In 2022, Gudrun “Gunna” Kristofersdottir, a nurse practitioner at a CVS MinuteClinic in Tequesta, Florida, believed she was left with the option of choosing between her job and her faith. Given she was a devout Catholic with beliefs in the sanctity of life and the moral evils associated with devices that subvert it, she had been granted a religious exemption, for the previous seven years, from having to personally prescribe contraceptives while working at the MinuteClinic. If a request to prescribe one of these drugs would arise, she would refer the patient to another CVS MinuteClinic nurse practitioner who would be able to complete the request. Referral of patients to other practitioners was not an uncommon practice in CVS MinuteClinics, regardless of religion. The exemption had posed no barrier to Kristofersdottir’s ability to perform her job, and throughout her many years of employment at the MinuteClinic, Kristofersdottir consistently received “High Performer” ratings. In August of 2021, CVS announced a new policy that revoked all previously existing religious accommodations without considering the individual circumstances of its employees, or whether an alternative to firing could be found. A year later, CVS terminated Kristofersdottir’s employment claiming she would not fulfill her job obligations. CVS believed sexual health counseling and treatment to be essential practices for the MinuteClinic. Kristoferdottir failed to compromise her religious beliefs.
This past week, First Liberty filed a federal lawsuit on behalf of Kristofersdottir. This is just one of the recent lawsuits against CVS by a former nurse practitioner over the company’s sudden refusal to continue granting any religious accommodations to their MinuteClinic nurse practitioners. The basis of this case pertains to whether the revoking by CVS of all religious accommodations, that gave employees the ability to refuse the prescribing of contraceptives, violates its employees’ rights to religious free exercise. The most salient issue present in the case centers around the relationship between granting religious exemptions, and the impact this might have on creating an “undue hardship” for CVS.
Determining what qualifies as an “undue hardship” is an additional relevant question in this discussion. In the recent Supreme Court Case of Groff v. DeJoy (2023), the court provided greater clarification on this murky issue. The court ruled that when an accommodation request is made, a business must consider all potential ways to accommodate the employee, as well as the impact these new accommodations will have on the business. Additionally, if the employer chooses to deny an employee a religious accommodation, it is required to show evidence of the undue hardships that the proposed accommodations would cause. Although the outcome of Groff v Dejoy still fails to provide clear-cut guidelines as to how to quantify an “undue hardship,” much of the precedent set regarding the navigation of the accommodation process can directly apply to Kristofersdottir’s case in her pursuit of the ability to freely practice her religion.
Title VII of the Civil Rights Act of 1964 states, “It shall be an unlawful employment practice for an employer - (1) to fail or refuse to hire or to discharge any individual, or otherwise to discriminate against any individual with respect to his compensation, terms, conditions, or privileges of employment, because of such individual's…religion…” I believe CVS directly violated this law, as it did not reasonably attempt to grant her an accommodation that would not cause an undue hardship while respecting her religious free exercise rights. Title VII also notes the concept of “undue hardships” by stating that if an employee requests an accommodation for a work requirement that conflicts with a sincerely held religious belief, the employer should reasonably accommodate the request unless it poses an undue hardship. There are numerous reasons as to why the continuation of religious exemptions from the prescribing of contraceptives would not produce an undue hardship for CVS. Kristofersdottir’s religious accommodation had caused no issues over the course of the seven years she had worked in the MinuteClinic. Each year, Kristofersdottir experienced between five to ten patients, out of the thousands she served, who requested access to contraceptives. In these cases, Kristofersdottir simply referred the patients to another nurse practitioner at either that same MinuteClinic, or at another nearby. Also, CVS’s new policy still allows religious accommodation requests by pharmacists and pharmacy technicians, just not for nurse practitioners. If Kristofersdottir’s religious accommodation was truly an “undue burden” and these exemptions substantially increased the costs of operation for CVS, then should this policy not apply to all employees within the MinuteClinic?
The precedent set in the Groff v. DeJoy case requires that employers must consider all potential ways to accommodate the religious beliefs of their employees. This did not happen in Kristofersdottir’s case, as CVS would not even discuss possible alternatives, such as switching her to a virtual position, a Covid-specific location, or an education or training position, despite her being qualified for each of these alternatives. The Director of Human Resources conveyed that no religious accommodation would be given to any CVS employee, if the accommodation exempted the employee from performing an essential function of the MinuteClinic. This illustrates the larger issue of the case regarding an employee’s ability to practice his constitutionally-guaranteed right to free exercise of religion.
In my opinion, Kristofersdottir was denied her right to free exercise of religion under federal law. Her previous religious accommodation had not placed an undue hardship on CVS, and the pharmacy had dismissed any discussions of possible ways to allow for her religious beliefs . The removal of religion from the list of categories protected from discrimination on CVS’s 2021 diversity statement and the company’s firing of Kristofersdottir unless she abandoned her religious beliefs reveal CVS’s discrimination against individuals holding certain religious beliefs. I believe the actions taken by CVS are dangerous, as pressure to conform to imposed regulations that are in opposition to one’s core values places tremendous stress on an individual. Also, other competitors, like Walgreens, could soon take similar measures in order to keep pace with the competition, thus harming religious freedoms further.
Sources
http://religionclause.blogspot.com/2024/01/nurse-sues-clinic-for-refusing-to.html
https://firstliberty.org/wp-content/uploads/2024/01/2024-01-18-Complaint-Gunna-Kristofersdottir.pdf
10 comments:
Bella,
I want to begin with the fact that this post was awesome - the format, the facts, the unbiased, and finally, your personal response. You made me excited to write mine here in a few weeks.
As far as the content, it's perplexing that this contemporary case is even happening. How are we, as a society and State, still questioning and challenging the Free Exercise Clause, regardless of workplace or not? On top of that, the plaintiff's employer is revoking a previously made precedent that had merely no impact on her work duties.
As you can probably tell, I am 100% in agreeance with you. The fact that this change in policy is being pushed through is, in my opinion, illegal and unethical, but on top of that, Kristofersdottir's employer had made no attempt to even accommodate her religious beliefs. Lastly, I want to say that the final point you made about CVS's competitors possibly taking additional measure was so valid and true. If this case rules in favor of CVS, there could become a "slippery slope" of religious discrimination amongst all workplaces, particularly the pharmaceutical realm.
Bella,
I greatly enjoyed reading this entry, and I think your reference to Title VII of the Civil Rights Act of 1964 is a crucial component to your argument framing CVS as flawed in their reasoning. Furthermore, I appreciate your incorporation of Groff v. DeJoy in your reasoning, as this case illustrates the general expectation that employers must try to accommodate religious preferences, so long as it does not impose "undue burden". Furthermore, since CVS previously permitted Kristofersdottir to avoid handling contraceptives, it is evident that there is no legitimate burden placed on CVS, and for this reason, I believe that CVS will struggle to form a compelling case in court.
This matter is certainly worth tracking as it progresses through the courts, as I agree that CVS's actions could yield a snow-ball effect of concerning changes within the pharmaceutical industry.
Hi Bella!
Great post! I do agree with your assessment on the constitutional breach by CVS for terminating Kristofersdottir's position as a nurse practitioner after her refusal to prescribe contraceptives. The policy imposed on all CVS staff as indicated by the head of Human Resources highlights the premise that no religious exemptions are given to ANY employee. This creates a sense of equality and uniformity for all staff members. It is at face value a non-discriminatory law. However, in order to access if there was a constitutional breach we need to conclude whether or not this is disparate to specific social/religious groups.
As is outlined by the precedent of Groff v. DeJoy, an employer is required by law to provide accommodations to employees for exemptions and if it does not then it needs to prove there is an undue burden for the company to grant such a right. As my fellow classmates have reiterated, there are several positions Ms. Kristofersdottir could occupy and keep her position as an NP. She did not need to be solely prescribing contraceptives. That job could have been reserved for a non-religious staff member. It is not like the patient is not being treated or provided the service they desire by her refusal. The patient is still being serviced by another staff member. In addition, the sheer fact that accommodations were company policy in the past demonstrates there is a protocol in place to deal with these issues. It is clear that Kristofersdottir is disparately affected by this policy and it is on the basis of her personal religious beliefs.
Great post! I find this constitutional breach interesting, as it proves to be very straightforward and clear. The most important element, as you noted, is the environment and conditions in which the employee was terminated. The fact that no accommodations were made, let alone suggested, proves the breach of the Free Exercise Clause. Also, the safety and common good of the patients were not at risk- as they were still able to be referred to a fellow employee for contraceptives. This would be a much different case if the health and safety of the patients were at risk. I also find it interesting why only the Nurse Practitioners were not allowed to have religious accommodations, but the pharmacists were. Besides the fact that this discrepancy does not relate directly to the Free Exercise Clause, there are many instances in this case where CVS does not indicate a proper procedure of termination for their employees. I think you really emphasized the key facts of this case, and I found it easy to follow and understand which really helped highlight a key instance of a Free Exercice Clause controversy.
Bella, I enjoyed reading your post. You layed out the case in your unbiased opinion and then brought in what you thought should be the ruling in this case. An element that has me confused reading the facts of the case is why all of sudden would CVS not accommodate Ms. Kristofersdottir even though they did for many years prior? I believe it is Ms. Kristofersdottir religious freedom to avoid handling contraceptives. Another point that I found interstring was only the Nurse Practitioners weren't allowed to have religious accommodations. Both these areas in which you emphasize cause a lot of controversy. I beleive the court should side with Ms. Kristofersdottir and it would be interesting to see how CVS handles this case after the fact.
Hi Bella,
This is a great post! I agree with you and the other comments saying that this is a pretty obvious infringement on the Free Exercise Clause. It is very perplexing that CVS previously provided Ms. Kristofersdottir with this religious accommodation for years and that it did not interfere with her ability to perform her duties as a nurse practitioner. In this case, CVS seems to hold the stance that Ms. Kristoferdottir’s religious beliefs and practices have potential to cause harm to patients because she refuses to provide certain medical services. I understand CVS’s position that sexual health counseling and treatment is an invaluable and essential service, but, in my opinion, the termination of Ms. Kristofersdottir demonstrates that CVS prioritizes secular beliefs over their employees’ right to free exercise of religion, especially because there is no evidence that her beliefs have disrupted her performance in the workplace.
Overall, I think this policy from CVS is dangerous because it actively deprives employees of their constitutional rights. It also intrigues me because I do not understand the reasoning behind the introduction of this policy. In this instance, religious accommodations posed no threat to the efficacy of the CVS clinic. Additionally, it is strange that CVS would enact such a sweeping policy that clearly violates the Free Exercise Clause. From both an ethical and business perspective, this policy appears to be highly questionable and unwise and the termination of Ms. Kristofersdottir is unjust.
I found this post very interesting and surprising and it left me questioning what CVS’s motivations were for changing this law as I am sure it is impacting many CVS nurse practitioners just as it is for Kristofersdottir. I fully agree with your statement that this was a violation of Kristofersdottir’s free exercise of religion under the first amendment due to the removal of her exemption from providing patients with contraceptives due to her religious beliefs. Kristofersdotti has been exempt from providing contraceptives for seven years and it has never once been a problem. I do not believe that the company can have any justification as to why they are not allowing this exemption. One aspect of this that I found very surprising was that CVS was not willing to make any accommodations for Kristofersdottir especially since she has been a loyal worker for many years. The fact that CVS still allows religious accommodations for pharmacists and pharmacy technicians but not for nurse practitioners adds inconsistency to the company's policy. If the concern is truly about the burden and increased operational costs, the policy should apply across all positions within the MinuteClinic.
Bella,
This was such a great post! I agree with you completely that Kristofersdottir's right of free exercise of religion was violated. I question CVS's actions to ban all religious exemptions in their stores because there are many that can occur. Also, I find it interesting that this couldn't be accepted because as it is stated in the article, swapping of patients happen all the time. My mom is a nurse, and she deals with so many different patients every day. Therefore, I wonder what they put in the policy specifically because it would have to be very strict for this to work. There are many individuals in that field that feel that way, and I think this is one of those areas that have a lot of gray areas. Another important fact is that it was only targeting nurse practitioners which makes it very job specific considering so many other jobs can prescribe birth control.
Bella, I thought this was a really good post. The layout and deliverance of your evidence and facts were very strong, and it was presented in a very well manner. The civil rights cases as well as the Groff v. DeJoy case definitely aided your argument in a positive direction. The Groff v. DeJoy case shows that there is a understanding that employers must try to accommodate religious preferences among employees, which is a strong case to argue for the precedent of this case that has already existed. I find it interesting how Kristofersdottir's right of free exercise of religion was completely violated by CVS and that there was such a split of opinions in this case. I also agree with you that by allowing CVS to violate their employee's religious rights, this sets a clear danger for what other competitors will be allowed to do as well, further putting religious rights in jeopardy. I also question why the company opted to fire an employee who has been there for many years and practiced her religious rights without an issue before. This makes me question how society is started to view religion, and why there is such a pressure to make everything "too secular" in a sense. How do you think this may be affecting society when religion is consistently being looked at as "problematic?"
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