Freedom of Conscience and Health Care in the United States of America: The Conflict Between Public Health and Religious Liberty in the Patient Protection and Affordable Care Act

Buyx

2016

Public Health Ethics

For much of the 20th century, vulnerability to deprivations of health has often been defined by geographical and economic factors. Those in wealthy, usually ‘Northern’ and ‘Western’, parts of the world have benefited from infrastructures, and accidents of geography and climate, which insulate them from many serious threats to health. Conversely, poorer people are typically exposed to more threats to health, and have lesser access to the infrastructures needed to safeguard them against the worst consequences of such exposure. However, in recent years the increasingly globalized nature of the world’s economy, society and culture, combined with anthropogenic climate change and the evolution of antibiotic resistance, has begun to shift the boundaries that previously defined the categories of person threatened by many exogenous threats to health. In doing so, these factors expose both new and forgotten similarities between persons, and highlight the need for global cooperative responses to the existential threats posed by climate change and the evolution of antimicrobial resistance. In this article, we argue that these emerging health threats, in demonstrating the similarities that exist between even distant persons, provides a catalyst for global solidarity, which justifies, and provides motivation for, the establishment of solidaristic, cooperative global health infrastructures.

Section: Footnotesmentioning

confidence: 99%

Global Health Solidarity

Buyx

2016

Public Health Ethics

“…(8) However, in recent years, the long running debate surrounding conscientious objection in health care has become increasingly heated. (9)(10)(11) This is partly because of the increasing number of cases in which requests for CBEs are made, and partly because of the way in which appeals to freedom of conscience are used in increasingly expansive ways that limit the rights of clients to basic health care services. 1 Equally, the enactment of the Obama Administration's Patient Protection and Affordable Care Act (PPACA) prompted a number of legal challenges to certain provisions of the Act on grounds that they obliged employers and insurers to 1 Follo wing West-Or a m a nd B uyx, we use the ter m "clie nt" to re fer to tho se acc essing hea lth care ser vice s in co nsc ie ntio us objectio n sce nario s, since co nscie nce c la ims ca n also be made b y p har macists and other provider s who do no t have "patie nts" .…”

Section: The Ohio Amendment In Contextmentioning

confidence: 99%

“…(10) provide insurance coverage for services which some people may believe are immoral. (9)(10)(11)(12) The scope of these various legislative and litigative expansions of the right to conscientiously object in the health care context varies. The British Abortion Act for example offers relatively limited concessions to objectors, while more recent legislation in Mississippi provides extremely broad scope to the range of health care services from which objecting providers may excuse themselves.…”

Section: The Ohio Amendment In Contextmentioning

confidence: 99%

“…1 Equally, the enactment of the Obama Administration's Patient Protection and Affordable Act (PPACA) prompted a number of legal challenges to certain provisions of the Act on grounds that they obliged employers and insurers to provide insurance coverage for services which some people may believe are immoral. [9][10][11][12] The scope of these various legislative and litigative expansions of the right to conscientiously object in the health care context varies. The British Abortion Act for example offers relatively limited concessions to objectors, while more recent legislation in Mississippi provides extremely broad scope to the range of health care services from which objecting providers may excuse themselves.…”

Section: The Ohio Amendment In Contextmentioning

confidence: 99%

“…1 Equally, the enactment of the Obama Administration's Patient Protection and Affordable Care Act (PPACA) prompted a number of legal challenges to certain provisions of the Act on grounds that they obliged employers and insurers to provide insurance coverage for services which some people may believe are immoral. 9–12…”

Section: The Ohio Amendment In Contextmentioning

confidence: 99%

See 2 more Smart Citations

Conscience absolutism via legislative amendment

Nunes

2021

Clinical Ethics

On 30 June 2021, Ohio state Governor, Mike DeWine, signed a Bill which would enact the state's budget for the next two years. In addition to its core funding imperatives, the Bill also contained an amendment significantly expanding entitlements of health care providers to conscientiously object to professional duties to provide controversial health care services. This amendment has been heavily criticised as providing the means to allow health care providers to discriminate against a wide range of persons by denying them access to often contested services such as abortion and contraception. In this paper, we examine the implications of this amendment and situate it in relation to other legislative actions intended to guarantee absolute rights to conscientious objection. In doing so, we argue that the entitlements extended to health care providers by these Bills are overly broad and ignore their potential to allow significant harm to be caused to clients. We then argue that if health care providers should have rights to conscientiously object (a question we do not try an answer here), then any legislation intended to protect such rights should be limited, specific, and parsimonious. Where it is not, the ideological liberty of HCPs treads dangerously on the physical freedom of their clients.

Solidarity in Bioethics

Encyclopedia of Life Sciences

Buyx

Prainsack

2016

The concept of solidarity is frequently cited in discussions about distributive justice and what we owe to other people. In addition, solidarity is increasingly the focus of debates in bioethical theory and practice, where it is treated as a concept of fundamental importance, for example in public and global health contexts. Despite the attention that solidarity increasingly receives, however, an exact definition of the term and its role in bioethics remains elusive. Solidarity is understood as a commitment to accept costs to support others with whom people recognise relevant similarities, a definition that we consider particularly fruitful in using solidarity as a guiding principle for policy and practice. Key Concepts Solidarity has recently been gaining more prominence in bioethical, public health and global health debates. The history of solidarity is patterned. Throughout its history, the concept has been imbued with different meanings, with the common denominator being that solidarity is a prosocial notion. The authors define solidarity is as a (shared) commitment to accept ‘costs’ (in the wide sense of the word) to support others with whom people recognise relevant similarities. Defined in this manner, solidarity can be clearly distinguished from related concepts such as altruism or charity. The threat posed by global climate change demonstrates the importance of a solidaristic response by the governments and citizens of all countries. The risks of climate change also provide the catalyst for cooperative action by highlighting an important similarity that exists between all persons – common vulnerability to serious harm. In the context of bioethical policy and practice, solidarity has the potential to ground just, effective public policy and can motivate individuals and governments to participate in programmes intended to alleviate common threats.