The Christian Medical and Dental Association (CMDA) is a group that provides representation for Christian healthcare professionals and students in America. They are claiming in the case Christian Medical & Dental Association v. Bonta, that California's End of Life Option Act is a violation of their First Amendment rights of free speech, free exercise of religion, and their Fourteenth Amendment rights of due process and equal protection. The End of Life Option Act
When a patient of a physician who does not want to participate in distributing an aid-in-dying drug requests it, the physician must say that they do not want to participate, and make note of the patient's oral request. This counts as the first oral request of the patient, and their medical records will be promptly given to another participating physician. The CMDA argues that this is forcing them to participate in the act, against their religious beliefs, because they must document the oral request, or they will face consequences such as getting their medical license revoked. Leslee Cochrane, a member of the CMDA, works in a hospice care center that does not practice physician assisted suicide. However, patients often say they would like to receive an aid-in-dying drug, so Cochrane must submit this request and refer them to another physician. This takes a toll on Cochrane’s everyday life and puts her in a moral dilemma.
The question at stake here is; Is it unconstitutional to force doctors to request aid-in-dying drugs for patients even if it is against their religious
beliefs? In July 2022, the court ruled that this does not violate the physician's right to free exercise. In the End of Life Option Act, the language that states the rules of physician participation in the act is neutral, thus religion is not directly referred to. When discussing the guidelines for participating and non participating physicians, the language is exactly the same. It is stated that there are no consequences for participating in or opting out of participation in the act, as long as the correct documentation is provided. Since the act is deemed as neutral and generally applicable, strict scrutiny does not apply in this case either. The court ruled that this is not a compelling state interest and does not target religion. Although unfortunately it violates the CMDA’s religious beliefs, the act does not go against religion in general, thus does not violate their right to free exercise. The court however did rule that this is a violation of the CMDA’s free speech. There is a penalty for not submitting the request of the patient for the aid-in-dying drug, so the right to free speech was deemed as violated and physicians are no longer forced to submit this request.
I agree with the court and I think that forcing physicians to participate in the End of Life Option Act is not a violation of free exercise. Although it is unfortunate that this act goes against their religious beliefs, it is a neutral law and religion is not being targeted. I think this issue is important because it is a slippery slope. If religious exemptions are allowed for opting out of physician assisted suicide, what else can exemptions be allowed for? Will physicians start opting out of risky surgeries that can ultimately save the lives of patients? I also think that physicians should have their patients' best interest in mind, and I do not think this is a violation of their right to free exercise. They should not have to administer the drug first hand, but they should at least have to help the patient obtain the drug, regardless of their beliefs. The bioethical principle of beneficence states that a physician is obligated to benefit the patient. Refusing to give a drug to help a terminally ill person who is in extreme pain, is not benefiting the patient, and going against the physician’s obligations. What do you think? Is forcing physicians to record the patients first oral request of aid-in-dying drugs a violation of their right to free exercise?
6 comments:
Just because a doctors religious beliefs prohibits them from partaking in physician assisted suicide does not mean their patients beliefs do the same. Not reporting their requests is dishonorable to the patient's wishes, and is not being reported because of the religious belief of the doctor. For a doctor to not submit a request a patient makes for the aid-in-dying drug, they are indirectly forcing their religious beliefs onto their patients. If a doctor is against physician assisted suicide, they by no means are required to perform it themselves as they can pass the patient onto another doctor. I agree with Angie and the court that forcing physicians to participate in reporting a patients request for physician assisted suicide is in no way a violation of free exercise of religion. Again as Angie said, physicians having to report their patients requests is not a direct attack on their religious beliefs. Protecting physicians from having to report their patients requests would ultimately be viewed as their particular religion being favored and established in law over others. Physicians need not perform the acts of end-of-life drug administration, but they must not fail to report a patients request. This is not unconstitutional by any means.
The best point made was the idea of the slippery slope. If physicians were allowed to opt-out of performing this procedure, what other procedures would they be able to do the same for due to religious freedoms? The law is neutral, and as stated, this law does not target one religion. These physicians also choose to be physicians, and it is upsetting that doing this procedure does not fall in line with their religious beliefs, but it is the only neutral and fair way to do such a procedure.
I really enjoyed reading this post and learning about this case. I ultimately agree with the court’s decision, because although the act might go against the physician’s beliefs, it is neutral in practice and does not target any specific religion. I really like when you mentioned the slippery slope because it is extremely important to acknowledge especially in a case like this one. If they make exemptions due to religious beliefs, doctors might not perform surgeries because they might be scared that if the patient were to die that this would be a sin and they would be responsible for it. If you allow these religious exemptions, some physicians might start to not do their job and refuse to treat certain patients due to their religious beliefs. Making an exemption could lead to a lot of problems within the workplace and could have a negative impact on the patients themselves.
I do not believe that having to record an oral request is violating a doctor's free exercise. These physicians are simply doing their job by recording the patient's wishes, they do not have to administer the drug and if the patient does not request again then they did not even aid in the administration of the life-ending drug. Just as physician's are required to log when a patient refuses care or when a patient asks a doctor to record that they are refusing to treat the patient, this is no different in my opinion. I do absolutely agree with the court's in that this is not a religious violation due to the fact that the law is neutral for both religious and non-religious persons. If giving life-ending medication is against a physicians moral or religious virtues, they can recommend another physician.
I agree with the courts statement that this does not violate the physicians First Amendment right because they are not performing the procedure or giving the drugs to the patients directly. Although it is an indirect aid by the physicians referring them to another physician I do not think this puts a substantial burden on the physician that it would constitute a violation of their First Amendment rights. I also agree with the statement that although this act may go against their personal beliefs I do not think that it is not neutral in practice. The court is making all physicians not just this medical group and there is no facially neutral aspect it is purely neutral in my perspective.
I wholly agree with the analytical concept of a slippery slope. This case is hard to decipher what is right and wrong. I am happy that the court did decide to somewhat agree with the CMDA’s free speech and the physicians no longer are forced to submit a request. I believe doctors hold an oath to help others. It is known that doctors are to do no harm to their patients, but where do we draw the line between pain management and a drug that kills them? If I am being completely honest, doctors hold patients' lives in their hands, but don’t think it should be taken seriously. The religious view is that all life is precious no matter what. Therefore, if it does violate their beliefs, I do not think they should be forced to give consent to death. I see both sides and however, I disagree with the court’s decision.
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