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.