The Brocher Foundation, spread throughout eight buildings on three acres of land in Geneva, Switzerland, is dedicated to providing a meeting venue for “scientists and experts in the ethical, legal and social implications of the development of medical research and biotechnologies” to gather and collaborate on bioethical issues.
A group of philosophers and bioethicists gathered at the Brocher Domain in early June 2016. Their object: to discuss and ultimately propose a set of guidelines for the regulation of conscientious objection in the healthcare field.
The result of the workshop was published by the University of Oxford on August 29 in the form of a “consensus statement” of 10 points, signed by 15 scholars hailing from around the world. The contents of the statement reflect the challenges that have faced—and will increasingly face—healthcare practitioners who object to participating in certain practices on conscience-related grounds.
Of these “ethical guidelines that should inform, at the level of legislations and institutional policies, the way conscientious objections in healthcare is regulated,” four points in particular stand out as problematic for healthcare professionals.
First, the scholars claim, “Healthcare practitioners’ primary obligations are towards their patients, not towards their own personal conscience.” Professional obligations must take priority over moral or religious beliefs, that is. Second, where a conflict between a practitioner’s conscience and a “patient’s desire for a legal, professionally sanctioned medical service” does occur, the objecting practitioner “ought to refer their patients to another practitioner who is willing to perform the treatment.” Further, in emergency situations or when referral “poses too great a burden on patients or on the healthcare system, health practitioners should perform the treatment themselves.”
Lastly, a fourth point adds that practitioners “who are exempted from performing certain medical procedures on conscientious grounds should be required to compensate society and the health system for their failure to fulfill their professional obligations by providing public-benefitting services.” Interestingly, what is meant by “compensating society” is left undefined and without example. For good measure, the scholars write that medical students “should not be exempted from learning how to perform basic medical procedures they consider to be morally wrong” because even if they object to the procedures, they will still be forced to perform them “in emergency situations” as noted above.
Converting the language of the statement into plain prose—as if the message was not already clear—the thrust of these passages is that the religious and moral beliefs of doctors, nurses, pharmacists, and other healthcare practitioners should not factor into their practice of medicine. The use of the phrase “legal, professionally sanctioned medical services” means that depending on the state or country in which one practices medicine, one may be forced to participate in—or, at a minimum, refer for—elective abortions, euthanasia, assisted suicide, sex change surgery, treatments involving cells taken from embryos whose lives were ended in the cell-derivation process, or even organ transplants using organs taken from mentally ill patients.
The scholars seek to disguise this coercion by referring to “professional obligations” and “public-benefitting services.” But these thinly veiled euphemisms only serve to indicate how extreme is their position. In their vernacular, abortion and euthanasia are considered “public-benefitting services” and partaking in an individual’s ending his life prematurely is a “professional obligation.” Whatever happened to “first, do no harm”?
Among the signatories to the statement are Julian Savulescu, Director of the Oxford Uehiro Centre for Practical Ethics, and Alberto Giubilini and Francesca Minerva, who published an article in the Journal of Medical Ethics in 2012 arguing in favor of infanticide on the grounds that newborns do not have the same moral status as “actual persons.”
The “consensus statement” is misguided in a number of ways. The first is its redefinition of terms such that ethically condemnable acts of direct killing—abortion and euthanasia, for example—are considered to be professional obligations for healthcare practitioners, and are considered legitimate objects of health care at all.
Beyond that, the scholars get the ordering of priorities precisely backwards. Professional obligations do not trump conscience, if a conflict arises between the two. Conscience is a “stern monitor,” in the words of Cardinal Newman, and “the most sacred of all property,” as James Madison reminds us. If one’s “professional obligations” come to include the performance of services to which one objects—such as abortion—conscience must trump work responsibilities.
Mandating that practitioners refer patients to other providers who are willing to provide these objectionable services is not an acceptable panacea for some medical professionals. While a referral is further removed from direct participation in actions in which they cannot in good conscience participate, it still constitutes a form of cooperation in the objectionable act that they cannot perform.
When it comes to emergency situations, the scholars would have objecting practitioners perform the services themselves. In some instances, for example, where a true emergency is occurring and the life of a pregnant woman is in serious danger, objecting practitioners would surely help the woman. (Note that pro-life doctors hold that inducing direct abortion is never medically necessary.) But the language of the statement indicates that, as has already been the case, practitioners will be coerced into participating in objectionable procedures even when there is no true emergency.
To be sure, this “consensus statement” is only a proposal of guidelines issued by a group of philosophers and bioethicists and has no immediate force. But violations of the conscience rights of healthcare practitioners are already occurring in various fields, and the impetus given to the movement to suppress faith-driven, pro-life medical practitioners and eject them from their profession by the imprimatur of “intellectual respectability” is dangerous.
These guidelines reflect a growing trend of violations of conscience rights, and pro-life individuals need to speak out forcefully against such abuses, if we are not to see pro-life individuals driven from healthcare fields—or screened out before even having the chance to practice medicine. If we do not refute and condemn the propositions put forward by these scholars—which are increasingly embodied in practice—all women may face the prospect of having their babies delivered by doctors who also perform abortions, and all seriously ill patients may be treated by doctors who consider killing them to be a legitimate treatment.
Abraham Lincoln affirmed that “the guarantee of the rights of conscience, as found in our Constitution, is most sacred and inviolable,” and in a country founded on the principle of religious liberty and the proposition that all men are created equal, we should hope that the defense of conscience will be successful.
Tim Bradley is a research associate at the Charlotte Lozier Institute.