Religion Archives - Page 8 of 12 - Protection of Conscience Project Library

Clash of definitions: Controversies about conscience in medicine (Conscience in Medicine)

Ryan E Lawrence, Farr A Curlin

Abstract
What role should the physician’s conscience play in the practice of medicine? Much controversy has surrounded the question, yet little attention has been paid to the possibility that disputants are operating with contrasting definitions of the conscience. To illustrate this divergence, we contrast definitions stemming from Abrahamic religions and those stemming from secular moral tradition. Clear differences emerge regarding what the term conscience conveys, how the conscience should be informed, and what the consequences are for violating one’s conscience. Importantly, these basic disagreements underlie current controversies regarding the role of the clinician’s conscience in the practice of medicine. Consequently participants in ongoing debates would do well to specify their definitions of the conscience and the reasons for and implications of those definitions. This specification would allow participants to advance a more philosophically and theologically robust conversation about the means and ends of medicine.

Lawrence RE, Curlin FA. Clash of definitions: Controversies about conscience in medicine (Conscience in Medicine). Am J Bioeth. 2007;7(12):10-14.

Conscience and Conflict (Conscience in Medicine)

Marcus P Adams

Extract
Asserting that we should encourage dialogue is one thing; showing that such dialogue is possible is another. My commentary has in no way argued against having beliefs that result from religious conscience; rather, I have argued only that religious conscience, regardless of the religion from which it develops, has no place in medical decision-making.

Adams MP. Conscience and Conflict (Conscience in Medicine). Am J Bioeth. 2007;7(12):28-29.

Caution: Conscience is the Limb on Which Medical Ethics Sits (Conscientious Objection and Emergency Contraception)

Farr A Curlin

Extract
Card (2007) does not merely claim that practitioners are obligated to provide EC; he argues that they are obligated to do so even if they have a conscientious objection. This last clause may seem harmless on the surface, but a closer look reveals that it effectively saws off the limb on which the first clause and all medical ethics sit. . . . A genuine conscientious objection, even if misinformed, is an expression of a commitment to acting morally, and . . . judgments of conscience need not be informed by explicitly religious ideas. Moreover, all ethical arguments are appeals to conscience. As such, acting conscientiously is the most fundamental of all moral obligations.

Curlin FA. Caution: Conscience is the Limb on Which Medical Ethics Sits (Conscientious Objection and Emergency Contraception). Am J Bioeth. 2007;7(6):30-31.

(Correspondence) Religion, Conscience and Controversial Clinical Practices

Nada L Stotland

New England Journal of Medicine, NEJM — New England Journal of Medicine

Extract
It is unrealistic and unfair to expect patients to anticipate all conditions that may befall them, identify which ones might be problematic for their physicians, and agree either to reach a compromise or to seek care elsewhere.

Stotland NL. (Correspondence) Religion, Conscience and Controversial Clinical Practices. N Engl J Med.. 2007;356(18):1889-1890.

Reflexiones a propósito de algunos textos sobre la conciencia de Juan Pablo II y Benedicto XVI

(Reflections regarding some texts on conscience by John Paul II and Benedict XVI)

JL Barragan

Proceedings of the Pontifical Academy for Life

Abstract

Al leer algunos textos de Juan Pablo II y de Benedicto XVI sobre la conciencia, me ha llamado la atención la manera como plantean la relación entre subjetividad y objetividad en la sociedad actual en la que fácilmente se cae en el Relativismo. Este problema se profundiza a tratar las relaciones entre Dios y la conciencia y entre la Teología y el Magisterio de la Iglesia. Mi propósito en esta intervención al inicio del trabajo de la Pontificia Academia de la Vida es aportar una modesta reflexión que pudiera contribuir a iluminar estas relaciones desde el concepto de cultura. Comienzo presentando una selección de textos de ambos Pontífices, donde resalta la problemática aludida. En una segunda parte intentaré profundizar en dicha problemática.

[Translation] Reading some texts by John Paul II and Benedict XVI on conscience has directed my attention to the way in which they present the relationship between subjectivity and objectivity in today’s society which easily falls into Relativism. This problem is deepened to deal with the relationships between God and conscience and between Theology and the Magisterium of the Church. My purpose in this intervention at the beginning of the work of the Pontifical Academy of Life is to contribute a modest reflection that could contribute to illuminate these relationships from the concept of culture. I begin by presenting a selection of texts from both Pontiffs, where they highlight the problem alluded to. In a second part I will try to delve into this problem.

Barragan JL. Reflexiones a propósito de algunos textos sobre la conciencia de Juan Pablo II y Benedicto XVI. In: Sgreccia E, Laffitte J editors. Proceedings of the 13th General Assembly of the Pontifical Academy for Life. 2007;10-20.

Conscientious Objection and Testimonials in the Field of Bioethics Research

Patricio Lopez Barahona

Extract
Man is a free being who establishes his behaviour and forges his will in a series of ethical and/or religious principles. Loyalty to these principles brings the right and the need of conscientious objection. Man, in his own legitimate exercise of freedom, can and must object to exercising any action that is against or transgresses those principles that his conscience dictate. . .

One should have to distinguish between civil disobedience and conscientious objection. The latter comes from a personal motivation. One person feels that he cannot fulfil a certain juridical regulation because it goes against his/her conscience and moral principles, which are based on faith and on ethical considerations. However, civil disobedience , which can also be founded on conscience motivations, is a type of attitude that pretends to put forward a change or a breach in the law. In case of civil disobedience the law is also considered immoral or unjust. Civil disobedience and conscientious objection can happen together because civil disobedience is considered massive conscientious objection, if not massive, at least very numerous.

Barahona PL. Conscientious Objection and Testimonials in the Field of Bioethics Research. In: Sgreccia E, Laffitte J editors. Proceedings of the 13th General Assembly of the Pontifical Academy for Life. 2007;123-126.

Respect for Conscience in Common Law Countries

Carl Anderson

Extract
The trend toward freedom of religion and conscience has been building over the past centuries. Certainly, the last hundred years have brought a greater tolerance of religious ideas in England, with restrictions on Catholic finally lifted in the early 19 th century, and the United States has, since the late
18th century enshrined religious freedom as a preeminent right. There is thus reason to hope that we may be moving toward a situation in which the precedent will be established that provides a greater understanding and accommodation of the conscience of the individual healthcare provider. However, there is not unanimity of opinion and contradictory decisions about the freedom of conscience in this area continue. “This issue is the San Andreas Fault of our culture,” said Gene Rudd of the Christian Medical & Dental Associations. “How we decide this is going to have a long-lasting impact on our society.”

Challenges to the conscience of a health care professional certainly continue in common law countries, and the current system of dealing with such issues in these countries is far from adequate, or uniform. The problems will only grow as new unethical procedures become seen as “the norm” by some and as a “right” by others. . . . Common law countries certainly have much to do to develop more fully the ideal of a conscience clause for those in the medical field. However, the fact that in most common law countries some accommodation at least seems to be made for the conscience of those in the health care field provides hope.

Anderson C. Respect for Conscience in Common Law Countries. In: Sgreccia E, Laffitte J editors. Proceedings of the 13th General Assembly of the Pontifical Academy for Life. 2007;102-114.

Moral Conscience and Christian Innovation: Elements for a Theological Reading

Brian V Johnstone

Extract
The aim of this article is to answer the question: what are the norms that guide conscience in judging whether a proposed innovation ought to be accepted into the Catholic tradition or not? For the purposes of this article, we need to integrate conscience into a wider theological context that embraces faith, the Church, the tradition of the Church and authority in the Church. The first step in the argument will be to clarify the nature of conscience and its relationship to the elements that have just been mentioned. The second step will be to explain the notion of tradition and the relation between conscience and tradition. In this context I will seek to establish the structures of tradition in relation to the two most basic innovations: the innovation of Creation and the innovation of the Incarnation, Death and Resurrection of Jesus. These, I will suggest, provide the source of the norms for accepting or rejecting other prospective innovations into the tradition.

Johnstone B. Moral Conscience and Christian Innovation: Elements for a Theological Reading. In: Sgreccia E, Laffitte J editors. Proceedings of the 13th General Assembly of the Pontifical Academy for Life. 2007.

Emergency Contraception for Women Who Have Been Raped: Must Catholics Test for Ovulation, or Is Testing for Pregnancy Morally Sufficient?

Daniel P Sulmasy

Abstract
On the grounds that rape is an act of violence, not a natural act of intercourse, Roman Catholic teaching traditionally has permitted women who have been raped to take steps to prevent pregnancy, while consistently prohibiting abortion even in the case of rape. Recent scientific evidence that emergency contraception (EC) works primarily by preventing ovulation, not by preventing implantation or by aborting implanted embryos, has led Church authorities to permit the use of EC drugs in the setting of rape. Doubts about whether an abortifacient effect of EC drugs has been completely disproven have led to controversy within the Church about whether it is sufficient to determine that a woman is not pregnant before using EC drugs or whether one must establish that she has not recently ovulated. This article presents clinical, epidemiological, and ethical arguments why testing for pregnancy should be morally sufficient for a faith community that is strongly opposed to abortion.

Sulmasy DP. Emergency Contraception for Women Who Have Been Raped: Must Catholics Test for Ovulation, or Is Testing for Pregnancy Morally Sufficient? Kennedy Inst Ethics J. 2006;16(4):305-331.

Ethical misconduct by abuse of conscientious objection laws

Bernard M Dickens

Abstract
This paper addresses laws and practices urged by conservative religious organizations that invoke conscientious objection in order to deny patients access to lawful procedures. Many are reproductive health services, such as contraception, sterilization and abortion, on which women’s health depends. Religious institutions that historically served a mission to provide healthcare are now perverting this commitment in order to deny care. Physicians who followed their calling honourably in a spirit of self-sacrifice are being urged to sacrifice patients’ interests to promote their own, compromising their professional ethics by conflict of interest. The shield tolerant societies allowed to protect religious conscience is abused by religiously-influenced agencies that beat it into a sword to compel patients, particularly women, to comply with religious values they do not share. This is unethical unless accompanied by objectors’ duty of referral to non-objecting practitioners, and governmental responsibility to ensure supply of and patients’ access to such practitioners.

Dickens BM. Ethical misconduct by abuse of conscientious objection laws. Med Law. 2006 Sep;25(3):513-522.