While mainstream, establishment medical journals have published opinion pieces condemning conscientious refusals in medical care, American law has consistently and repeatedly supported a right to such refusals. Law has not relied on a particular philosophical basis for health care. Indeed, legal precedents reject any monolithic model, whether based on consumerism or on professional obligations. Law focuses on the coexistence of diverse understandings, motivations, and delivery models. Scholarly approaches tend to ignore the fact that, fundamentally, conscientious objection involves a minority telling the majority that the objector(s) cannot ethically participate according to the majority's preferred model or set of rules. Religious liberty is protected in the US by applying strict scrutiny. Any governmental burden on religious liberty must further a compelling governmental interest and be implemented using the least restrictive means reasonably available. After years of scholarly controversy, strict scrutiny continues to be the law. The moral basis for the legal right of conscientious objection has been affirmed and expanded by Hobby Lobby in 2014, outlined in an Attorney General Memorandum in 2017, and codified in a Final Conscience Rule by the Department of Health and Human Services in May 2019.


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pp. 489-502
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