Protection of Conscience Project Library
Service, not Servitude
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The ethical principles of care have to balance patient autonomy or control with the justice owed to society as a whole. Our choices do not take place in a purely individual setting and the change in society’s attitude when a hastened death is available is illustrated by the changes that are taking place in the Netherlands.
Saunders C. In Britain Fewer Conflicts of Conscience. Hast Cent Rep. 1995 May-Jun;25(3):44-45.
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Proposals to legalize assisted suicide challenge hospice’s identity and integrity. In the wake of Measure 16, Oregon hospice programs must develop practical policies to balance traditional commitments not to hasten death and not to abandon patients with dying patients’ legal right to request lethal prescriptions. . . . . .
Regardless of the path an individual hospice may follow,-it cannot avoid the uncharted and unknown territory of a law that legalizes a lethal prescription and a scheduled death for some terminally ill patients. Whether a hospice forges a path through the middle of this territory through full participation, skirts along its borders by forms of indirect participation, or creates a detour through abstention and nonparticipation, the nature and mission of hospice in Oregon will be irreversibly altered.
Campbell CS, Hare J, Matthews P. Conflicts of Conscience: Hospice and Assisted Suicide. Hastings Cent Rep. 1995 May;36-43.
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If the state itself does not presume to order the consciences of its citizens, how can employers, physicians or hierarchical superiors assume such authority? For those in positions of power, it is all too easy to stifle the criticisms and consciences of subordinates by a summons to authority – or by an accusation of insubordination. The irony of it is that whether you succeed or fail in your attempts to force obedience through such tactics, you will have lost your most valuable asset – a man or woman of integrity. Within the ethical, professional and legal restraints to which all of us are subject, we can and must create a system that allows for respectful dissent and conscientious objection.
Curtin LL. Conscience and Clinical Care. Nurs Manag. 1993 Aug;24(8):26-28.