Conflicts of Conscience: Hospice and Assisted Suicide

Courtney S Campbell, Jan Hare, Pam Matthews

The Hastings Center Report
The Hastings Center Report

Extract
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.

The Pro-Life Maternal-Fetal Medicine Physician: A Problem of Integrity

Jeffrey Blustein, Alan R Fleischman

The Hastings Center Report
The Hastings Center Report

Abstract
If the practice of maternal-fetal medicine sometimes results in abortion, can a physician strongly opposed to abortion maintain his own integrity and still practice in this field? . . . In the final analysis, we are not persuaded that a physician with strong pro-life convictions can be a participant in the practice of maternal-fetal medicine without betraying her or his integrity. We respect the attempts of thoughtful pro-life maternal-fetal physicians to reconcile their deeply held moral or religious beliefs with their profession’s standards of care, but it may be best for all concerned if individuals with strong objections to abortion avoided the practice of modern perinatal medicine.


Blustein J, Fleischman AR. The Pro-Life Maternal-Fetal Medicine Physician: A Problem of Integrity. Hastings Cent Rep. 1995;25(1):22-26.

Bioethics: Private Choice and Common Good

Daniel Callahan

The Hastings Center Report
The Hastings Center Report

Extract
There is a peculiar and disturbing feature of our times. On the one hand, biomedicine unceasingly extends its power to shape our lives and our culture. . . On the other hand, our protean selves and malleable culture are themselves more wary than ever about responding to that challenge with what might be the only means at our disposal: the search for some coherent, plausible view of what constitutes the good of human beings and their societies. In the absence of such a view, all the real power is in the hands of science, which can decisively bring about fundamental changes even without aiming deliberately to do so. Only an understanding of the self that has substance and direction can fight back, setting its own counteragenda. Choice alone cannot do that. For its part also, a society that itself lacks a compass, devoted only to fostering a minimalist civic accord, is in no less vulnerable a position. If there is no common picture of what biomedicine can do to foster a good human life-if the very question of what constitutes such a life has been banished in the name of pluralism-then that life will be pushed about in ways it is helpless to control, a frail ship that has lost its direction on a stormy, confused sea.


Callahan D. Bioethics: Private Choice and Common Good. Hastings Cent Rep. 1994 May-Jun;24(3):28-31.

Religious Ethics and Active Euthanasia in a Pluralistic Society

Courtney S Campbell

Kennedy Institute of Ethics Journal
Kennedy Institute of Ethics Journal

Abstract
This article sets out a descriptive typology of religious perspectives on legalized euthanasia — political advocacy, individual conscience, silence, embedded opposition, and formal public opposition — and then examines the normative basis for these perspectives through the themes of sovereignty, stewardship, and the self. It also explores the public relevance of these religious perspectives for debates over legalized euthanasia, particularly in the realm of public policy. Ironically, the moral discourse of religious traditions on euthanasia may gain public relevance at the expense of its religious content. Nonetheless, religious traditions can provide a context of ultimacy and meaning to this debate, which is a condition for genuine pluralism.


Campbell CS. Religious Ethics and Active Euthanasia in a Pluralistic Society. Kennedy Inst Ethics J. 1992;2(3):253-277.

The Nurse’s Appeal to Conscience

Ellen W Bemal, Patricia S Hoover

The Hastings Center Report
The Hastings Center Report

Abstract
A case is presented in which a registered nurse caring for a 63-year-old patient in severe pain from terminal cancer disagrees with the attending physician’s order of morphine for fear that it will hasten the patient’s death. The nurse finds herself on duty alone one night when the patient and her daughter request more morphine. Bernal and Hoover contend that, because the nurse apparently took no prior action to explore alternative courses of pain relief for the patient or to make other arrangements for care, her duty of care overrides her appeal to conscience in the immediate situation. Aroskar believes that the nurse in this situation must give the injection, find someone else who can, or contact the physician. She holds, however, that nurses should be allowed to refuse to carry out particular procedures based on an appeal to personal conscience if the decision is founded on accurate information, acceptance of consequences, and advance planning.


Bemal EW, Hoover PS. The Nurse’s Appeal to Conscience. Hastings Cent Rep. 1987;25-26. Available from: