Secular state, conscientious objection and public health policies.

Secularity matters to health policies. Secularity is more than religious neutrality in government affairs – it is a condition for governability in a plural and democratic state. In health, it matters where government leaders seek inspiration for their official acts, whether in academic knowledge or in religions. The post-modern concern over the statute of truth is insufficient to strip science of its value for public policymaking. Thus, not everything in the moral field is fair grounds for health practices in duties to the citizens of a secular state. My argument is simple – religion should be a matter of private ethics, and public policies should not be based on religious mystics concerning welfare. Therefore, psychotherapy aimed at reversing homosexuality is not good scientific practice, but quackery. Likewise, banning embryonic stem cell research with the pretense of safeguarding the frozen embryo’s right to life is religious dogma and not a serious discussion on the morphology of human genesis. Science or quackery, research or dogma, are not adjectives to qualify practices, but political nouns. It is with a political noun that I intend to provoke the principal expression of the Brazilian state’s weak secularity in health – the growing concern over conscientious objection as a device. What does conscientious objection mean? In this case it is health professionals’ denial, on purported moral grounds, of their duty to provide care. The most common scenario is that of abortion: physicians, nurses, social workers, or psychologists, each according to their own knowledge and power systems, refuse to assist a woman who wishes to undergo an abortion. This is not new today, when the Congressional Committee on Human Rights is chaired by a fundamentalist pastor. Severina’s story took place in 2004, a few days after a preliminary injunction that allowed abortion in cases of anencephaly was overruled by the Brazilian Supreme Court 1,2. Even with a court authorization in force, the anesthetists at the hospital where the patient was referred for a legal abortion refused to assist her – claiming religious grounds. Severina was Catholic and failed to understand why a court ruling was not enough to guarantee her right to the abortion. Her proof of identity was her worker’s card – an existential imprint of her class and origin. She waited for hours: carrying a non-viable fetus, was incapable of convincing those who had the duty to assist her. Her potential caregivers claimed they were in moral suffering: the abortion was a grave threat to their feeling of religious integrity. Thus, their refusal was supposedly a legitimate form of objection. No anesthetist at the hospital stepped up to relieve her pain. Severina waited and trekked from one hospital to another. She was finally as-