Objeção de consciência institucional aplicada aos hospitais confessionais

Abstract

This dissertation examines institutional conscientious objection (ICO) in religious-affiliated hospitals, taking as its starting point the case of Hospital São Camilo in Brazil, which refused to provide intrauterine device (IUD) insertion on religious grounds. Given the limited treatment of institutional religious freedom in Brazilian legal scholarship, the study adopts a qualitative and hypothetico-deductive methodology, combining doctrinal analysis, theoretical inquiry, and comparative law. The research first addresses the historical and constitutional development of freedom of conscience and religion, as well as its relationship with state secularism. It then analyzes the Brazilian debate on ICO, highlighting the normative and doctrinal gap regarding the institutional dimension of conscience, in contrast to foreign legal systems that recognize institutional conscience clauses to varying degrees. The dissertation defends the constitutional legitimacy of institutional conscientious objection, challenging strictly individualistic conceptions of conscience and arguing that institutions may be understood as moral agents endowed with normative identity. This claim is supported by the interpretivist theory of group agency, social anthropology, and theoretical frameworks that affirm the autonomy of social spheres, including sphere sovereignty, systems theory, and societal constitutionalism. The study concludes that the protection of institutional religious autonomy is a necessary corollary of pluralism and a legitimate limitation on state power, requiring a constitutional framework capable of balancing fundamental rights without reducing religious freedom to an exclusively individual phenomenon.