Law, religion and health in the United States

Should physicians be required to disclose their religious beliefs to patients? How should we think about institutional conscience in the health care setting? How should health care providers handle situations in which a family refuses treatment based on religious objections?  These questions and more are tackled in a new book co-edited by an expert on health law at Washington University in St. Louis.

Law, Religion and Health in the United States,” published by Cambridge University Press, is co-edited by Elizabeth Sepper, associate professor of law, along with I. Glenn Cohen of Harvard Law School and Holly Fernandez Lynch of the University of Pennsylvania.


“Questions of religion in health are complicated,” Sepper said. “Instead of a straightforward conflict between the government and believers, these issues involve health professionals, patients and institutions like employers, insurers and hospitals — all of which may hold their own religious or conscientious beliefs. U.S. law doesn’t grant religious believers absolute license or people seeking health care an absolute right to demand it.  So lawyers, ethicists and advocates must grapple with the various interests at stake.”

This book uses as its springboard the conflicts over law, religion and health that were brought to the fore by the landmark 2014 U.S. Supreme Court decision, Burwell v. Hobby Lobby.

In the book, lawyers on opposing sides of the Hobby Lobby case square off. Chapters cover topics such as: How should providers respond when patients’ families expect miracles, have religious definitions of death, or refuse treatment contrary to modern medicine? When must health care professionals disclose their religious beliefs or refer patients whom they cannot counsel for religious reasons? How can we balance public health concerns against religious practices — for examples, Caribbean religious practitioners who employ the ritualistic use of mercury or Christians who oppose contraceptive coverage?

“I think the book is quite unique in bringing together scholars with diverse methodologies — from theology to public health — and varying perspectives of what success in balancing religion and health would look like,” Sepper said.

“My chapter evaluates religion in the context of health care consolidation,” she said. “I show a growing trend of health care institutions and their providers agreeing by contract to religious restrictions on care.  Sometimes hospitals even continue religious compliance after they are sold to a secular owner. This development challenges the traditional perceptions of religious institutions as mission-driven or associations of faithful.”

Rachel Sachs, associate professor of law and expert on drug regulation and health law, contributed a chapter on the role that Christian health care sharing ministries play in the health care system.

“As Sachs shows, these Christian ministries distinguish themselves from insurance companies and reimburse for care in accordance with religious values,” Sepper said. “Sachs argues that the ministries’ preference for personal responsibility over health promotion may lead to their instability or permit their success — offering a natural experiment for empiricists interested in insurance theory.”

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