In the United States, their persistent legal challenges prompted a series of state and federal court rulings that reinforced judicial protections for civil liberties. Among the rights strengthened by Witness court victories in the United States are the protection of religious conduct from federal and state interference, the right to abstain from patriotic rituals and military service, the right of patients to refuse medical treatment, and the right to engage in public discourse. Similar cases in their favor have been heard in Canada.