**1. Introduction: A New Sort of Religious Exemption to a Well-Established Mandate**

In the United States, religious exemptions to health-driven mandates in the workplace and, under exigent circumstances, even in the public square, enjoy, and should enjoy, protected status in medical ethics and healthcare law. Religious exemptions are defined as seriously professed exceptions to state or federal laws that appeal to Title VII of the Civil Rights Act of 1964, allowing workers to request an exemption to a job requirement, including a health-protective mandate, if it "conflicts with their sincerely held religious beliefs, practices, or observances" (US Department of Labor 2014). In the context of labor law, religious ethics, and medical ethics, religious exemptions are justified on the basis of the principle of *autonomy*, whereby one's personally held convictions, often reflected in the scriptures or established norms of the religious traditions of which they are a member, are safeguarded on the basis of the first amendment. The invocation of autonomy in this respect constitutes an important area in which the societal good must yield to individual liberty. According to the principle of autonomy, one should have the freedom to make

**Citation:** Flescher, Andrew. 2023. How Well Do Religious Exemptions Apply to Mandates for COVID-19 Vaccines? *Religions* 14: 569. https:// doi.org/10.3390/rel14050569

Academic Editor: Katarzyna Skrzypi ´nska

Received: 26 December 2022 Revised: 7 March 2023 Accepted: 27 March 2023 Published: 24 April 2023

**Copyright:** © 2023 by the author. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https:// creativecommons.org/licenses/by/ 4.0/).

decisions about one's body for oneself, as a result of which one cannot be forced against one's will to undertake any proposed medical therapy (Beauchamp and Childress 2001, pp. 176–77). In its strongest versions, autonomy presupposes that patients should be free to override their caretakers when the latter paternalistically propose a course of action that, in good faith, is in the patient's medical interests. (Glover 1977, pp. 80–81; Buchanan and Brock 1990, pp. 38–39; Gillon 2003, p. 310).

Notably, what is *not* entailed in this understanding, neither here nor in any other standard definition of the term in medical or legal ethics, is that autonomy should be considered an absolute claim, not required to be in balance with the other principles with which it stands in tension. More important, while autonomy implies one's stewardship over one's body, it does not give license to put others in danger. While there is a burden on employers and public officials to *accommodate* individuals claiming exemptions reasonably, this does not imply unrestricted prerogative in the public square or the workplace. The critical question before us is what happens when a pandemic arrives and public health officials, with the state's backing, have determined that the safety of the population under their jurisdiction requires adherence to a health-mandated vaccination, which, given the stakes, cannot be worked around through a "reasonable accommodation"?

Until recently, the answer in our country has been that while one is not required to be forced to stick one's arm out to receive an injection—there is no *direct* bodily coercion—it is within the state's jurisdiction to decide to refuse entry of vaccine-refusers into shared spaces. Specifically, this precedent had been set in Jacobson v. Massachusetts, where the majority ruled: "The liberty secured by the constitution of the United States to every person within its jurisdiction does not import an absolute right in each person to be, at all times and in all circumstances, wholly freed from restraint. There are manifold restraints to which every person is *necessarily* subject for the common good". (Jacobson v. Massachusetts 1905). Religious exemptions are real and must be respected, but not at the expense of the "life and liberty" of everyone who lives in society, not just privileged or exempted groups.

Acknowledging the longstanding category of "religious exemptions", and referencing a controversial example that does adhere to its parameters in good faith (namely, that of objections made by some institutions to HPV vaccines), I set out to argue that, to date, no coherent basis of religious exemptions to COVID-19 vaccines has been offered, particularly through appeal to the principle of autonomy, or, in a health care context, to "medical freedom". Indeed, proponents who characterize *these* exemptions as legitimate misconstrue autonomy and even abuse the reputation of the religious traditions they invoke in support of their endeavors to opt out. While in what follows I address recent developments in how "religious exemptions" are being interpreted in the workplace, as this is where labor law applies, the conclusions I draw about policy are applicable also to the public square, more broadly. In both settings, at work no less than in a grocery store or at a motor vehicles department, there is a group of people who constitute a captive audience insofar as they cannot perform functions necessary for basic daily living without convening in these shared spaces. This noted, the scope of this effort is neither to affirm nor to undo legal grounds for abstention. The law about what the state can do to impose vaccine mandates is changing so rapidly, in some instances being overturned at the appellate level only to be re-overturned by the Supreme Court, that at this time it is anyone's guess to say where things land (Council on Foreign Relations 2021). What I do hope to present, if not prescriptively then descriptively, is that the checks and balances customarily in effect when individuals object to public health mandates issued in response to exigent crises, alarmingly, appear to be no longer.

Traditionally, one would have had to justify a claim of a violation of individual rights within the context of a coherent belief system to which one had showed evidence of adhering over time. A sharp shift in the way in which "religious belief" itself is now understood, however, as a strictly *subjective* conviction, makes it an unchecked prerogative. This historical shift, in essence, awards a blank check to prospective believers claiming exemptions to not be compelled to justify their choice. One may simply assert that one's

personal interests trump the public good when the two come into conflict. In this manner, a believer exempting oneself from a health-protective vaccine mandate is afforded an opportunity to cloak ideological objections under the guise of religious rationale. The burden shifts to the state to demonstrate that *it* is not violating individual freedoms, thereby allowing for a strategic exploitation of religion that promotes political activism.

Thus, what I present here is neither a legal argument nor an argument about the threat we collectively face when we do not respond to a pandemic such as COVID-19 on a population level (which is an empirical argument), nor even an argument about the normative justification for collective action, e.g., that the threat entailed by the contagious and ubiquitous virus of SARS-CoV-2 is so compelling that individual beliefs ought not to take precedence over the public good, even if it is evident that that case can be made. Rather, it is an elucidation of what the consequences in fact are for a rampant subjectivism in the application of religious exemptions, particularly in the Abrahamic traditions, amidst a worldwide exigent health crisis. In such a state of affairs, not only does the traditional requirement of "sincerely held beliefs", a requirement for which there has been longstanding and historical respect, lose its power of distinction, but we inhabit a world in which public health—and the public good—is declared to be ancillary to political identity and self-interested action.

What are the options available to public health officials, and more broadly to policy makers, who want to promote safety and human flourishing, in a shifting legal landscape according to which personally held beliefs can likely no longer be checked by reasonable constraint? Is there a threshold beyond which claims of the sacrosanct nature of "bodily autonomy" lead to a harmful state of affairs from the perspective of shared health goals and policy initiatives? These questions become even more pointed in a legal and cultural environment in which religion and religious belief are increasingly fragmented, individualized, and divorced from traditional religious institutions and communities.<sup>1</sup> No doubt, there are ethical implications tied to these inquiries, particularly in light of the seeming tension this shift reveals between safety and individual expression in the public square. (What does an individual living through the pandemic owe to other individuals in the state? Conversely, what must the state tolerate for the sake of preserving individual liberty, a prized and precious good in our society?) However, the principal contribution of this article is descriptive. Specifically, it elucidates the consequences of modifying the longstanding framework for interpreting and adjudicating claims about individual belief in the public square, consequences for which, in the context of a pandemic, the stakes could not be higher.
