The Conscience Clause: What Would Hobbes Do?


In his New York Times blog, Stanley Fish applies philosophy to the Provider Conscience Rule debate. He points out that Hobbes’s definition of “conscience” was almost exactly the opposite of the way we think of the word today. Hobbes looked to the word’s etymology—“to know in concert with one another”—to reason that the word could refer to public or common knowledge. Fish summarizes Hobbes’s argument: 

Since conscience, correctly understood, refers to those occasions “when two or more men know of one and the same fact . . . which is as much to know it together,” it is a violation of conscience — of knowing together — to prefer their “secret thoughts” to what has been publicly established.

Hobbes is aware that others take conscience to be the name of the private arbiter of right and wrong, but he regards this as a corrupted usage invented by those who wished to elevate “their own . . . opinions” to the status of reliable knowledge and try to do so by giving “their opinions . . . that reverenced name of Conscience.”

Hobbes’s line of reasoning and Fish’s apt application of it get at something that’s been obscured in the conscience clause debate. As supporters of the clause argue that the provision is in the true American spirit—freedom of thought, freedom of religion—it can be easy to forget what exactly we’re talking about here. The Provider Conscience Rule, established last December, doesn’t protect either of these things; our Constitution already does that. The people “protected” by this rule are people who’ve chosen to provide health care to other people, and it’s reasonable to expect that a person entering this field respects the field. We have to assume that a doctor trusts and believes in medicine because our society relies on systems and institutions, as Fish points out: 

When a professional hangs out his shingle doesn’t he offer his services and skills to the public and not just to members of it who share his morality? Isn’t it a matter of conscience (in Hobbes’s sense) to abide by the rules that define the profession you’ve signed up for?

This is not to say that individual thought has no place in professional life. A high-school history teacher’s political views may influence the way he presents the material to his students. But if that teacher refused to cover the Holocaust because he didn’t believe it had happened, or if he refused to teach Latino students because of fiercely anti-immigrant beliefs, most people would agree that that teacher wasn’t doing his job.  Individual freedom is central to this country. But Fish reminds us that secularism is just as central: 

Th[e] sequestering of religion in a private space is a cornerstone of enlightenment liberalism which only works as a political system if everyone agrees to comport himself or herself as a citizen and not as a sectarian, at least for the purposes of public transactions.

At some point, individual freedom cedes to the public good. Otherwise, you don’t have any laws at all; you have anarchy. For the country to exist, certain important systems, like health care and education, must remain strong. Because Americans believe in institutions—which can be reformed and overhauled, but must remain intact, in some form—we have always sought to maintain a balance between job obligations and personal convictions, between civic duty and private beliefs. The conscience clause clearly upsets this balance.

Fish’s post helped me, for one, pin down what is so offensive and alarming about the Provider Conscience Rule: that it violates the principles on which this country was founded.

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  • http://ontheotherfoot.blogspot.com invalid-0

    Your conscience is the property of the state. If it’s legal, it’s right. Shut your brain off and obey.

  • harry834

    they should be sure to advertise their values so customers will no them before they enter.

    For example, doctors who won’t give emergency contraception, or regular contraception to unmarried people should proudly, openly make this practice known so that any and ALL would-be customers looking them up will know what they are willing and not willing to give.

    Will these doctors be this proud and bold in their public statements to customers? I’m wondering…

  • http://ontheotherfoot.blogspot.com invalid-0

    So far it’s been a selling point, at least for the pharmacists who have advertised their refusal to deal in Plan B. I wouldn’t go to a doctor that I knew performed abortions, and if I know a pharmacist doesn’t sell abortifacients, I’ll drive a long way out of my way to patronize them. Nor am I alone. Google “pro-life pharmacies” and see how many other people say the same thing.

  • progo35

    I agree with Joel. My conscience is not the property of the state or the public good to be disposed of at the state’s (or NARAL’s) will.

    "Well behaved women seldom make history."-Laurel Thatcher Ulrich

  • progo35

    P.S.
    Hobbes believed that people were too stupid to decide right and wrong for themselves and thus were only to be regarded as a part of the state as a mechanism. Sound like a bastian of pro choice philosophy? I don’t think so.

    "Well behaved women seldom make history."-Laurel Thatcher Ulrich

  • colleen
    I agree with Joel.
    I’m shocked, shocked….
  • harry834

    it should be on the door, and other places. Everyone in the neighborhood should know that their local pharmacy does not give out Plan B

    If the only way they find this out is the Google search, then it’s just pro-lifers who find this out. Shouldn’t it be on the doors:

     

    "We don’t give Plan B, because we believe it is abortion. We don’t give contraception to unmarried people because we don’t believe that is right".

    Could this be on the door?

  • progo35

    What a salient statement, Colleen. It shows how incredibly mature you are.

    "Well behaved women seldom make history."-Laurel Thatcher Ulrich

  • progo35

    I also agree with Harry that pharmacies should advertise clearly if they do not intend to distribute abortifacients, plan B, etc. But, I would like to clarify that there aren’t any pharmacies performing “marriage checks” on people before selling contraception, as much as some people on this blog would like to believe, and convince others to believe this.

    "Well behaved women seldom make history."-Laurel Thatcher Ulrich

  • invalid-0

    Harry,

    The problem is not Pharmacy A refusing to give out these medications, when a person can just cross the street and get them at Pharmacy B.

    The problem is when Pharmacy A is the only pharmacy within reasonable driving distance (as it is in many rural areas). Whether or not the refusal is publicized, this situation means that women in the area have legal health options denied to them.

    Informing customers isn’t a bad thing, but this is addressing a problem that isn’t the central issue, vis-a-vis women’s health.

    • invalid-0

      Some medicines raise sensitivity of a skin and, accordingly, do you by more vulnerable for a cancer and burns so you should or wait with sunburn, or to be smeared with a protective cream more densely. In group of risk antibiotics, medicines for a hypertension, means for the cholesterol fall, some contraceptive, not steroid anti-inflammatory and even some creams from spots. Therefore for the sake of health of the woman it is recommended to sell them under the recipe.

  • invalid-0

    Progo35 opined, “Hobbes believed that people were too stupid to decide right and wrong for themselves and thus were only to be regarded as a part of the state as a mechanism.

    I suggest you should read Hobbes rather than claim ideas which he does not espouse. Hobbes was the first modern philosopher on the nature of government and it’s relationship to society. His main thesis is that an individual who operates without the benefit of society has a very short and brutal life.

    You want to talk about freedom?

    With respect, Progo35 and Harry 834, neither of you are required to purchase Plan B, or any contraception. Sounds like everyone is free to avoid that potential horror.

    Instead, for possibly the best moral reasons, you are trying to restrict the freedom of others. You want to make it impossible for other people to get conception.

    Your argument in reply, of course, is that some freedoms, like the freedom to murder others, should be restricted. You are right, unlimited freedom is as harmful to society as tyranny is.

    However, you need to successfully convince people that contraception is, in itself, morally wrong. To desire to change the current acceptance of contraception by restricting the freedom of other people is to desire to use the force of the state to enforce your minority opinions.

    The Provider Conscience Rule does what you claim Hobbes believed, it suggests that individuals are too stupid to decide what contraception to use for themselves and allows the pharmacists to decide, with the backing of the state, what is appropriate for others. That, my friend, cannot be called freedom.

  • invalid-0

    Whoa, lost my nice little line-breaks and formating. I apologize for the density of the text.

  • invalid-0

    Same here – except the opposite. I won’t give my dollars to businesses or professionals that deny women access to basic health care. I always check my pharmacy’s policy before patronizing them. If they allow pharmacists to deny prescriptions based on “conscience,” I take my business elsewhere.

  • http://ontheotherfoot.blogspot.com invalid-0

    Your argument in reply, of course, is that some freedoms, like the freedom to murder others, should be restricted. You are right, unlimited freedom is as harmful to society as tyranny is. However, you need to successfully convince people that contraception is, in itself, morally wrong.

    No, I don’t. All I have to do is not sell it. Other people can decide for themselves if they will or won’t sell it.

    The Provider Conscience Rule does what you claim Hobbes believed, it suggests that individuals are too stupid to decide what contraception to use for themselves and allows the pharmacists to decide, with the backing of the state, what is appropriate for others.

    Same fallacy. Those health care workers who are willing to provide abortions or abortifacients are perfectly free to do so. This is about forcing those who are unwilling, not restricting those who are.

  • http://ontheotherfoot.blogspot.com invalid-0

    Mine too. Sorry about the unreadability.

  • progo35

    Flex-

    READ MY POST, please. I DID NOT SAY that people should not be able to use contraception. I said that if a pharmacy does not intend to sell it, they should be clear about it. You obviously cannot read or do not care and want to misrepresent what people say in order to prove your point. I totally support contraception, and believe that people have a right to know which pharmacies they should go to in order to get their prescriptions. They shouldn’t have to go to their local pharmacy expecting to get their prescription filled only to be told that the pharmacy doesn’t distribute it. So, READ BEFORE YOU REPLY, PLEASE.

    "Well behaved women seldom make history."-Laurel

    Thatcher Ulrich

  • progo35

    Flex-

    READ MY POST, please. I DID NOT SAY that people should not be able to use contraception. I said that if a pharmacy does not intend to sell it, they should be clear about it. You obviously cannot read or do not care and want to misrepresent what people say in order to prove your point. I totally support contraception, and believe that people have a right to know which pharmacies they should go to in order to get their prescriptions. They shouldn’t have to go to their local pharmacy expecting to get their prescription filled only to be told that the pharmacy doesn’t distribute it. So, READ BEFORE YOU REPLY, PLEASE.

    "Well behaved women seldom make history."-Laurel

    Thatcher Ulrich

  • progo35

    Hobbes believed that people existed to serve the agencies of the state and that the state was the mediator of conscience, etc, that it isn’t what one may believe is right or not right, it is what is right in regard to what society determines is right in regard to one’s profession or role in society. In short, people needed the state to moderate their behavior or they would descend into chaos. Fish is using that argument to argue that people do not have the right to their own conscience if their conscience does not coincide with what society decides is right (legal.)
    For your information, I have a Cum Laude degree in cultural studies and a significant portion of that degree was philosophy courses. So, I have read Hobbes, several times, and know what I’m talking about. Sorry if that doesn’t jive with your agenda of making everyone who disagrees with you look like a misinformed, misanthropic freak.
    "Well behaved women seldom make history."-Laurel Thatcher Ulrich