Obama Defends Conscience
Yesterday, the Obama administration upheld the original provision for religious exemption in the Affordable Care Act by not extending it to religiously-affiliated organizations that employ non-adherents. This is, of course, a victory for all those who care about the religious liberty of individuals and the freedom of individual conscience, which by definition is meant to be protected from the unwelcome coercion by institutions to do things (or not do things) that are not relevant to the performance of one’s explicit duties to them, including one’s employer. The Obama administration did offer one gratuitous concession to those religious institutions, like the USCCB, that seem to be muddled on what exactly conscience is by giving religiously-affiliated employers extra time to comply with the mandate.
New York Archbishop Timothy Dolan responded to the announcement saying, “In effect, the president is saying we have a year to figure out how to violate our consciences.” In fact, the Archbishop could take the year to reflect on what the concept of “conscience” actually means. If he truly believes that the provision of contraception through insurance coverage involves a morally significant participation in evil, then it seems that he, as an individual, has options. He could resign. He could get out of the business of employing non-adherents. He could get out of the business of providing health insurance. He could get out of the business of lobbying for government subsidies. Something tells me, though, that one’s conscience has its limits.
Closer to home, University of Notre Dame President John Jenkins appealed to the desire of religious organizations to participate in a “vibrant democracy” and called for “a national dialogue among religious groups, government and the American people to reaffirm our country’s historic respect for freedom of conscience and defense of religious liberty.” It seems to me that the dialogue has been had, and the best argument prevailed. Of course, it’s ironic that Jenkins is calling for a national dialogue when he has not even hosted a campus dialogue and represents a Church that is decidedly non-democratic in its constitution. Like Dolan, Jenkins too has options. Will he stop providing health insurance to his employees, as he suggested this past fall? Or, will he get out of the business of employing and instructing non-adherents by having them sign a credo, as is done at some other religiously-affiliated universities and colleges? Will Notre Dame stop applying for government grants? Again, something tells me that one’s conscience has its limits.
Perhaps the most disheartening part of this whole affair is the fact that there seems to be very little faith afforded to the consciences of individual religious believers on the part of their religious leaders. If the USCCB really cared about religious liberty and freedom of conscience, it would, I think, trust that those who fill the church pews on Sunday just might have the ability to come to their own moral conclusions in consultation with the spiritual guidance they have come to receive. As it stands, the bishops and other religious leaders seem intent on protecting their prerogative to coerce rather than counsel, and this is a slap in the faces of the faithful, who have already endured and forgiven so much loss of moral credibility among their clergy. It is also a tacit admission that the clergy themselves are perhaps not so confident in their own charism to amplify the small, quiet voice of God in the hearts of those who hear them. In this case, as in all cases where the right to coerce is claimed over the right of individual conscience, fear, insecurity, and, indeed, unbelief seem to be drowning out the voice of faith itself.
At least the Obama Administration is being honest before the election. It is attempting to be what it wishes to seem to the general public. I guess Catholics just have to make way for a president who chooses to boldly push past them/us (on this issue). He believes there is no option or truth but on his own side. There is no room for further compromise (no matter how often voices of conscience undergo mutations). Basically, he seems determined to make Catholic institutions less Catholic through his policies (or through the trangressions of others).
Archbishop Dolan also got a sympathetic phone call from the president. One can always be kind to people about whom one cares nothing, as Wilde puts it.
The regulations are designed to protect the freedom of choice of the employees, many of whom are not Catholics. In short, the religious freedom of the Catholic employers at Catholic hospitals, colleges, universities, and certain other agencies does not trump the freedom of choice of the employs who are covered by the medical insurance.
How does “individual conscience” or “freedom of choice” require that another individual or institution subsidize another person’s sex life?
If someone wants to have sex, they should do so in their own privacy, and not drag other people and their pocketbooks into the bedroom with them. Authentic conscience and freedom of choice are not compulsions to force others to violate their own conscience and freedom. If someone wants to have sex, he can pay for his own birth control.
Besides, with respect to “individual conscience,” the obligation is NOT to follow one’s “conscience” simpliciter; rather, the obligation is to follow a good conscience. No one can rightly claim a right to follow a bad conscience. And good, being a species of truth, is objective, not subjective. One cannot, in good conscience, do an objectively immoral thing or otherwise claim “conscience” as a justification to do what is contrary to objective moral truth.
Thanks Eric for a very perceptive article.
The conflict here seems to be between religious institutions which wish to impose their own moral views on their employees where the employees in good conscience are merely doing what Pope Benedict XVI once described as their moral obligation to follow their conscience, even against the Pope.
In this case 95% of married Catholics do not accept the Catholic teaching on contraception. Their consciences also need to be respected, even though they may be in error.
One’s ability to follow ones conscience ends at the point where one attempts to impose one’s own views on others (here employees) in violation of their conscience.
One hopes and prays that the new Bishops committee on religious liberty will rush to strenuously defend the religious liberty of employees to follow their own consciences, in accordance with the clear teaching of the Catholic Church as taught by the last Council.
God Bless
“The regulations are designed to protect the freedom of choice of the employees, many of whom are not Catholics. …religious freedom of the Catholic employers at Catholic hospitals, colleges … does not trump the freedom of choice of the employees who are covered by the medical insurance.”
Thomas Farrell,
Let’s call a spade a spade. President Obama simply wants the Catholic Church/Notre Dame/any Catholic agency to do the devil’s drudgery (i.e., perform surgical sterilizations, etc.) under the Cross, in Christ’s uniform as it were. He wants to pay tribute to “freedom of choice” so that his administration can impose “Catholic sins” upon Catholic administrators who sponsor these schools and hospitals. Catholic consciences don’t count. He wants “freedom of choice” to pay homage to sin (on Catholic turf). Not hard to figure out.
Just mu opinion:
In the current Commonweal there’s an article by a prominent canonist that divorced/remarried Catholics should have a conscienc eprovision t oreceive the Eucharist.
While I think that’s what a number already do anyway, I bring thios up because it indicates a glimmer of hope that the individual’s conscience s may be begun to be taken seriously and not just theimposition of the current rules and regs.
I need to say that I think the voice of the Church in the public square is deeply important.
I posit that using that voice to impose our faith view through law is counterproductive.
Usually the argument is that we need to reduce the number of murders committed through abortion; recent data seems to indicate that there are less abortions in countries wher eit is legal, so the argumen tis questionable.
It strikes me that, in the public square, making your values cogently is what is needed.
Comments like Obama is doing the devil’s drudgery is precisely the kind of counterproductive ideplogically driven that weakens the credibility of the Church’s policy maker’s views and drives more into drift from the Church they once heartily embraced.And, if large swaths of Catholics in conscience do not buy those policy maker’s views, insisting on them more, by law, is not an effexctive use of the public square!
Eric: “He could resign. He could get out of the business of employing non-adherents. He could get out of the business of providing health insurance. He could get out of the business of lobbying for government subsidies. Something tells me, though, that one’s conscience has its limits.”
Or Catholics could just leave the public square after serving the poor and needy via hospitals and schools for hundreds of years in this country…nothing discriminatory about that – ha!
This argument is so narrow minded and individualistic that it is really outrageous.
Eric’s piece is perfect embodiment of the new liberal “tolerance.”
I really doubt that President Obama and his Secretary of HHS were “defend[ing] conscience,” as the title of this post proclaims. Yesterday’s decision was instead the result of cold, hard political reckoning that had nothing to do with an intra-Catholic dispute about the moral dimensions of the exercise of personal conscience. A president who thinks that it is “above my pay grade” to opine on the issue of when human life begins likely did not get bogged down in the intricacies of Catholic freedom of conscience when he mulled over the decision not to extend the religious exemption. Instead, his advisers no doubt informed him that the great majority of Catholic voters disagree with the bishops on the issue of contraception, and that it was therefore politically safe to make yesterday’s decision.
“President Obama simply wants the Catholic Church/Notre Dame/any Catholic agency to do the devil’s drudgery (i.e., perform surgical sterilizations, etc.) under the Cross, in Christ’s uniform as it were.”
That statenebt was hyperbole carried to an odious extreme.
Since when do these Catholic agencies perform surgical sterilizations? We are not talking about Catholic hospitals; we are talking about Catholic employers who provide group health coverage to all employees (irrespective of religious adherence or no religious adherence) who otherwise meet non-discriminatory ERISA-controlled eligibility requirements.
” If someone wants to have sex, they should do so in their own privacy, and not drag other people and their pocketbooks into the bedroom with them. ”
If someone wants to have babies, they should do so in their own privacy, and not drag other people and their pocketbooks into the hospital room with them.
By the logic of this argument, Catholic institutions should also be required to pay for employees’ abortions. Anything else, according to Bugyis, is a violation of “conscience.”
“How does “individual conscience” or “freedom of choice” require that another individual or institution subsidize another person’s sex life?’
Bender –
This time I agree with you. It’s just more nanny government rearing her ugly head. I say buy your own contraceptives.
Thorin,
I think that the principle in the two cases in actually the same.
Just as the right of religious organisations to impose their consciences on their employees ends at the point that would violate the right of the employees to exercise their own consciences, so does the right to impose a conscience that approves abortion end at the point where it interferes with the right to life of others.
If we are going to argue a “religious” exemption from social policy then that would appear to be limited to clearly religious matters. Abortion may arguably be such a matter, but the Catholic Church teaches that abortion, contraception and sterilization are not religious matters but matters of natural law.
Religious organisations would appear to be on rather weak ground to argue against contraception being covered because
1. Contraception is not a religious matter but one of natural law.
2. The moral objection rests on a particular interpretation of natural law which only a tiny fraction of Catholics accept.
3. The employees are not all even Catholic.
God Bless
The definition of freedom of conscience implied in this post is absurd. Does mr. Bugiys really think that if my employer does not pay for my contraceptives my freedom to use contraceptives has been violated? Is he joking? Can he use elementary logic?
This like saying that my freedom of movement has been violated because my employer does not want to buy me a plane ticket to Acapulco…
Carlo, I’m afraid that it is you who are engaged in faulty reasoning by equating a plane ticket to Acapulco to health. The former is, of course, a luxury, but the latter is the necessary precondition for the exercise of any free action whatsoever. If one is not well, one cannot work, provide food and shelter for oneself, and in extreme cases live. Healthcare legislation, like the Affordable Care Act, is aimed at starting to outline the minimum preventative and curative care to which all citizens are entitled as a precondition for the exercise of any freedom whatsoever. By asking to opt out of any of these provisions without the express consent of its employees, an employer is denying those individuals services deemed necessary by a board of medical experts for the maintenance of health, which, if I may repeat myself, is a necessary condition for the exercise of freedom. Now, as with all things, an individual has the right to follow his or her conscience in refusing care that he or she feels would do more harm to the soul than is worth the good it does for the body, but as with the conscientious abnegation of any right (or duty), only the person in question can choose to make such a sacrifice. No person or institution can coerce another to sacrifice his or her life, and the refusal to provide medical coverage for those services that are deemed medically necessary is just such coercion. Now, if you can make that argument for plane tickets to Acapulco, perhaps we should begin lobbying congress to consider an Affordable Vacation Act.
ISTM that the basic principle that is being violated here is this: just because one person has a legal right to do X, that does not imply that he/she has a legal right to demand that someone else must help him/her to do it. A right to contracept is not mentioned, while the right to the free exercise of religion is. It seems to me that that mentioned right (the religious one) trumps the (purported) right to demand contraceptives from another person/institution, a right which is not mentioned in the Constitution.
Therefore, if Big Nanny thinks its agents have a right to demand contraceptives, *it* should provide them, and it should not demand them from persons who have religious objections to providing them.
“How does “individual conscience” or “freedom of choice” require that another individual or institution subsidize another person’s sex life?”
The State subsidizes the health of its citizens, or should, and it cannot exclude those aspects of health that connect with sexuality.
“If someone wants to have sex, they should do so in their own privacy, and not drag other people and their pocketbooks into the bedroom with them.”
You forget pregnancy, which very much breaks the sealed cocoon of privacy. If pregnancy is a concern, so is its prevention. Also you forget sexually transmitted disease, which is far from being a private concern, as is its prevention.
” Authentic conscience and freedom of choice are not compulsions to force others to violate their own conscience and freedom.”
Yet we do compel extremist sects to refrain from non-cooperation with doctors.
” If someone wants to have sex, he can pay for his own birth control.”
Not in the case of the Philippines, for example, where mothers of 10 live by scavenging and certainly cannot afford even a humble packet of condoms.
“One cannot, in good conscience, do an objectively immoral thing or otherwise claim “conscience” as a justification to do what is contrary to objective moral truth.”
Paul VI stated that objectively immoral acts can be inculpable, diminished in guilt, or subjectively defensible.
Actually I think that the Obama Administration is correct that family planning is a health issue and one which the state has a duty to help provide. Humanae Vitae would agree on the former, teaching that parents are obliged to make prudent decisions about family size. And the Church has long taught the social obligation to make decent health care available to all.
If the method was Natural Family Planning, the Church would have no problems with this.
If we can accomodate that, and I think Humanae Vitae and Catholic Social Teaching requires the Church to, then whyI can’t we apply Vatican I’s teaching on the moral obligation to follow ones one informed conscience (even when it is mistaken) to allow adults to make up their own minds as to what methods they consider suitable for themselves ?
The more I think about this, the more the Obama administrations decision here appears to be solidly grounded in Catholic teaching.
God Bless
Eric:
right. Except nobody in his right mind would think that your conditional sentence
“If one is not well, one cannot work, provide food and shelter for oneself, and in extreme cases live.”
applies to CONTRACEPTIVES! Again, are you serious?
If people cannot work without buying their own contraceptive pills (or, better, abstaining from sex for a few days a month), then my case, I cannot work without immediately spending a week on the beach in Acapulco. Please give me a break.
Ann, in this case the right to health, as a precondition for the exercise of all of the other rights, trumps the right to religion. The provision of contraception falls under the former insofar as it is deemed medically necessary in some cases for the maintenance of health. Now, no employer is being forced to provide health insurance, but if they do, they are required to meet the minimum standards of coverage for such insurance to be worthy of the name. Otherwise, the employer is not, as advertised, offering the coverage to which the employee is entitled. In order to oppose this, you either must (a) deny that health is a right or (b) deny that contraception is medically necessary in some cases for its maintenance. If you say (a), then you are simply against healthcare reform all together, and I suppose we have nothing to talk about. If you say (b), then you are challenging the medical expertise of those doctors who determined the minimums, in which case I trust that you are yourself a doctor with the relevant expertise or you have a reason to mistrust the doctors in question.
Carlo, are you a medical expert?
Eric:
“Carlo, are you a medical expert?”
Just as much as you are an expert on “freedom of conscience.”
“Finally, some common sense in this world.
“If you’re tired of your human rights being trampled on — like not being able to take free vacations every year — then you’re in luck. At least if you’re over in Europe, anyway.
“The Times of London is reporting that the European Union could declare tourism to be a basic human right, and if you can’t afford to travel, then government should take care of the expense for you.”
http://latimesblogs.latimes.com/washington/2010/04/no-free-vacation-this-year-your-human-rights-have-been-violated-at-least-in-europe.html
“…the devil’s drudgery is precisely the kind of counterproductive….”
Bob,
We are agruing principles. President Obama’s administration wants religious leaders who sponsor schools and hospitals to pay for their employees’ transgressions through a health care package. “Freedom of choice” of employees trumps the religious principles and the institutional ethos of the sponsors and guarantors of these institutions.
One doubts, however, that “freedom of choice” of government employees would trump the military principles and the ethos of government foundations in the same way. The Obama Administration, for example, came down hard on Bradley Manning’s “freedom of choice” for leaking classified material to the public (because it threatened “national” security).
It seems if an institution is decked out in flags, transgressions are a serious matter, prohibited by the government. But if a religious institution is under a Cross or under “the protection of Jesus and Mary,” transgressions are not serious matters, can be “free choices” (which have to be supported by the religious sponsors of the institutions). It’s also as if a religious principle can be switched on and off in the hearts of religious sponsors like a light switch without affecting their consciences.
When a government, on the one hand, starts obliquely dictating what religious principles can be transgressed by citizen employees working at a religious institution (and which trangressions have to be paid for by religious sponsors and leaders of those institutions), but, on the other hand, dictates a “hands off” policy regarding their own government and military institutions, something is awry. Why are government institutions suffused with a certain standard, but religious institutions stripped of that? It seems the nails of justice are not hammered in a row when it comes to separation of church and state. It seems Church institutions are pinned under the government’s foot because such institutions dared to raise their eyes higher than the flag.
Eric –
You are really maintaining that there is only one means for the individuals to secure their health right. But there are more then one way. So the bishops not paying for the contraceptives does not peclude the exercise of their health right/right to buy contraceptives.
The analogy of a “right to vacations” that Patrick is an excellent one. Let’s say one of your employees is so stressed out he’s about to have a nervous breakdown. A European tour would prevent the breakdown. Are you obliged to pay for it?
I had a very unhappy experience, about one hour and 45 minutes ago, at St. Bonaventure Catholic Church, in Huntington Beach, about 15 minutes into the 10:30 AM Mass.
First, just a little background. I am 64 years old and was raised as a Protestant; in my adolescence, I had an evangelical, born again experience. In college, I fell in love with and married a Catholic girl. We wanted to be married in the Catholic Church (this was 1969). However, I could not in my conscience promise to raise any future children in the Catholic faith. We ended up being married at a Presbyterian Church. We subsequently had 2 wonderful children and we celebrated our 42nd wedding anniversary last August. We remain very happy.
After our wedding, in 1969, (which caused a lot of anguish for my wife’s family) we just fell into having an entirely secular marriage. Religion has not been a part of our family life. Perhaps that has been the secret to our happiness and long marriage and great family — I don’t know. Anyway, for the past year, I’ve been speaking with a Catholic friend, about all matter of religious and Christian subjects. I have, throughout my life, disappointed myself in not being as good a person as my conscience would want me to be. I had a long talk with my wife this morning, and I told her that I wanted to start attending Mass regularly. I thought the the spirituality and discipline would be good for me. Were faith to emerge as a result of this, so much the better.
So I dressed up and went to mass this morning. I really enjoyed the first 15 minutes. It’s exactly as I’d hoped for, particularly the group confession and opening prayers, readings, and so forth.
Then the Priest started his homily. He noted in passing the death of Penn State football coach Joe Paterno. He offered his opinion that Mr. Paterno may have died of a broken heart.
Then he noted that on page 7 of the morning’s LA Times was a story about the national health care law including a provision which mandated coverage for contraceptive (not abortion) services. What he said next just stunned me: “This President has declared war on the Catholic Church, just like Adolph Hitler did.”
I felt sick to my stomach. Just nauseated. It was a punch to the gut. I quietly got up and slipped out the back door, trying not to make any sort of a scene.
I can’t tell the good people at St. Bonaventure how to run their church. I was grateful to be welcomed as a guest.
But it’s going to be some time before the Holy Spirit moves me to return. I didn’t go to St. Bonaventure to seek the politics of hate. I meet whatever need I have for those things on TV and on the Internet.
- Larry Weisenthal
Huntington Beach CA
First, Mr. Bugyis states the mandate incorrectly. Catholic institutions do not have the option to avoid it “by getting out of the business of employing non-adherents … [or of ] lobbying for subsidies.” It is a flat mandate, not a condition tied to subsidies. And to avoid it, they must also substitute preaching/proselytizing for serving others as their main focus, AND they must not only stop employing non-Catholics but (mostly) stop serving them as well. The very things that progressives say they most appreciate from religious organizations–assistance to the community, not preaching or benefits to members–are the things this mandate pushes them to stop doing.
I also just don’t understand the idea that this is a case of coercing employees’ conscience. It’s not like firing someone for doing the act, which takes away other benefits; this purely and simply refuses to pay for it. Mr. Bugyis suggests (seriously?) that it’s a viable option for Abp. Dolan to resign (or equivalently I suppose for Notre Dame to stop providing education), but not viable for an employee to pay for contraception separately. I find that a strange weighing of competing conscience claims (even I assuming that “I want to be able to use contraceptives” is a claim of conscience).
To be clear, I write as someone who does not agree with the bishops’ moral position on contraception.
“How does “individual conscience” or “freedom of choice” require that another individual or institution subsidize another person’s sex life?’ ”
How does “individual conscience” or “freedom of choice” require that another individual or institution subsidize another person’s procreation?’ ”
Larry: I suspect your experience at St. Bonaventure is not so much an exception as it might have been in the past. This church is retreating into the 1950s as fast as its ever decreasing number of legs can carry it. Think long and hard about finding a good parish (I’m told that St. Monica’s in Santa Monica is one) before you and your wife make another visit.
Ann, the Affordable Care Act is meant to provide access to necessary health services (which is not the same thing as the “right to buy” health services) such that they are not cost prohibitive for those who require them. It is precisely because buying services on the open market is cost prohibitive for many people that the minimum insurance mandates have been created. So, by denying coverage of services deemed essential, the Bishops et al. are asking to infringe upon the rights of those employees who are entitled to receive medically necessary contraceptive services at a price they can afford, which, again, is not the price available on the open market. And…finally…why not vacations as a human right? I think that’s a topic for another time, however.
Larry, I’m very sorry that you had that experience this morning. Unfortunately, the Bishops’ statements are breeding precisely the kind of over-the-top rhetoric to which you were subjected. I will just say that there are good priests and congregations out there who are not driven by fear, but I understand if the wind of the Spirit has been taken out of your sails. It really is only by the grace of God that any wind remains in mine, and I can honestly say that I show up on Sunday in spite of and not because of most of the hierarchs.
Larry, I want to believe that that priest that you heard was an exception, an outlier.
In my parish this morning our priest’s homily went along the following lines: “as we grow old, if you’re like me, we tend to become more cynical. But we have to pray for the grace of hope. I remember four years ago, in 2008, President Obama gave a speech during his campaign, and Pope Benedict spoke during his visit to the United States, and they both spoke about the same thing: hope.” Then he went to talk speak about hope in today’s readings.
I thought that speaking of Obama during the presidential campaign was not in the best taste, and would have preferred our priest to keep our president out of his homily. I am sure that those in the congregation who are Republicans, few as they might be, were displeased with that piece of the homily. Still, that’s as far as he went. Too far already in my opinion, but incomparably more restrained than the preacher you heard. And that is how things are in one of the most progressive parishes of my diocese. So, I hope that such relative restraint is typical, and that what you heard was really an exception.
I must say, though, that I have the impression that a presidential campaign is not the best time to start attending Mass in the US. You’ll probably have better luck after the elections.
Eric –
Where does the Constitution mention “the right to health”? Or where does it imply it? You might argue that “the pursuit of happiness” implies health care, but that’s in the Declaration of Independence, not the Constitution.
Whether the Constitution *ought* to guarantee it is another matter. As I see it, parents have the obligation to provide health care for their families, if possible, just as they have the obligation to provide education. Indindividuals have the obligation to provide the care for themselves. Sometimes meeting that obligation can be assisted by government. But it isn’t an automatic thing.
Further, “health” is a relative notion. Do you think that everyone has a natural right to perfect health? If you define “health” as “life”, then you have an argument. But health and life aren’t the same thing.
Certainly, not everyone understands the Constitution as guaranteeing good health. See the recent knock-down drag-out congressional arguments over Obamacare.
Today’s homily in my parish was about Roe v. Wade, which seemed appropriate given that today is the 38th anniversary of the Supreme Court’s issuance of this decision (along with its companion case, Doe v. Bolton). While the priest did speak about the grave evil of abortion, his primary focus was on the need to work hard to change hearts and minds, and he provided a laundry list of ways for people to start doing so. I thought it was an excellent homily.
Tom, I think my last comments to Ann might clarify how and why the denial of contraceptive coverage constitutes a kind of coercion. If employees are entitled to certain basic benefits, like affordable medical care, and an employer denies them those benefits on religious grounds that they themselves do not except, then essentially those individuals are being forced to seek medical care on the open market at a rate that may be cost prohibitive. If, as a result of this, one is unable to purchase the services required, then, in effect, the employer is making a choice for the employee that he or she will not receive certain necessary medical care on the grounds that it is immoral (again, a position to which the employee has not assented and is not included as a condition of his or her employment). I also take this to be a kind of covert proselytizing, since the employee is now being forced, through the removal of the means of care to which he or she is entitled, to observe the religious convictions of the employer, i.e. not using contraception. It seems to me that the Obama administration is simply asking religious institutions to be upfront about the fact that they are engaging in this kind of material evangelization by asking that they make explicit to their employees and those they serve that these individuals are expected to adhere to the religious tenants of the administering institution. As long as they do this, I see no reason why we can’t have hospitals or schools for Catholics by Catholics, but if you are going to serve and employ the public then you have to do so “publicly” by affording your employees and customers the same rights and privileges guaranteed everywhere by the government.
Ann, it seems to me that the Affordable Care Act is engaged in the precisely the kind of relative definition of minimum health rights as pertains to the conditions of the possibility for life that you are seeking, and as you say, it is a point that is being hotly debated in congress and in anticipation of the election. If you would like to contest these minimum provisions, you should write your congress person or run for office. But, what provisions are medically necessary for the maintenance of life is a question of medical science. It is not a question of religious liberty.
“the Bishops et al. are asking to infringe upon the rights of those employees who are entitled to receive medically necessary contraceptive services at a price they can afford,”
Eric –
No, the bishops are asking no such thing. They are not in the business of preventing the other people the exercise of their rights. They are asking that their own rights be respected. There is simply no necessity that the bishops be involved in the employees getting contraceptives. It boils down to a matter of convenience to the employees and a matter of some money, but if the employees are being paid a just wage there is no rip-off by the bishops. Food is also a necessity, even more than contraceptives. But the bishops are not obliged to pay for it. Again, all they owe is a decent wage. If the government says the employees need help, then the government is quite capable of providing it, thus not violating the bishops’ consciences.
Ann – are you a secret speech writer for St. Newt?
Ann Olivier is exactly right.
By the way, I see that Eric Bugyis does not deny my point that the logic of his argument would also require Catholic institutions to pay for their employees’ abortions. The bishops are quite right to fight back on this.
Aw,c’mon, JImmy Mac. Just because I think the bishops are right about this one, don’t insult me!!
Actually, I think my position would require a lot of rearrangement of who has the function of doing what. Sure, everyone must eat and everyone ought to have health care, but who should provide it how? To me the most basic new historical fact is the number of people making demands on the planet. Efficiency in utilizing resources has become a very large moral issue, and because the greater number of people requires greater complexity of social structure, I think the whole civilization has to be re-thought from bottom up. Or top down as the case may be.
Eric:
“but if you are going to serve and employ the public then you have to do so “publicly” by affording your employees and customers the same rights and privileges guaranteed everywhere by the government.”
wow! Another unbelievably ideological statement. You are effectively giving the government the power to establish moral values for all of society, and to prevent all those who disagree from participating in public life. You would be happy in North Korea.
But seriously: have you ever read any Catholic social doctrine about the primacy of civil society, the meaning of subsidiarity and the proper role of the state? Or do you think that Catholic social teaching is totally misguided and that the bishops should just adopt the policy platform of the Democratic party?
“essentially those individuals are being forced to seek medical care on the open market at a rate that may be cost prohibitive. If, as a result of this, one is unable to purchase the services required, then, in effect, the employer is making a choice for the employee that he or she will not receive certain necessary medical care on the grounds that it is immoral…”
Boy, there are a lot of fudge words in there: “essentially” being forced to buy in the market; “may be cost prohibitive” (what about those for whom it’s not?); “in effect, making a choice for the employee” (the government could perhaps pay–is the government coercing by not paying? What if the employer denies all health insurance–which may happen now–isn’t that more “coercive” then?). All of these partial links meant to claim there’s a bigger coercion of the employee’s conscience than there is on the employer’s when the government subjects it to civil or criminal penalties for refusing to pay for a particular procedure. I still find that weighing highly implausible.
It’s hard for me not to conclude that what’s doing the work here is a view about the underlying moral question, rather than any plausible account of greater and lesser burdens on conscience.
Tom Berg:
I agree about your diagnosis. Eric’s word acrobatics are a good example of what sophistry was in the history of ancient philosophy: a systematic manipulation of language in order to support theses that had been pre-decided on purely political grounds.
A good sophist can turn the oppressor into the oppressed, the guilty into the innocent and a prevaricating goverment into a defender of fredom of conscience!
Eeek!!!! I was coerced.
A repressed memory from the pre-ObamaCare era, just now surfacing – - In grammar school, along with everyone else, I had to participate in janitorial activities at my, needless to say, highly repressive Catholic grammar school (in another post this was declared to be a scandalous and morally repugnant practice). With no wages and no health care and definitely no coverage for contraceptives. My precious human rights were totally ignored. What an unspeakable outrage!
I can’t go into more details because to recall the horrible experience is too painful.
Ok, Tom, so let’s take out the “fudge words.” Employees would have to buy services on the open market. For some, that would make them cost prohibitive. (We’re not concerned about those for whom this is not the case… Good for them.) Since healthcare legislation is meant to mitigate against this, such people would not be able to afford the services to which they are entitled.
Meanwhile, the employer, since it technically provides “health insurance” (even though it doesn’t meet the minimum standards of coverage), is not required to pay the penalty for not providing coverage to the government so that it can subsidize insurance for those employees who are not covered. The government will subsidize coverage for those who are not already insured, but since the employees in question are technically “insured” they will not be able to “double dip.” So, actually, the employer would be more honest to not provide any coverage, because then it would be paying the government to provide the coverage that the employer either cannot or will not.
Given all of this, the Bishops et al. are asking for permission to provide substandard “health insurance” to employees in place of the minimum health insurance that would otherwise be provided by the government. These employees have not willingly agreed to accept substandard insurance, because they have not assented to Catholic teaching as an expectation of their employment or as a precondition for receiving services from that institution. So, in fact, these employees are, without their consent, not receiving health insurance as defined by a board of medical experts chosen by their democratically elected government. They are receiving “health insurance” as defined by the Bishops. But, if these employees are not Catholic, why should the legitimacy of their health needs be dictated by the Church? As citizens of the United States, they are entitled to the full rights and privileges protected by the government, not some subset chosen for them by their religious employer.
And, while we’re at it, how about letting me argue what I think is the central issue here instead of presuming to know what is subconsciously motivating my claims about conscience. Armchair psychoanalysis is worse than sophistry, because at least the latter requires some skill.
I guess this is just one of those issues where either you see the absurdity of forcing church groups to pay for contraceptives or you…see the absurdity of it, but pretend that you don’t because you find the end agreeable anyway.
Is it really not apparent that forcing these groups to provide this coverage necessarily violates conscience? And that not providing coverage does not preclude the employee paying for the pill or buying condoms or the morning after pill out of his or her salary? And did anyone address by what logic church groups would not have to pay for abortion if HHS decided to include abortion as well?
Eric:
“not receiving health insurance as defined by a board of medical experts chosen by their democratically elected government.”
So, is there any limit to what experts chosen by a democratically elected government can tell people to do? What would you do if the experts decide that some women need late term abortions? Or what if the experts decide that “feeble minded” people should be sterilized for their own good, as they did in this very country in the 1930′s? Please tell me.
Don’t you see that by accepting that premise unconditionally you have just flushed the very notion of freedom of conscience down the drain?
And by the way, the accusation of sophistry has nothing to do with psychoanalysis. It just points to a way of reasoning that it is politically driven, and so accepts uncritically untenable premises like the one I just quoted.
Carlo, who’s being sophistical now? No one is saying that anyone must or even should use contraception. No action is being dictated to or prescribed for individuals. We are only defining the minimum healthcare to which individuals have a right. Now, certainly we as a morally rational community have the capacity to debate what constitutes such minimums, but that is different than unilaterally opting out of them. At the very least, it is obvious that no one is forcing anyone to use contraception or to be sterilized, which is why I say that if the Bishops think contraception is wrong they should appeal to the rational conscience of their adherents (and non-adherents, for that matter) and not try to make it materially harder for them to get it. What happened to changing hearts and minds?
Your argument also seems to call into question the integrity of medical expertise as well as the legitimacy of a democratically elected government. This seems to be a favorite trope among conservatives: “Who are these so-called experts? That’s not my government!”
You are being sophistical because I was obviously talking about what DOCTORS and HOSPITALS have to do. Let me give you a little “reductio ad absurdum” of you argument:
STEP1: “Medical experts chosen by a democratically elected government” can determine that some women need late term abortions.
STEP2 Hence, late term abortons belong in a set of “rights and privileges guaranteed everywhere by the government.”
STEP3 Hence, hospitals who want to offer “public services” must offer late term abortions.
STEP4 But women must have the freedom of conscience to have late term abortions.
ERGO Women’s freedom of conscience demands that Catholic hospitals and doctors be forced to provide late term abortions.
Beautiful! With your permission I would like to call this reasoning the “Bugyis Theorem.” As a professional mathematician I especially appreciate the fact that the proof of the Bugyis theorem works in all kinds of situations! Just replace the words “late term abortion” with any morally senistive issue about which you want your beloved “medical experts” tell Catholic medical institutions what they have to do…
And, just to be prevent another useless distinction: obviously the Bugys Theorem works beautifully also to determine what medical services must be covered by the insurance plans provided by Catholic employers to their employees…
One more thing: I am not conservative, thank you.I am just a Roman Catholic. Since times immemorable Catholics believe that some questions are irreducibly moral, not technical, and thus “medical experts” have no expertise whatsoever to tell people what they must do.
…”absurdum,” indeed.
Mr. Lancellotti’s reductio ad absurdam is devastating. That is exactly the logic behind Mr. Bugyis’ argument.
There are two (obviously) different points of view.
One is deeply invested ISTM in maintaining policy/magisterium as the THE Catholic point of view and one that emphasizes individual’s consciences.
BTW. I remember a distinguished catholic moralist saying “good medicine makes good morals”. Of course how you frame that matters or maybe it doesn’ t matter any more.
Carlo, There is at lest one “fallacy” (as long was we’re being logical) in your “devistating” reduction (by which I mean simplification) of my comments. You commit a “naturalistic fallacy” by assuming that you can derive a moral conclusion from an empirical premise. The senses of “determine” and “need” in step 1 are not moral. For a doctor to determine that something is medically necessary, he or she is merely saying that it is required for either the immediate or eventual preservation of one’s life. This is a question of science and not morals.
I am loath to get into the abortion debate, but if we must… If a doctor says, “An abortion is medically necessary in this case (i.e. to preserve the life of the mother).” He is simply reporting the facts. The patient will die if an abortion is not performed. You are quite right that this expert determination is not a moral recommendation. In order to get into the moral discussion, we have to shift gears and ask, “Is it obligatory for a woman to sacrifice her life for the sake of her unborn child?” (This, of course, gets us into the philsophical question concerning the personhood of the fetus and whether that “person” has a claim to the life of the mother.) But, all of this is not even to ask the legal question, “Is it just for the State to require a woman to sacrifice her life for the sake of her unborn child?” (This gets us into whether, if the fetus is a person, that person has rights that supervene on those of the mother.)
Since, so far, the pro-life lobby has not convinced the American public and their elected representatives that it is just for the State to ask for such a sacrifice, the legal argument has not been won. Thus, all we have is the empirical fact that in certain instances women will die if they do not receive reproductive medical care, and since there is no good legal reason to compell them to die for the sake of procreation, we must make sure that these services are made available.
Of course, this is all a pretty long digression from the main topic of the post, which has to do with the exercise of conscience and the best prudential means of making medically necessary services available to individuals. Since we’ve decided to go through employer provided insurance as a first step, this brings us to the current dilemma, on which I have articulated a position quite apart from the above considerations. If we decided to go with a single-payer national insurance, which I would actually prefer, we might be able to side-step a lot of this. But, again, we digress…
Eric:
of course it’s a naturalistic fallacy! But it is YOUR argument, not MINE.
In case you missed it I was mocking your own argument about insurance coverage of contraceptives, which goes exactly along the lines I described.
Carlo, I suppose I did miss something. I have no idea what you are talking about. Where did I say that the “medical necessity” of contraception made it a moral imperative? All I have been saying is that if healthcare is a right, then those things deemed medically necessary must (in a non-moral sense) be made available, unless they are explicitly renounced by those who are entitled to them. This statement involves a legal argument for the right to healthcare (and about rights in general) and an empirical argument as to what is medically necessary (i.e. constitutes “healthcare”). I have made no moral statements anywhere. So any fallacy you have “discovered” is one you have read into my comments. I have taken no position on the morality of the situation, which is why your (and Tom’s) “diagnosis” is off. You are both assuming that I have a certain moral position on the issue, which is “driving” my argument. In fact, “freedom of conscience” implies that no moral decision has been made for anyone, but it has been left up to the individual to come to his or her moral conclusion regarding the allowances in which one would like to participate. So, it would, indeed, be strange if I did take a moral position. Sorry, but your mockery has missed its mark. I do appreciate the attempt though. Very clever.
Eric,
If something is “medically necessary” only if “it is required for either the immediate or eventual preservation of one’s life,” then how is the pill as it is commonly used “medically necessary”? If your argument were that Catholic institutions should be forced to cover contraception (or abortion) only where a woman’s life is in jeopardy without it, I don’t think you’d find much resistance here. In any case, I don’t think you’ve answered Carlo’s point. Why doesn’t your argument work for any legal abortion, and not just for abortions performed to save the life of the mother? Or do you also think that coverage for abortion services should also be mandatory?
The real question is this: Should the federal government prohibit the sale of group insurance policies that don’t include contraception? Or if you prefer: Should the government be able to tell a Catholic institution that it cannot offer its employees health insurance that covers things that are medically necessary by your own definition unless it also covers something that isn’t?
I would be modestly interested to learn how Mr. Bugyis believes his blogging here comports with the relevant principles of Lumen Gentium nos. 30-38. In the alternative, I’d be interested to learn why he doesn’t think those principles govern the activity of the laity in this (and other) contexts.
Matt, I am willing to debate the definition of “medically necessary,” which I was not intending to define in “if and only if” terms. I imagine medical necessity exists on a continuum with imminantly life threatening, emergency room kinds of intervention at one end and elective, cosmetic kinds of treatment at the other. The deliberation that goes into determining healthcare minimums would involve determining exactly where on this continuum we are going to draw the line, and this is a question of medical expertise. Since I am not a doctor, it is hard for me to speak with any authority as to when and how a condition becomes sufficiently life-threatening to warrant the expectation of care. Is it only when there is a 100% chance of death or is it when their is a 10% chance of death? I think we can agree that if there is a 0% chance of death, which is to say there is no chance of dying without receiving the treatment in question (like a purely cosmetic nose job), these services would not be considered medically necessary. But, if there is even a 10% chance of dying from respiratory problems caused by an untreated deviated septum, does surgical intervention count as medically necessary? What if the chance is 50%?
So, to come to the question of abortion, which I didn’t want to get into, it should be clear that it depends on what the specific situation is. The difficulty is that in every pregnancy there are health risks, unforseen complications, general wear and tear on the body, potentially pre-existing conditions that could be exacerbated by the pregnancy. From a purely scientific perspective, I suppose preganacy might come with the kind of warning you would find at the entrance to a roller coaster: “Warning: People with heart conditions, a history of high blood pressure, etc… are advised to ride at their own discression.” All the medical profession can do is outline the risks, and make recommendations based on what is legally permissable. Since there is no supervening legally recognized obligation to protect the fetus, then it is up to the mother how much of a risk she is willing to take in carrying a preganancy to term. Again, this says nothing about the morality of the situation. I may think she has a moral obligation to risk everything for the life of her child, but that has nothing to do with what can be legally required of her. So, in light of all of that, I leave it to the doctors to determine what counts a sufficiently “life threatening” enough to be included in the basic healthcare provisions, and I leave it to biologists/geneticists to prove the scientific personhood of the fetus (if that’s possible), philosophers/theologians to convince people of the ethical personhood of the fetus, and legal scholars to convice us that this person has rights that supervene on the rights of the mother. You need to prove all three, it seems to me, in order to make abortion illegal.
In short, I don’t think abortion could be considered medically necessary if there is a 0% chance that the pregnancy could harm the mother, but if there’s a 1% chance? I think the law says its up to her and her doctor.
To your real question, which is really two different questions. In light of these reflections, I trust medical experts to tell me what is medically necessary. So, it’s not “my” definition that is under consideration. If I go to the doctor and she says I have a 1% chance of surviving cancer with just radiation treatment, but I have a 90% chance of surviving if I get surgery. Then, even though I won’t definitely die without surgery, I think the doctor would say that the surgery is medically necessary, all things considered. It is the doctors who are saying this menu of services is medically necessary and, since minimum healthcare is a right, any citizen can expect to be provided with an insurance policy that covers all of these services. So, if the Catholic employer is employing non-Catholics and claiming to provide them with health insurance, those employees have a right to expect that their plan covers all of the medically necessary services to which they are entitled. So, if you forget the last distinction regarding medical necessity “by your own definition,” then the answer to the second question is “yes.”
Now, for the first question. Should groups of people be able to come together freely and being of one conscience decide to renounce the rights afforded to them by the government and adopt an insurance policy that does not cover all of the “medically necessary” services, omiting those that are morally objectionable on grounds to which the group has agreed? Absolutely. This is exactly what the current religious exemption allows for. So, no, the government should not strictly prohibit the sale of insurance policies that don’t include contraception.
Eric,
The reason I referred so pointedly to your definition of “medically necessary” is that it is not in fact the definition doctors commonly use — or the definition according to which the list of standard benefits was determined by HHS. A doctor doesn’t treat my cold or back ache because he has made a calculation about the probability of its killing me. A man born with no leg beneath his right knee gets some kind of prosthetic device not because he is more likely to die from his birth defect without one but because he wants to be able to walk. An elderly woman gets cataract surgery not because she is about to die — although she may be; she’s old — but because what’s left of her life will be better if she can see clearly. Health insurance will cover her surgery, as it will cover treatments for my back ache; and so it should, even though neither cataracts nor back aches are lethal. Nor do we need a doctor or a board of medical experts to tell us that these things should obviously be treated if possible, or that health insurance should cover them.
In one way, the same is true of contraception. Doctors don’t consider birth control a standard medical service just because every pregnancy involves some risk of death, however slight. Even if no one ever died from complications of a pregnancy, birth control would still be considered a medical service. And even some of those morally opposed to the pill might be willing to describe it as an elective medical service. Only, they would probably want to add that employers that offer their employees group health insurance should not be required to offer insurance that covers elective medical services.
We plainly don’t all agree about the relationship between a woman’s ‘quality of life’ and her having lots of children — the way we all do agree that everyone would be better off without back pain. Most of us would say it’s up to each woman to figure whether her life will be better without lots of pregnancies to endure and lots of children to care for (others would say that God will figure it out for her). In any case, the question of how much physical risk — of death or illness — is too much risk is not after all a “question of medical expertise,” as you suggest. Doctors are specially qualified to tell us what the risks of pregnancy are, not whether this or that woman, given her physical condition, should run those risks.
Bearing all this in mind, let’s have another look at the HHS’s announcement. It instructs us that “scientists have abundant evidence that birth control has significant health benefits for women and their families, it is documented to significantly reduce health costs, and is the most commonly taken drug in America by young and middle-aged women.” This is weak stuff. If the evidence is so abundant and the benefits so significant, the HHS should mention a few. In the absence of any specifics this looks a lot like a pompous way of saying that childbirth can be dangerous, and that having lots of pregnancies takes a toll on a woman’s body. We did not need scientists to tell us that. Nor does anyone require documentation to believe that more pregnancies and births mean more medical expenses. Maybe the Food and Drug Administration should announce that birth control is also documented to cut down on a family’s food costs.
Matt, as I said, I’m happy to debate the meaning of “medically necessary,” but I still think that as far as the State is (and should) be concerned, “medical necessity” is not a moral or religious category. So, whether contraception or abortion is considered “medically necessary” (by whatever relevant criteria, which would, at least, NOT include “because the Bible tells me so” or “because of the inherent command placed on humans to procreate” or some such speculation about the will of God), cannot be dictated by the moral/religious consciences of a few employers. I’m only committed to a definition of “medically necessary” that does NOT include moral or religious considerations, but I suppose I’m happy to open it to non-scientific ones. So, I don’t find the HHS quote you offer so weak – “health benefits,” “health costs,” and prevalence seem to be fine criteria to begin the conversation. I just don’t think you can refute these criteria by saying, “But some think the service in question is evil!” If you were to point out that its illegal, then you’d have a trump card. But, as long as contraception and abortion are legal, it’s up to the one choosing to take advantage of the service to decide whether they’d like to take the “religious/moral risks” associated with it.
“Employees would have to buy services on the open market. For some, that would make them cost prohibitive.”
This is a uninformed premise that Bugyis keeps proclaiming. In fact, Wal-Mart sells a few contraceptive pills for $9 a month, about 30 cents per day. There is basically no one in modern America who would find this cost-prohibitive. If you bought the cheapest hamburger at McDonald’s, you’d have to split it with THREE other people to spend that little. Pretty much anyone in America who is able to stay alive at all can come up with 30 cents a day if they really want to.
Moreover, your blind trust in “medical experts” is interesting, but ignores the fact that if it wouldn’t be so politically unpopular, contraceptives would likely be banned for causing such an increased risk of breast cancer. http://www.sciencedaily.com/releases/2006/10/061030143351.htm
In fact, the World Health Organization, after reviewing hundreds of studies, classified oral contraceptives as a “Group 1″ carcinogen. Oral contraceptives thus appear on the same carcinogen list as arsenic, asbestos, benzene, HIV, mustard gas, and radium. See http://en.wikipedia.org/wiki/List_of_IARC_Group_1_carcinogens
“Medically necessary,” so much so that moral objectors have to be forced to subsidize it? Hmmm.
In any event, the notion of conscience in the first paragraph of this post is completely absurd.
There is no “conscience” on the employee’s part at all, in the scenario Bugyis discusses. “Conscience” is the inner sense that tells us our own actions are right or wrong. But “conscience” by definition is not involved if my inner sense is merely telling me, “I wish I could get cheaper contraceptives subsidized by someone else.” Whatever that employee is feeling, it is not “conscience,” not even arguably so.
Whose victory is it?
It seems to my view absolutely absurd the twisting and abuse of the meaning of conscience and other noble principles, along with the self-serving ways of argument that the author here engages in.
Where did he learn such arguments that seem to only benefit his own needs and desires and subjective interests and define it as conscience to force other people to pay for evil deeds? Clearly he does not know the meaning of conscience, and defines it only in relation to force others to pay for possible desires and actions acting against the divine law of God. Then he calls it a victory to force religious individuals and religious institutions who wish to follow divine law and to trust in God, to pay for evil actions of other people.
IS not conscience formed by the Holy Spirit and God and virtuous action? Or is it the right to do whatever you wish even if contrary to divine and natural law? Then is the liberty
to do whatever you wish not good enough, but you wish to force others to be complicit in what the church and revelation and Jewish law and the long standing tradition, to be complicit in your crimes (if you so chose them) and to even pay for your choices to commit an immoral evil.
You are the one trying to force coerce other citizens (not only the hierarchy and church institutions but individuals who wish to be religious and abide by God’s law) to support criminal acts as stated in revelation and interpreted by saints and the longest standing tradition.
Is not there a notion of conscience that is informed by the divine law and not a spirit of inequity?
It seems that people like the author are very blind to their own injustices and selfish and self-serving desires, who think it a victory to force with violence the conscience of those following the morally binding precepts of revelation.
What he calls a victory of conscience seems rather a victory for Satan and evil principalities as St. Paul defines it? – gloating over the ;right’ (or injustice) to force religious minded taxpayers and observant faithful Catholics or those Christians or other faithful of religious institutions that may be Jewish or Christians or other faiths- who believe in principles of what is in divine revelation and the religion of our forefathers from time immemorial?
Who is doing the coercing and violation of conscience, in the victory for non-moral or anti-moral positions and anti- human positions and anti-Christian positions- that extremely violates God’s laws.
The orthodox Jews would also agree with the Catholic tradition that
supporting abortion is an extreme violation of the divine law and commandments as testified in the sacred scripture.