As readers of SHS and my other writings know, I think one of the big coming fights in bioethics will be over “medical conscience,” that is, efforts to force Hippocratic and/or pro life doctors to participate in procedures or treatments that involve the taking of human life. Since the ethics of the medical system have diverged sharply from those of the Hippocratic Oath, I believe that doctors, nurses, pharmacists and other medical professionals need to be protected if they wish to adhere to the traditional life-affirming values of medicine—with conditions, including that life sustaining treatment can’t be refused, refusals can’t be based on discrimination (e.g., refusing to treat a smoker or a gay person because they smoke or are gay), and that patients need to be told ahead of time that their doctor won’t do certain things, e.g. abortion, assisted suicide, embryonic stem cell treatments (should they ever become part of clinical practice).
Now the Council of Europe has adopted just such a medical conscience policy. From the resolution, “The Right to Conscientious Objection in Lawful Medical Care:”
Resolution 1763 (2010)[1]
1. No person, hospital or institution shall be coerced, held liable or discriminated against in any manner because of a refusal to perform, accommodate, assist or submit to an abortion, the performance of a human miscarriage, or euthanasia or any act which could cause the death of a human foetus or embryo, for any reason.
2. The Parliamentary Assembly emphasises the need to affirm the right of conscientious objection together with the responsibility of the state to ensure that patients are able to access lawful medical care in a timely manner. The Assembly is concerned that the unregulated use of conscientious objection may disproportionately affect women, notably those having low incomes or living in rural areas.
3. In the vast majority of Council of Europe member states, the practice of conscientious objection is adequately regulated. There is a comprehensive and clear legal and policy framework governing the practice of conscientious objection by healthcare providers ensuring that the interests and rights of individuals seeking legal medical services are respected, protected and fulfilled.
4. In view of member states’ obligation to ensure access to lawful medical care and to protect the right to health, as well as the obligation to ensure respect for the right of freedom of thought, conscience and religion of healthcare providers, the Assembly invites Council of Europe member states to develop comprehensive and clear regulations that define and regulate conscientious objection with regard to health and medical services, which:
4.1. guarantee the right to conscientious objection in relation to participation in the procedure in question;
4.2. ensure that patients are informed of any objection in a timely manner and referred to another healthcare provider;
4.3. ensure that patients receive appropriate treatment, in particular in cases of emergency.
The area with which I disagree about this is the duty to refer. If the duty means cooperating when a patient obtains another physician in transferring records, etc., then absolutely. But if it means procuring a doctor to do the procedure that you don’t wish to do—no. That makes the doctor fully complicit in the act and obviates the point of the protection.
Still, this is a good step in the right direction. I hope that individual European nations will heed this call and that the USA will also understand the importance of maintaining a Hippocratic medical sector.
