The Constitutionality of Using Religion to Discriminate

Last week, U.S. District Judge William Alsup presided over a hearing regarding three lawsuits challenging the Department of Health and Human Services’Religious Conscience Rule. In President Trump's attempt to remain loyal to his pledge to “promote and protect the fundamental and unalienable rights of conscience and religious liberty,” The Conscience Rule protects health care workers who oppose medical procedures on religious moral grounds.

The rule, intended to take effect on November 22, invites any health care worker, including doctors, paramedics, receptionists or even the board members of hospitals to deny a patient’s medical care if it conflicts with their personal beliefs. The rule extends to allowing denial of care in life-threatening circumstances. Important to note is the provision under this Rule that not only allows providers to refuse care but does not require the referral of patients to alternate, available care. Refusal to comply with the administration’s rule would result in federal defunding of health care facilities.

Opponents of this rule have found this a misinterpretation of the fundamental principle of religious freedom. Critics allege the rule allows and encourages continued discrimination of at-risks populations such as women, LGBTQ people and religious minorities. There are at least six lawsuits including plaintiffs from 23 states around the nation that filed to block the rule due to its unconstitutional nature. The city of San Francisco filed its lawsuit almost immediately after the rule was realized, in the U.S. District Court for Northern California, claiming the new regulations are discriminatory and prioritize providers’ religious beliefs over the health and lives of socially vulnerable populations. San Francisco claims if they choose to not comply with the rule, it would lose $1 billion in federal funding that support critical services. The plaintiffs of the case argue the rule violates the constitutional Spending Clause because of the threat to withhold or terminate federal funds with failure to comply. Proponents of the regulation say if the rule is blocked, their constitutional rights of religious freedom will be infringed upon. I will focus solely on the proponents claim and argue that the court should block the rule and that doing so is not an infringement on freedom of religion. 

Embedded in the Free Exercise Clause is the absolute right to believe whatever religious doctrine one chooses. However, the precedent set in Reynolds v. United States determined “congress was left free to reach actions which were in violation of social duties or subversive of good order.” Therefore, the limitations of this clause allow for an infringement on religious freedom if there is a compelling state interest at hand that outweighs the burden of religious freedom. 

I argue that The Conscience Rule impedes on the compelling state interest of ensuring the health and safety of all citizens. The San Francisco lawsuit recognizes and supports the conscience rights of health care professions, but argues the exercise of these rights must be balanced against the fundamental obligations of the medical profession and the right of patients to receive quality care.

This argument is supported by the recent decision by the New York Supreme Court that upheld the ban of religious exemptions from vaccinations. Due to a measles outbreak directly correlated to religious communities, requiring vaccinations for school children was essential to the state interest of protecting the public health. The court found the compelling state interest of ensuring the health and safety of the citizens of New York to outweigh the burden on free exercise, which is synonymous to the facts of this case at hand. This case poses the reoccurring and relevant question about the constitutionality of using Religion as an excuse to violate anti-discrimination laws. 

I will outline the differences between a similar case of discrimination based on religious beliefs to support my argument. In Masterpiece Cake Shop v. Colorado Civil Rights Commission, Jack Phillips declined to create a cake for a same-sex couple because of his religious beliefs against gay marriage. The court found that although same-sex couples are afforded civil rights protection under the Constitution, religious and philosophical objections to same-sex marriage are also protected views by the constitution, ruling in favor with Masterpiece. The distinguishing factor between the two cases is the harm imposed by freely exercising religious beliefs. In Masterpiece, nobody was physically harmed by failing to make the cake, in contrast to denying necessary medical care to patients, a possible matter of life and death, which is allowed under this new regulation. 

The implications of this ruling cannot be understated for the future of religiously based discrimination in our nation. This regulation allows for an open invitation to discriminate against Americans who already face serious, systemic oppression. The outcome of this case will have implications for our future understanding of the intersections of religion and law. Allowing this law to go into effect would assume the court is placing the importance of religious rights above the civil rights of citizens. The health and safety of citizens must come before the absolute right to act on religious beliefs in order to maintain order in society.