Monday, March 23, 2009

Doctors' Right of Conscience

The Bush administration put forth a ‘right of conscience’ rule recently (end of 2008) permitting health care professionals to refuse in any procedure they find morally objectionable (this could include abortion, artificial insemination, birth control, etc.). Doctors already had the right to refuse to do abortions by federal laws which have existed for more than thirty years, so what was the objective of the ‘right of conscience’ rule (what does it change)? First of all it covers a broader spectrum of personnel, from the surgeons right on down to the people who clean the instruments. It also allows professionals to not only refuse to do the procedure, but also to refuse giving advice or information to someone wanting the procedure. It's language also suggests that it may cover more than abortion. "The real battle line is the morning-after pill," Dr. David Stevens president of the Christian Medical Association (CMA) said. "This prevents the embryo from implanting. This involves moral complicity. Doctors should not be required to dispense a medication they have a moral objection to." He also stated that “the rule is not limited to abortion, it will protect doctors who do not wish to prescribe birth control or to provide artificial insemination.” Critics of the rule say that it is an attack on patient’s rights to receive proper medical care. Should patients sacrifice their medical care for the religious beliefs of their providers? We have a right to freedom of religion after all, but how far do those boundaries reach? "Although respect for conscience is important, conscientious refusals should be limited if they constitute an imposition of religious or moral beliefs on patients [or] negatively affect a patient's health," American College of Obstetrics and Gynecology (ACOG)'s Committee on Ethics said. It also said physicians have a "duty to refer patients in a timely manner to other providers if they do not feel that they can in conscience provide the standard reproductive services that patients request." Obama has already taken steps toward overturning the bill.


Elliott said...

Hey Aaron! I found your blog via facebook. Insightful entries, I've added your blog to my reader.

A recent editorial in the New England Journal of Medicine sums up most of my thoughts on the subject.

Worth a read.

Aaron said...

Great article, thanks for sharing.

My thoughts are similar to yours. I think the idea of a physician forced to perform a procedure he is morally opposed to is unrealistic. Like your article says, physicians choose which field to practice in. People naturally select outside of fields in which their "conscience" may interfere with their perceived professionalism. Also, we can't forget that patients select their physicians, often based on the physicians moral beliefs, personality, etc. (I go to my doctor back in California because he is LDS for example). The system often takes care of itself in this way. If perchance a problem does arise, the physician can direct the patient to a different doctor who is willing and able to perform the desired procedure.

Anyway, in talking to the doctors I shadow about this subject, they all say they have never felt obligated to perform a procedure they were morally opposed to. Perhaps this whole issue is making something out of nothing.