Journal OpEd Archives - Protection of Conscience Project Library

Conscientious objection in reproductive health – an ancient prerogative or harmful practice

JM Thorp Jr

Extract
We must return to our Pythagorean roots and not substitute a secular group conscience to replace individual conscience, and thereby protect the rights of all parties. My hope is that our specialty will uphold the right of individual clinicians to practise according to their consciences and we will continue to welcome Hippocratic clinicians into our ranks.

BJOG: An International Journal of Obstetrics and GynaecologyJr JT. Conscientious objection in reproductive health – an ancient prerogative or harmful practice. BJOG: An International Journal of Obstetrics and Gynaecology. 2018 Oct;125(11):1357-1358.

The law and physician-assisted dying

Tom Koch

Canadian Medical Association Journal, CMAJ — Canadian Medical Association Journal

Extract
For most Canadians, the arguments that began on Oct. 14, 2014, at the Supreme Court in Ottawa are about medical aid in dying. But what is really at stake in Carter et al v Attorney General of Canada et al is Canadian law itself, the meaning of its guarantees, promises and injunctions.

Koch T. The law and physician-assisted dying. Can Med Assoc J. 2014 Nov 18;186(17):1336.

(Debate) Should doctors feel able to practise according to their personal values and beliefs? Yes.

Brian V Conway

Extract
Respect for doctors’ right to conscientiously object is the ultimate safeguard against abuses of power, error and exploitation in medicine. It is the key safeguard of the doctor–patient relationship.

Conway BV. (Debate) Should doctors feel able to practise according to their personal values and beliefs? Yes. Med J Aust. 2011 Nov 07;195(9):496-497.

Would Accommodating Some Conscientious Objections by Physicians Promote Quality in Medical Care?

Douglas B White, Baruch Brody

Journal of the American Medical Association

Abstract
Conclusion
The notion that protecting physicians’ consciences benefits physicians at the expense of patients has created an overly simplistic dialogue about conscience in medicine. Viewing the issue from a societal perspective and conceptualizing medical quality as a public good allow a more robust understanding of the relationship between CBR and quality medical care. Policies that allow some CBRs while also ensuring patients’ access to the requested services may yield better overall medical quality by fostering a diverse workforce that possesses integrity, sensitivity to patients’ needs, and respect for diversity. This analysis is necessary for a genuine public discussion about how to handle moral pluralism among patients and physicians. The societal perspective should be incorporated into efforts to develop a comprehensive framework for when CBRs should and should not be accommodated.

White DB, Brody B. Would Accommodating Some Conscientious Objections by Physicians Promote Quality in Medical Care?. J Am Med Ass. 2011 May 4;305(17):1804-1805.

Betrayal of conscience

Jeanine Young-Mason

Extract
. . .It behooves us always to strive to understand and search for the roots of other’s humanity without which we are left with dangerous assumptions and fear. All violence breeds tragic consequences for the victims and for the perpetrators who are betraying the consciences they have been given. In sum, the tragedy is not that the perpetrators have no conscience but that they are by their actions betraying the conscience they have in denying the humanity of others.

Young-Mason J. Betrayal of conscience. Clin Nurse Spec. 2011 January;25(1):49.

Ethical Distinction Between Direct and Indirect Referral for Abortion

Frank A Chervenak, Laurence B McCullough

Extract
Conclusion
The ethics of referral for abortion is autonomy based with a beneficence-based component, the clinician’s obligation to protect the woman’s health and life, similar to referral for cosmetic procedures. At a minimum, indirect referral— providing referral information but not ensuring that referral occurs—should be the clinical ethical standard of care. Direct referral for abortion is a matter of individual clinician discretion, not the clinical ethical standard of care. Conscience based objections to direct referral for termination of pregnancy have merit; conscience-based objections to indirect referral for termination of pregnancy do not.

Chervenak FA, McCullough LB. Ethical Distinction Between Direct and Indirect Referral for Abortion. The Female Patient. 2009 Dec;34:46-48

(Debate) Do FPs agree on what professionalism is? Yes

Michael Yeo

Extract
Closing Arguments
• Professionalism is in vogue today, as evidenced by the proliferation of discussion in the academic literature and in policy and guidance issued by various medical organizations.

• There is general agreement in the literature that, essentially, to be a medical professional is to profess competence in medicine and to use it primarily for the benefit of patients and communities.

• Although there has been no formal study of whether FPs agree on what professionalism is, there is reason to suppose that they agree on the general concept as it is generally elaborated in the literature and on the moral norms associated with the professional ideal.

• Family physicians might disagree about particular applications of the moral norms that make up the professional ideal, but such disagreement is perfectly compatible with the idea of professional judgment and is indeed a part of it.

Yeo M. (Debate) Do FPs agree on what professionalism is? Yes. Can Fam Physician. 2009 Oct;55:968-971.

Transparency in the delivery of lawful abortion services

Rebecca J Cook

Abstract
• Laws limiting access to abortion services do not reduce the number of abortions, only their safety.

• Governments of countries are obligated to collect official statistics on the number of abortions and their health effects.

• Where statistics show deficiencies in the delivery of abortion services, governments are obligated to remedy the problem.

• Governments are obligated to ensure that women, irrespective of age or other socio-demographic factors, have transparent access to abortion counselling and services where they are legal.

Cook RJ. Transparency in the delivery of lawful abortion services. Can Med Assoc J. 2009 Feb 03;180(3):272-273.

Abortion and the politicisation of conscience

Megan-Jane Johnstone

Extract
In formulating a response to the abortion issue, the nursing profession needs to be careful not to lose sight of its moral obligation to ensure that women receive the care they require. Nurses also need to be wary of the politicisation of conscience and the corrupting influence this can have on authentic debate about complex moral issues.

Johnstone M-J. Abortion and the politicisation of conscience. Aust Nurs J. 2008 Dec;16(6):21.

Abortion is more than a debate about conscientious objection

Jenny Talia

Extract
Too much effort is expended on debating the rights and wrongs about abortion and not enough is done to prevent it. What proportion of conscientious objectors makes a conscientious effort to ensure men and women use contraception? Conversely, is the pro-choice contingent too lax about initiating discussions on contraception to men and women opportunistically? Of course, there is responsibility for everyone along the chain. What I have a problem with are health professionals who not only deny the rights of women for abortion, but also refuse to offer contraception on religious and moral grounds and insist on abstention.

Talia J. Abortion is more than a debate about conscientious objection. BMJ Sex Repro Health. 2007;33(4):243.