Ethics and Religious Expression

A Catholic healthcare network in Colorado, Centura Health, terminated a doctor’s employment after she attempted to provide euthanasia for a man with an incurable cancer. In 2016, Colorado adopted Proposition 106, also known as the “End-of-Life Options Act” which “allows a physician to prescribe medical aid-in-dying medication to a terminally ill individual under certain conditions.” According to CBS, Dr. Morris “looked into referring him to a doctor affiliated with another hospital, but he [the patient] would have had to repeat tests as part of a re-diagnosis, which he said he did not want to do.” The doctor, Barbara Morris, and her patient, Neil Mahoney, filed a preemptive lawsuit against Centura Health “asking a state court to declare that she could not be sanctioned for attempting to help her patient end his life,” and was fired shortly thereafter. 

Centura Health believes it is justified to have terminated Dr. Morris’s employment because she had violated their guidelines as prescribed by the Ethical and Religious Directives for Catholic Health Care Services (ERDCHCS). The guidelines state: “Euthanasia is an action or omission that of itself or by intention causes death in order to alleviate suffering. Catholic health care institutions may never condone or participate in euthanasia or assisted suicide in any way…” Centura Health’s position, from a Constitutional standpoint, is that “the state cannot prevent religious organizations from disciplining employees who disagree with their belief systems.” Dr. Morris argues that Centura Health’s policies were in violation of state law in the first place, and that the hospital network has directly interfered with her doctor-patient privileges. 

This case is about free exercise. The first salient issue is how individual speech can be differentiated from speaking as an agent or extension of a larger entity (whether that be the state or private). Another issue is to what extent the Constitution protects religious expression when it comes to action (not just belief). I argue that with regards to the first issue, the First Amendment should protect an individual from government-compelled speech, but these protections should not extend into the private realm. Additionally, I believe that the hospital’s actions were not Constitutionally justifiable. 

The Supreme Court set a precedent in the case West Virginia State Board of Education v. Barnette for the government’s (in)ability to compel students in public school to salute the Amerincan flag. This decision, which overturned the precedent set in an earlier SCOTUS case Minersville School District v. Gobitis, recognized more broadly that the government cannot Constitutionally compel individuals’ speech in a public setting (i.e., public schools). There is even a caveat to this, which is whether the government can compel its employees (i.e., agents of the state) to violate their religious expression (see Miller v. Davis). There isn’t as strict a precedent, however, for privately-compelled speech. I personally believe that it is Constitutional  for a private entity to regulate speech. This already happens all the time, whether an employer asks a professor not to share their political views on Twitter or if a sorority mandates that its members not post photos of themselves on social media with their “letters” on. The reason I find privately-compelled speech more acceptable than government-compelled speech is because individuals always have an alternative (whether that be finding another employer or choosing not to participate in Greek life). However, the government cannot compel speech (religious or otherwise) because they are the ones with the power to take speech away. This is dangerous, especially when taking into consideration the Founding Fathers’ concerns about tyrannical government. In the case of Centura Health, I think that the hospital was justified to compel the speech of its employee and take action if she does not comply. The health network’s values (including those expressed against practicing euthanasia) were evident prior to Dr. Morris’s decision to consult patients about end-of-life treatment. 

Another Constitutional issue present in this case is whether the First Amendment protects religious action, as well as belief. The precedent set in Reynolds v. United States is that the First Amendment protects religious belief, but does not protect religious action. In this case, the hospital believes that its right to freely exercise their religious commitments (including the discouragement of euthanasia) extends to the action of firing Dr. Morris for failing to comply with the guidelines. This is not Constitutionally valid, I argue, because the hospital cannot act on its religious beliefs to do something unlawful (i.e., fire the doctor for the reasons provided).

Ultimately, in this specific case, I support Dr. Morris because the hospital’s ethical guidelines clearly did not comply with state law in the first place. Had this not been the case (i.e., euthanasia was illegal in Colorado) I still don’t agree that the hospital would be Constitutionally protected to compel its employees’ speech on religious grounds.