In this article, we examine the evolving landscape of Regulatory Impact Assessment (RIA) decisions made by the National Health Regulatory Agency (Agência Nacional de Vigilância Sanitária [Anvisa]), a prominent federal agency leading RIA implementation in Brazil. We quantify Anvisa’s RIA usage rates, exploring the influence of emergency and other justifications for RIA exemptions both pre and post the enactment of detailed procedural requirements in a recent Presidential Order No. 10,411/2020. Our quantitative analysis shows a sharp decline in RIA usage after Presidential Order No. 10,411/2020 came into force in April 2021, as well as a diversification of the justifications given in decisions not to use RIA (exception decisions). This effect is present even if we take into consideration a large proportion of exception decisions tied to Anvisa’s regulatory stock review and to urgent measures prompted by the COVID-19 pandemic. Additionally, we conduct a qualitative analysis of exception decisions due to emergency, post-Presidential Order. We find that Anvisa failed to provide compelling justifications for exempting RIA in emergency regulations in several cases and avoids ex post reviews when RIAs are waived due to emergencies. We conclude the article with recommendations to enhance the scrutiny and transparency of Anvisa’s exception decisions to conduct RIA.

This article explores the interpretation and application of the term ‘doctrine’ within the Anglican Church of Australia and its implications in Australian civil law, particularly anti-discrimination legislation. It examines the tension between (1) the constitutional definition in the Church's constitution and (2) broader interpretations found in General Synod resolutions. The anxiety evident in the General Synod resolutions underscores ongoing debates within the Church about same-sex marriage and relationships and the application of secular exemptions in anti-discrimination legislation. The article concludes that the civil law definition of the term ‘doctrine’ is wide enough to encompass both the Anglican Church of Australia's constitutional definition and the broader meaning found in General Synod resolutions. Nevertheless, care needs to be taken by the Church to avoid the risk of civil courts being called upon to engage in their own exegesis of scripture, and thereby come to conclusions which are at odds with the avowed beliefs of the Church.

Expressivist theories of law focus not only on what legal arrangements do but also what they communicate. The expressivist view has gained special currency in the context of religious establishment. Even when governmental involvement with religion is not coercive or does not materially violate anyone’s rights, it may nevertheless be undesirable by virtue of expressing a preference for a certain religion or a privileged status for certain religious groups over others. The existing literature, however, lacks an equivalent expressivist analysis of the related but distinct domain of free exercise of religion. What is expressed when a religious individual or group is granted special relief from the legal requirements that would otherwise apply to them? I argue that just like religious establishments, religious exemptions not only implicate rights and material interests but also have important expressive dimensions that both help account for their value and impose limits on their desirability.

This article asks whether firms should exempt employees when they object to elements of their work that go against their conscience. Fairness requires that we follow the rules of an organization we have joined voluntarily only if these rules express mutual advantage. In corporations, I argue that subordination and exemption provides for mutual advantage better than subordination plus right of exit. This is because agents want to protect their conscientious convictions, even in hierarchical organizations geared towards efficient preference satisfaction. Thus exemptions should be granted in unforeseeable circumstances, provided the costs are limited.

A version of the principle of alternate possibilities (PAP) claims that one is only blameworthy for actions which one was able to avoid. Much of the discussion about PAP concerns Frankfurt’s counterexamples to it. After fifty years of refined debates, progress might seem hopeless. Yet, we can make headway by asking: “what’s our reason for believing PAP?” The best answer is this: lacking eligible alternatives—alternatives whose cost is not too high to reasonably opt for—is a good excuse. Yet, this principle is subject to straightforward counterexamples, unless it is given an epistemicised reading. And in this latter case, it does not support PAP. So, PAP is unsupported, at least for now.

Complicity in an immoral, and even criminal, activity, such as robbery or murder, is itself regarded as involving responsibility for those acts. What should the position be of health professionals who are expected to participate in actions that they believe are morally wrong? Professional responsibilities may clash with private conscience. Even referring a patient to someone else, when what is in question may be assisted suicide, or euthanasia, seems to involve some complicity. This is a live issue in Canada, but similar dilemmas occur elsewhere. Physicians and others should not be coerced into involvement of any kind in what they regard as wrong. Such coercion goes against the very principles of liberal democracy. Conscience matters. Reasonable accommodation should be given to those whose moral judgment may be at variance with prevailing professional norms. Moral questions should still be given weight within medicine, and disagreements respected. Dedication to the promotion of human welfare should be paramount, but it should be recognized that there may be different visions of what such welfare consists of.

This article first critically reviews the major philosophical positions in the literature on conscientious objection and finds that they possess significant flaws. A substantial number of these problems stem from the fact that these views fail to assess the reasons offered by medical professionals in support of their objections. This observation is used to motivate the reasonability view, one part of which states: A practitioner who lodges a conscientious refusal must publicly state his or her objection as well as the reasoned basis for the objection and have these subjected to critical evaluation before a conscientious exemption can be granted (the reason-giving requirement). It is then argued that when defenders of the other philosophical views attempt to avoid granting an accommodation to spurious objections based on discrimination, empirically mistaken beliefs, or other unjustified biases, they are implicitly committed to the reason-giving requirement. This article concludes that based on these considerations, a reason-giving position such as the reasonability view possesses a decisive advantage in this debate.

This paper argues that secular legal systems need a better defined space for freedom of conscience because this important right has been crowded out by both freedom of religion and freedom of thought. Based on the principles of the Protestant Reformation, American constitutionalism expanded the idea of freedom of conscience to the point of making it almost interchangeable with freedom of religion. On the other hand, international law, followed by European constitutional law, reduced the political force of the concept of freedom of conscience by assimilating it to freedom of thought. And yet freedom of conscience cannot be treated just the same as either religious freedom or freedom of thought. By nature, the secular legal systems of political communities are moral, but nonreligious. So morality and religion affect legal systems in different ways. For this reason, freedom of conscience and freedom of religion should be protected using different legal devices. The so-called privilege of abstaining (beneficium abstinendi) best protects freedom of conscience; freedom of religion, by contrast, is appropriately protected by what I call the religious exception (exceptio religiosa). The consequences of applying these legal tools in particular cases, and their proper scopes, depend on the constitutional model of the political community in question. But in general, an increasingly globalized, diverse, and multicultural society demands a wider application of both these legal tools.

When this essay appears in print, it will be two years since the death of legal philosopher and constitutional law scholar Ronald Dworkin. One recurring reminder of the magnitude of that loss is the absence of Dworkin's regular, insightful essays for the New York Review of Books analyzing significant US Supreme Court decisions. Thus, when, last term, a closely divided (5–4) Court released its much-anticipated decision in Burwell v. Hobby Lobby, upholding a challenge by three for-profit corporations to the contraceptive coverage provisions (the so-called contraceptive mandate) of the Patient Protection and Affordable Care Act of 2010 (ACA), sadly missing in the flurry of commentary was Dworkin's assessment of the case. Readers of this journal may perhaps appreciate the allusion when I say that the decision prompted me to wonder, “What would Dworkin do?” That same question arose again when, on July 3, 2014, in Wheaton College v. Burwell, over a strong dissent by Justices Sotomayor, Ginsburg, and Kagan, the Court granted the emergency request of Wheaton College to be relieved from complying with the ACA's accommodation procedure for religious nonprofit organizations that object to contraceptive coverage on religious grounds, even before the lower courts had ruled on the merits of the college's claim.