], we are bound to transgress that human law, or
else we must offend both the natural and the divine."[25]
Thomas More certainly held fast to this principle, as "the king's good
servant, but God's first," however, King Henry made no allowance for a
man's conscience.
Thankfully, England and other common law countries grew more tolerant
of conscience in the years that followed, but to this day there is no
absolute standard in common law countries with reference to exemptions on
behalf of conscience for medical or pharmacy personnel confronted with
issues of conscience, and common law countries struggle to balance the
rights of conscience with perceived "rights" to various medical
procedures.
However, common law countries generally seem to be moving in the
direction of accepting at least some conscience claims, though there are
troubling exceptions. To follow their conscience, providers of health
services have sometimes had to pursue legal action, however, in many cases
the right to conscience seems to have prevailed in common law countries
and thus, in many instances, doctors, other medical staff and
pharmacists such countries can make successful moral objections to performing
certain procedures such as abortions -- or dispensing certain drugs, such
as so-called emergency contraception.
[I have limited this commentary to abortion and the dispensing of
abortifacients since they are the most likely to cause grave moral concern
among health care providers. Moreover, the apparent trend toward
allowing conscience exceptions for health care providers in this area may well
set a precedent in other (newer) areas of medicine fraught with ethical
dilemmas].
The trend toward freedom of religion and conscience has been building
over the past centuries. Certainly, the last hundred years have brought
a greater tolerance of religious ideas in England, with restrictions on
Catholic finally lifted in the early 19th century, and the United
States has, since the late 18th century enshrined religious freedom as a
preeminent right.
There is thus reason to hope that we may be moving toward a situation
in which the precedent will be established that provides a greater
understanding and accommodation of the conscience of the individual health
care provider. However, there is not unanimity of opinion and
contradictory decisions about the freedom of conscience in this area continue.
"'This issue is the San Andreas Fault of our culture,' said Gene Rudd of
the Christian Medical & Dental Associations. 'How we decide this is
going to have a long-lasting impact on our society.'"[26]
While many jurisdictions have moved to incorporate some element of a
conscience exemption into the law, especially in the areas of abortion
and contraception, the absolute right to such an exemption is not yet
universally accepted -- and is the subject of widespread debate and
lobbying by abortion advocates, who often seek to force those in the medical
profession to perform immoral procedures.[27]
Too common are opinions like that of philosophy professor Ken Kipnis:
"If your religious orientation is such that you can't discharge your
professional responsibilities, then you shouldn't take on those
responsibilities in the first place […] You should find other work."[28]
Fortunately the law has often been more generous to healthcare
professionals. With respect to abortion, an early example of a conscience
clause occurs in England. Section 4(1) of the Abortion Act of 1967, states:
"No person shall be under any duty, whether by contract or by any
statutory or other legal requirement, to participate in any treatment
authorised (sic) by this Act to which he has conscientious objection
[…]."[29]
While the burden of proof of the conscientious objection rests with the
person making the claim, a statement under oath that the person indeed
has such an objection "shall be sufficient evidence for the purpose of
discharging the burden of proof."[30]
"Section 4(1) of the 1967 Act … was not in the original bill, but was
introduced in response to concerns that doctors would be under pressure
to perform terminations against their beliefs. Interestingly, one
amendment that didn't make the final act proposed that, "no person [shall
be] … deprived of, or be disqualified from, any promotion or other
advantages by reason of the fact that he has such conscientious
objection."[31]
So it would seem, the protection, while better than nothing, is
limited.
Pharmacists in England also appear to enjoy the benefit of certain
conscience exemptions. The Royal Pharmaceutical Society allows some freedom
of conscience for pharmacists: "The Code of Ethics, Part 2A1(k) states
"that before accepting employment pharmacists must disclose any factors
which may affect their ability to provide services. Where pharmacists'
religious beliefs or personal convictions prevent them from providing a
service they must not condemn or criticise (sic) the patient and they
or a member of staff must advise the patient of alternative sources for
the service requested."[32]
However, because the guidelines do stipulate that a pharmacist must
"advise the patient of alternative sources for the service requested,"
pharmacists objecting to providing a particular prescription may find
themselves in the awkward position of having to be if not actors, at least
accomplices. Some have evidently refused to refer their patients, and
the legal consequences of such actions are, as of now, unclear.[33] In
fact, the issue of referral has become a sticking point in many common
law countries as health care professionals refuse to be involved in
immoral treatment in any way.
It seems that many common law countries have followed England in
allowing physicians and pharmacists to decline to dispense medical services
that they find morally unacceptable -- at least under certain
conditions.
In Canada, a 2002 article in the BC Catholic noted: "They remain
anxious, but Canadian nurses seem to have their right to conscientious
objection worked out, for the most part. The nurses' code of ethics and their
collective agreements recognize their right to withdraw from giving
care that offends their morality as long as the patients they tend are
placed in others' care …
"However, a recent contract cancellation at B.C. Women's Hospital, as
well as developments in other provinces, raises doubt as to whether
nurses do in fact enjoy unfettered freedoms of conscience and
religion."[34]
The article cites several examples of nurses whose hospitals were
forced to participate in abortions, though, in most of the cases, the
results -- sometimes after years of struggle --favored those who held to
their conscientious objection.
The Canadian Medical Association discourages any discrimination
stating: "No discrimination should be directed against doctors who do not
perform or assist at induced abortions. Respect for the right of personal
decision in this area must be stressed, particularly for doctors
training in obstetrics and gynecology, and anesthesia."[35]
"Pharmacists across Canada have the right to refuse to sell the
contraceptive as a 'matter of conscience' as long as they refer customers to
someone who will," the Daily Herald Tribune in Grande Prairie, Alberta,
reported earlier this year.[36]
Both in Canada and in Australia, things seem to be improving for
conscientious objectors. Many legal battles and debates over conscience were
seen over the past 20-30 years, with a shift in favor of conscience as
the norm.
Australia generally allows for conscience exclusions for doctors and
pharmacies. For example, in 2002, along with passage of a liberal
abortion law in Canberra, a conscientious objection amendment allowed doctors
to opt out of the procedure.[37] In many areas of the country including
the Australian Capital Territory, South Australia, Tasmania and
Victoria the law allows medical personnel to opt out of performing
abortions.[38]
The Age in Australia reported in 2003 that "[p]harmacists who are
morally opposed to selling emergency contraception can refuse to dispense
the drug but may leave themselves open to legal action."[39] In 2004 CNS
News reported that a pharmacist "who has moral objections is not
obliged to supply a product, but is expected to refer the customer to an
alternative source." The story went on to report that some pharmacists are
refusing "to refer customers to other suppliers."[40]
As recently as last year the debate continued in Australia: "Health
Minister Tony Abbott believed individual pharmacists had the right to
choose whether they supplied the morning-after pill. But the federal
opposition maintained pharmacists were obliged to offer a full range of
products, particularly in one-chemist towns."[41]
There is some gray area, to be sure, but overall, the idea of a
conscience-exemption for those morally opposed to procedures such as abortion
seems to be making headway in Australia.
In the United States, both the federal government and many states have
provided some conscience exemptions for doctors who are morally opposed
to abortion: "The dispute over abortion access began almost as soon as
the U.S. Supreme Court legalized the procedure in 1973. Six months
later, Congress carved out exceptions for doctors and hospitals with moral
objections to abortion. Forty-seven states passed similar laws.
Louisiana's, one of the most restrictive in the nation, says no one should be
forced to 'recommend or counsel' an abortion, either."[42]
More recently, Congress took steps to protect health care workers
whose consciences prevent them from performing abortions. The Weldon
Amendment became Federal Law in 2004 and gave "federal protection for health
care providers, including hospitals and insurers, who choose not to
participate in abortion."[43]
The amendment stated: "(1) None of the funds made available in this Act
[the federal Health and Human Services appropriations bill for Fiscal
Year 2005] may be made available to a federal agency or program, or to a
state or local government, if such agency, program, or government
subjects any institutional or individual health care entity to
discrimination on the basis that the health care entity does not provide, pay for,
provide coverage of, or refer for abortions.
"(2) In this subsection, the term 'health care entity' includes an
individual physician or other health care professional, a hospital, a
provider-sponsored organization, a health maintenance organization, a health
insurance plan, or any other kind of health care facility,
organization, or plan."[44]
The amendment was not universally accepted. California' Attorney
General Bill Lockyer quickly filed suit to block the Amendment from taking
effect. [The case is still pending]. For pharmacists in the United
States, the laws vary according to state.
As of Aug. 1 of this year: "Four states -- Arkansas, Georgia,
Mississippi, and South Dakota -- have passed laws allowing a pharmacist to
refuse to dispense 'emergency contraception' drugs.
"Illinois passed an emergency rule that requires a pharmacist to
dispense FDA-approved contraception.
"Colorado, Florida, Maine, and Tennessee have broad refusal clauses
that don't specifically reference pharmacists, while California
pharmacists have a duty to dispense prescriptions and only can refuse when their
employer approves the refusal and the patient can still access the
prescription in a timely manner."[45]
Unresolved and troublesome issues remain, however. While pharmacists
and medical personnel can often have recourse to a conscience exclusion,
hospitals -- including Catholic hospitals -- are increasingly under
attack by laws requiring them to provide so-called emergency contraception
to rape victims.
"Connecticut is part of a growing number of states that are considering
or have passed legislation requiring hospitals to dispense Plan B or at
least provide information about the emergency contraception to rape
victims.
"According to advocacy groups, Massachusetts, California, New Jersey,
New Mexico, New York, South Carolina and Washington require hospitals to
dispense the drug. Catholic hospitals are not exempted from those laws,
yet the laws in New Jersey and New York include provisions to appease
the church that prevent the pill from being given if a woman is already
pregnant.
"Similar bills are pending this session in 12 states, including
Connecticut."[46]
The Connecticut bill was defeated, but the trend toward forcing
hospitals to provide unethical treatment is troubling. Also troubling is the
fact that abortion can be made nearly mandatory for physicians in
training, with career consequences if they opt out.
Such is already the case in New York City: "In July 2002 the 11 public
hospitals in New York City imposed mandatory abortion training for all
medical residents. Amid the bad news, an encouraging sign has been
reported. Some 25% (or 38 of the approximately 150 doctors in residency
training) have opted out of the abortion program, though doing so could
compromise their medical careers."[47]
Challenges to the conscience of a health care professional certainly
continue in common law countries, and the current system of dealing with
such issues in these countries is far from adequate, or uniform. The
problems will only grow as new unethical procedures become seen as "the
norm" by some and as a "right" by others.
A good overview of the situation in the United States, at least
occurred in 2002 when the United States Conference of Catholic Bishops
submitted a statement to Congress, which included the following: "While the
principle of protection for conscience rights is widely acknowledged, its
implementation has been far from perfect, creating a need for more
comprehensive and forward-looking legislation. Most federal conscience
protections apply only to specific federal programs or are tied to the
receipt of federal funds (5).
"Their scope is limited by this fact, and by the narrow range of
procedures covered. Though the majority of states acknowledge and protect
rights of conscience, their laws suffer from similar inadequacies. Most of
these laws are limited to abortion. Only a few states protect health
care providers from being forced to perform sterilizations. Few existing
laws protect the full range of individuals and institutions that may be
involved in providing health care in our increasingly complex health
care system.
"Many states do not protect the rights of conscience with respect to
newly created technologies such as cloning or embryonic research, or even
current misuses of older technology such as 'surrogate' motherhood.
States have also not addressed the need to protect providers with respect
to new threats to human life at the end of life, such as
physician-assisted suicide and euthanasia.
"As noted by one commentator: 'As the range of medical technologies
continues to expand ... the number of medical services involving
potentially serious conflicts of conscience is certain to increase.'(6)
"Finally, with new organized threats to conscience on the horizon, it
is especially important for states to expand and strengthen their
existing protections now. These threats have become especially apparent in
recent years in the fields of abortion and contraception, as reviewed
below."[48]
Common law countries certainly have much to do to develop more fully
the ideal of a conscience clause for those in the medical field. However,
the fact that in most common law countries some accommodation at least
seems to be made for the conscience of those in the health care field
provides hope. It may also provide a precedent upon which we can work to
build a society that does not require any protector of life with moral
objections to unethical medical procedures to actively participate in a
culture of death.
It may seem that the discussion of the role of conscience of a Catholic
politician and of a Catholic health care provider are two distinct,
unrelated issues. However, if it is true that much of the difficulty for
Catholic politicians concerns the failure to adequately form a Catholic
conscience or to properly understand the implications of the demands of
conscience on one's public responsibilities, then it is difficult to
see how it will be possible in the future to fashion laws -- either by
legislative or judicial action -- that respect the rights of a properly
formed conscience.
Once again we are reminded of a scene from "A Man for All Seasons,"
this time of the conversation between More and his friend, the Duke of
Norfolk. It is clear that More's stand on conscience is really
incomprehensible to the duke since he asks More to join the other members of the
nobility in agreeing to the demands of the king for the sake of
friendship.
When More asks the duke whether after he has done what has been asked
whether the duke will then follow More into hell for violating his
conscience for friendship's sake, the duke complains of More's obstinacy. In
short, how can we expect those who have failed to take due care of
their own conscience to properly care for the consciences of others?
John Paul II has elevated the role of Catholics by insisting in
"Veritatis Splendor" and "Evangelium Vitae" that any moral consensus within
society must be one which recognizes the three fundamental principles of
the culture of life.
The first is the incomparable value and dignity of every human being
regardless of age, condition or race. This is especially true in the case
of the poor, the weak and the defenseless. And this is also true for
the dignity of the human conscience.
The second is that it is always a violation of human dignity to treat
anyone as an instrument or means to an end. Instead, every person must
be seen as good in himself or herself and never as an object to be
manipulated.
The third principle is that the intentional killing of an innocent
human being, whatever the circumstances and particularly in cases of
abortion and euthanasia, can never be morally justified.
In these moral principles we can see that the Church's mission in
building the culture of life is inseparable from the legacy of the Second
Vatican Council. This is especially the case in regard to the teaching of
the council on conscience, freedom and human dignity.
By insisting that the Catholic people must be "a people of life and for
life" (No. 6), John Paul II has outlined the mission of the Catholic
people in the conversion of culture. In this mission, "Evangelium Vitae"
presents a blueprint for Catholic identity in the third millennium in
which "the dignity of the person and the Gospel of life are a single and
indivisible Gospel" (No. 2).
In becoming "a people of life and for life" Catholics will bear witness
most truly to the truth, to conscience and to the possibility of
building a culture of life. But "a people of life and a people for life" can
only be so if it is at the same time "a community of consciences for
life" or what John Paul II might have called "a great solidarity of
consciences for life."
A Catholic people must have a Catholic conscience and that conscience,
to be Catholic, must be for life.
---------------------
ENDNOTES
1. Robert Bolt, "A Man for All Seasons" (New York: Random House, 1960),
p. 91.
2. Ibid., p. 22.
3. "Complete Works of St. Thomas More", ed. Clarence Miller (New Haven:
Yale University Press, 1976), vol. 14, pt. 2, p. 775.
4. Thomas More, "De Tristitia Christi", "Complete Works of St. Thomas
More," ed. Clarence Miller (New Haven: Yale University Press, 1976) vol.
14, pt. 1, pp. 3-4.
5. F. Fukuyama, "The End of History and the Last Man" (The Free Press,
New York 1992).
6. John Paul II, Address to the General Assembly of the United Nations,
October 5, 1995; L'Osservatore Romano (English edition, October 11,
1995) p. 8.
7. John Paul II's recognition in No. 18 of the suffering and sense of
hopelessness which often pervades these decisions against life and his
sensitivity in No. 99 in discussing pastoral responses to women who have
had abortions reflect the depth of commitment to "solidarity" which
runs through the encyclical.
8. Carl Anderson, "'Evangelium Vitae' e cultura post-moderna" in
Evangelium Vitae: Enciclica e Commenti (Libreria Editrice Vaticana, Citta del
Vaticano 1995) also printed in L'Osservatore Romano 28 April 1995.
9. Jozef Tischner, "The Spirit of Solidarity" (Harper and Row
Publishers, San Francisco 1984) p. 4.
10. Roe v. Wade, 410 U.S. 113 (1973).
11. Reprinted in Vaclav Havel, "Living in Truth" (Faber and Faber,
London 1986), p. 62.
12. Ibid., p. 63.
13. Jacques Maritain, "Christianity and Democracy" (Ignatius Press, San
Francisco 1986) (first edition French 1943).
14. Ibid., p. 46.
15. Ibid., pp. 42-43. Certainly not all of Maritain's contemporaries
were as sanguine regarding the influence of Christianity in the modern
democracies. For example, Christopher Dawson wrote in 1938, "It may, I
think, even be argued that Communism in Russia, National Socialism in
Germany, and Capitalism and Liberal Democracy in the Western countries are
really three forms of the same thing, and that they are all moving by
different but parallel paths to the same goal, which is the
mechanization of human life and the complete subordination of the individual to the
state and to the economic process. Of course, I do not mean to say that
they are all absolutely equivalent, and that we have no right to prefer
one to another." See, Christopher Dawson, "Religion and the Modern
State" (Sheed and Ward, New York 1938), p. XV.
16. Joseph Ratzinger, "Church, Ecumenism and Politics: New Essays in
Ecclesiology" (St. Paul Publications, New York 1988) (first edition
German 1987), p. 173.
17. Ibid., p. 216.
18. Second Vatican Ecumenical Council, Declaration on Religious Liberty
Dignitatis Humanae, 6 (1965).
19. Address to the General Assembly of the United Nations, October 5,
1995, op. cit.
20. Naomi Wolf, "Our Bodies, Our Souls", The New Republic, October 16,
1995, p. 33.
21. Address to the General Assembly of the United Nations, October 5,
1995, op. cit.
22. Robert Clinton, "God and Man in the Law: The Foundations of
Anglo-American Constitutionalism." (Lawrence: Univ. of Kansas Press, 1997)
102-103.
23. James Stoner, Jr., "Common-Law Liberty: Rethinking American
Constitutionalism." (Lawrence: Univ. of Kansas Press, 1999) 5.
24. Wayne House, "A Tale of Two Kingdoms: Can There be Peaceful
Coexistence of Religion with the Secular State?" BYU Journal of Public Law.
(vol. 13, 1999) 221.
25. Quoted in Wayne House, "A Tale of Two Kingdoms: Can There be
Peaceful Coexistence of Religion with the Secular State?" BYU Journal of
Public Law. (vol. 13, 1999) 235.
26. Rob Stein, A Medical Crisis of Conscience in The Washington Post
July 16, 2006, A1, (online).
27. Feminist Majority Foundation, Feminist Daily Newswire Sept. 24,
2002
http://www.feminist.org/news/newsbyte/uswirestory.asp?id=6910
28. Stein.
29. Abortion Act of 1967 quoted in
www.consciencelaws.org/Conscience-laws-United-Kingdom/LawUK01.htm
30. Ibid.
31. Jacky Engel, Abortion Law Reform and Conscientious Objection in the
United Kingdom in Nucleus October 2004.
http://www.consciencelaws.org/Conscience-Archive/Documents/Abortion%
20Law%20Reform%20UK.html#13.
32. The Royal Pharmaceutical Society of Great Britain, Fitness to
Practise and Legal Affairs Directorate: Fact Sheet: Thirteen, Employing a
Locum/Working as a Locum. November 2005.
http://www.rpsgb.org/pdfs/factsheet13.pdf
33. Terry Sanderson, Nothing for the Weekend, in The New Humanist. May
3, 2005
34. Greg Edwards, Accommodating Conscience in The BC Catholic, Oct.
2002
http://www.consciencelaws.org/Examining-Conscience-Background/
Abortion/ BackAbortion29.html
35. http://www.cma.ca/index.cfm/ci_id/3218/la_id/1.htm
36. Pharmacists in Religious Community Balking at Plan B Pill in The
Daily Herald Tribune, Jan. 31, 2006, p. 7. (Lexis)
37. David McLennan, It's not over say abortion adversaries Canberra
Times. Aug. 24, 2002, C3. (Lexis)
38. http://www.childrenbychoice.org.au/nwww/auslawprac.htm
39. Miranda Wood Morning-after Pill Available over the Counter in The
Age Dec. 28, 2003
40. Patrick Goodenough, Objecting Pharmacists Refuse to Sell
'Morning-After-Pill' Cybercast News Service Jan. 6, 2004
41. Danielle Cronin, Morning After Pill Refused: 'Battleground' over
Contraceptives Supply in Canberra Times. April 2, 2005 A9. (Lexis)
42. Bill Walsh, Wording Bolsters Foes of Abortion: Women in Senate are
Ready to Fight It in Times Picayune Nov. 29, 2004, National 1, (Lexis).
43. http://www.nrlc.org/federal/ANDA/HydeWeldonwebnrlnews.html
44. Ibid.
45. States look at pharmacist 'conscience' laws regarding EC in
DrugFormulary Review Aug. 1, 2006, (Lexis).
46. Susan Haigh, Connecticut Bishops Pursuing Stricter Interpretation
of Abortion, Associated Press, March 12, 2006, (Lexis).
47. http://www.projectreach.org/nycDoctors.shtml
48. http://www.nccbuscc.org/prolife/issues/abortion/kansas202.htm
[Text adapted]
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