Religious objections are hardly limited to contraceptives and abortion, however. Clinicians have objected to an expanding number of practices, ranging from circumcising babies to participating in physician-assisted suicide and providing assisted reproduction services [24]. In any of these contexts, two very different parties may be asserting the need for accommodation of their religious beliefs: individual clinicians and health care institutions.
Conscience and Catholic Health Care: From Clinical Contexts to Government Mandates
Mandated health insurance presents an additional threat to patient and doctorautonomy insofar as it is a step toward mandated health care, which tendstoward socialism, and because medicine in these conditions can be coercive.Coercion is an attempt to bypass, override, or force choice by emotional,financial, or other pressures to accept (or render) a treatment or servicethat a patient of physician would otherwise not accept (or render). Coercivemedical practices from government institutions are well-documented,including:
However, the religious employer exemption met immediate and growing criticism from religious organizations and religious communities. During the comment period it drew more than 200,000 responses; while many supported the exemption as announced or sought a narrowing of the definition or elimination of the exemption, other commenters protested the narrowness of the definition and thus the limited scope of the exemption.6 Representatives of various religious organizations noted that their own institutions did not fit within the boundaries of the definition; in effect, they were defined as not being religious organizations whose conscience claims needed to be respected by the government and by insurers. The Catholic Health Association, for example, commented:
The definitions of religious organizations that the federal government is deploying in the context of the mandate, which requires health plans to cover a wide range of contraceptive services, have great religious-freedom significance not only because they will determine which religious freedom and conscience claims will be honored, and to what degree, but because they embody a governmental conception of what is authentic religion. That evident conception has proven to be greatly troubling to many religious organizations, both houses of worship and faith-based service organizations.
Because the federal government now subsidizes and manages such a large part of the medical insurance market, the proposed regulations would make it nearly impossible for private employers and individuals to find a health plan that does not cover gender transition treatments and procedures. It would also make it nearly impossible for medical professionals to work free from these regulations.
This would not be the first time the government used the administrative state to attack medical conscience rights in healthcare. For example, the Obama administration previously required employers to provide free access to contraception under the Affordable Care Act. But it also allowed a narrow religious exemption, which became the subject of years of litigation and Supreme Court cases under the Religious Freedom Restoration Act.
From this latter concern inevitably follows the consequentialist concern that enforcing restrictions on conscience rights may paradoxically result in worse service provision to dying patients. A majority of palliative care physicians in Canada have vocally opposed MAiD and have advocated that for many (but clearly not all), a desire to pursue MAiD stems from suffering and fear in an environment where there is inadequate provision of high-quality palliative care [14, 15]. Furthermore, individual palliative care providers (already in short supply) may stop accepting patients if they fear they may be compelled to violate their conscience rights [3], resulting in decreased overall provision of services. Similarly, faith-based institutions (especially Catholic hospitals and hospices) are motivated and likely irreplaceable providers of palliative care in Ontario and elsewhere [4, 16]. They are often more likely to serve vulnerable populations and may even provide higher-quality and more patient-centered clinical care [17, 18]. Sanctioning these providers financially or otherwise would be a Pyrrhic victory for MAiD proponents that would almost certainly do more harm than good [4].
What does it mean when we say that these products are made in "descendent cells"? Descendent cells are the medium in which these vaccines are prepared. The cell lines under consideration were begun using cells taken from one or more fetuses aborted almost 40 years ago. Since that time the cell lines have grown independently. It is important to note that descendent cells are not the cells of the aborted child. They never, themselves, formed a part of the victim's body. How does one know when a particular vaccine has an association with abortion? The cell lines WI-38 and MRC-5 are derived from tissue from aborted fetuses. Any product grown in the WI-38 and MRC-5 cell lines, therefore, has a distant association with abortion. The cells in these lines have gone through multiple divisions before they are used in vaccine manufacture. After manufacture, the vaccines are removed from the cell lines and purified. One cannot accurately say that the vaccines contain any of the cells from the original abortion. What does one do if a physician recommends one of these vaccines? Sometimes alternative products, which are not associated with these cell lines, are available for immunization against certain diseases. For example, there is a rabies vaccine (RabAvert) and a single dose mumps vaccine (Mumpsvax) without any association with abortion that are equally safe and effective. If doing so is practical, you should ask your physician to use an alternative vaccine, but there is no moral obligation to use products that are less effective or inaccessible. Parents should check with their physician regarding the efficacy and availability of these and any other vaccine. Are there any vaccines for which there are no alternatives? Unfortunately, at present there are no alternative vaccines available in the United States against rubella (German measles), varicella (chickenpox), and hepatitis A. All of these are grown in the cell lines WI-38 and/or MRC-5. (See note #7 of the statement of the Pontifical Academy for Life for a listing of vaccines and their source). What do I do if there is no alternative to a vaccine produced from these cell lines? One is morally free to use the vaccine regardless of its historical association with abortion. The reason is that the risk to public health, if one chooses not to vaccinate, outweighs the legitimate concern about the origins of the vaccine. This is especially important for parents, who have a moral obligation to protect the life and health of their children and those around them. What support is there in Church teaching for this position? A statement from the Pontifical Academy for Life issued in 2005 holds that one may use these products, despite their distant association with abortion, at least until such time as new vaccines become available. What can I do to ensure that alternative vaccines will be made available? You can write to the pharmaceutical companies that make these products and insist that they manufacture vaccines that can be used by all without moral reservation. Also, you can contact your local legislators about your concerns. Am I free to refuse to vaccinate myself or my children on the grounds of conscience? One must follow a certain conscience even if it errs, but there is a responsibility to inform one's conscience properly. There would seem to be no proper grounds for refusing immunization against dangerous contagious disease, for example, rubella, especially in light of the concern that we should all have for the health of our children, public health, and the common good. Won't my use of these vaccines encourage others to destroy human life for research purposes? Upon use, one should register a complaint with the manufacturer of the products as an acceptable form of conscientious objection. This signals opposition to the wider, morally reprehensible practice of using the unborn as little more than research material for science. There is no moral obligation to register such a complaint in order to use these vaccines. It should be obvious that vaccine use in these cases does not contribute directly to the practice of abortion since the reasons for having an abortion are not related to vaccine preparation. 2ff7e9595c