First Amendment on Life Support

“More sparingly should this praise be allowed to a government, where a man’s religious rights are violated by penalties, or fettered by tests, or taxed by a hierarchy. Conscience is the most sacred of all property.” John Madison, “Property,” National Gazette, March 29, 1792.

“In purity and holiness I will guard my life and my art.” Hippocratic Oath, approximately 400 BC.

“Refusals based on moral disapprobation, however, are not typical of medical ethics” R. Alta Charo, "Health Care Provider Refusals to Treat, Prescribe, Refer or Inform: Professionalism and Conscience." February, 2007.

Fully enjoying the protections of the First Amendment themselves, the New England Journal of Medicine has published yet another editorial, “Warning: Contraceptive Drugs May Cause Political Headaches,” by Robin Alta Charo, J.D., denouncing conscience and those of us who abide by ours. I suppose that she thought it was the right thing to do.

The Journal does not offer background on Ms. Charo’s previous editorials on the subject, including the notorious 2005 “The Celestial Fire of Conscience.” The editors don’t include any note – any “warning’ – that she was part of the political Obama transition team. Ms. Charo did not mention any of these possible conflicts of interest in her “disclosure form,” available online.

Charo’s entire argument relies on readers’ agreement that the argument is about “public policy and contraception.” It is vital to her argument since, as she quotes Georgetown University theologian Tom Reese, “If the argument is over religious liberty, the bishops win.” Because, if we understand that the issue relates to “an establishment of religion,” Congress cannot legitimately pass, and the Executive Branch may not enforce, any law that infringes on the free exercise of religion.

Charo would instead have us focus on “public institutions, public places, and public duties.” Although hospitals and universities serve the public by providing healthcare and education, they are still owned by private, religious entities. In addition, the Obama Administration’s “accommodation” – the suggestion that the institution’s insurance company provide contraception free of charge to the ensured who want it – becomes much more complicated in light of the fact that most large religious hospitals and universities privately self-insure rather than enter into the market to buy first dollar coverage from a third party insurance company.

Charo’s essay is political appeal to emotion and half-truths, full of the “partisan sound bites and slogans” she denounces. However, not even the lie about mandatory transvaginal ultrasounds compares with her earlier error of logic in warning that the institutions could withhold “ordinary salary.” I don’t know of any religious organization that considers agreed-upon salary for agreed-upon service as inherently sinful. Keeping a promise, like that in the First Amendment or a contract with an employee is sacred to those of us with a conscience.

The Constitution demands that Congress “shall make no law” limiting religious freedom. The attempt by the Obama Administration to write regulations that require religious institutions to engage in acts that are contrary to long-standing, organized tenets of that religion goes directly against the First Amendment and cannot be justified.

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