Research Centre Publications Archives - Page 2 of 4 - Protection of Conscience Project Library

Conscience Rules: Implications for Care

Ryan Blum

Extract
On February 18, the Department of Health and Human Services issued a rule, “Regulation for the Enforcement of Federal Health Care Provider Conscience Protection Laws,” that limits health care providers’ power to shape their practice by personal conviction. The rule narrows possible conscientious objection significantly, protecting patients’ rights and in the process eliminating public reinforcement of the harmful idea that religion and medicine are always destined to diverge.

Blum R. Conscience Rules: Implications for Care. Hastings Cent Rep 2011;41(3):c3.

(White Paper) Emergency Contraceptives & Catholic Healthcare: A New Look at the Science and the Moral Question

Thomas V Berg, Marie T Hilliard, Mark F Stegman

Emergency Contraceptives & Catholic Healthcare, Westchester Institute

Conclusion
Concern that provision of emergency contraceptives might occasion the chemical abortion of nascent human life is not only legitimate, but also a genuine expression of the solidarity and stewardship we owe to the most vulnerable members of our society. Catholic moral theologians currently disagree on how that legitimate concern should bear on the formulation of EC protocols in Catholic hospitals. We maintain that, in addition to a pregnancy test, victims of sexual assault should be administered an ovulation test which detects the presence of an LH surge. We sincerely hope that the present study will contribute to the continued substantive discussion of this issue among Catholic moralists. We further trust that it will serve to foster a more cautious approach within the Catholic healthcare establishment to unreasonable incursions by the state that strike at our principled institutional autonomy and identity, and at the very exercise of conscience in Catholic healthcare

Berg TV, Hilliard MT, Stegman MF. (Working Paper) Emergency Contraceptives & Catholic Healthcare: A New Look at the Science and the Moral Question. 2011;2(1)

In Search of a Wide-Angle Lens

Harold Braswell

Extract
That bioethicists had written hundreds of thousands of pages on “autonomy” without writing one article about its relation to subcontracting seemed, by the end of class, an indication that the field had misunderstood its own premises. The goal of bioethics in the next forty years should be to guarantee that such fundamental misunderstandings do not occur. This will happen by stopping the search for new topics and instead becoming more reflective about our methods and more proactive in building institutions that can produce thinkers with the sensitivity and analytical skills to realize the field’s founding ideals. Doing so will require redefining the contours of not only the field, but also our own identity as professionals.

Braswell H. In Search of a Wide-Angle Lens. Hastings Center Report. 2011;3(June):19-21.

A Not-So-New Eugenics: Harris and Savulescu on Human Enhancement

Robert Sparrow

Abstract
John Harris and Julian Savulescu, leading figures in the “new” eugenics, argue that parents are morally obligated to use genetic and other technologies to enhance their children. But the argument they give leads to conclusions even more radical than they acknowledge. Ultimately, the world it would lead to is not all that different from that championed by eugenicists one hundred years ago.

Sparrow R. A Not-So-New Eugenics: Harris and Savulescu on Human Enhancement. Hast Cent Rep. 2011 January-February;32-42.

Plan B and the Doctrine of Double Effect

Rebecca Stangl

Extract
An appeal to the doctrine of double effect supposes that the end aimed at is morally good. I claim that women who use emergency contraception need only intend the contraceptive effect of the medication, and not any possible abortifacient effect it may have. If one denies that even the former is a permissible end, then the doctrine of double effect makes no difference.

Stangl R. Plan B and the Doctrine of Double Effect. Hastings Center Report. 2009 Jul-Aug;39(4):21-5.

Martin Luther at the Bedside

Nancy Berlinger

Extract
Media coverage of conscientious objection tends to cast the refusing health care provider in the role of Martin Luther at the Diet of Worms: Here I stand, I can do no other (emphasis on the “I”). Commentators also do this, parsing the rights and responsibilities (but mostly the rights) in a dyadic relationship: Providers versus patients. Paternalism versus autonomy. “I believe” versus “I want.” . . .

Conscientious objection in medicine is not merely a right to be invoked at the bedside, nor a problem to be held in check through a pro forma conscience clause. Rather, [David H] Smith reminds us, openly discussing the nature of providers’ moral objections, while keeping the needs of the suffering person
uppermost, is a “difficult and unglamorous” communal
responsibility of “morally serious people.” Amen.

Berlinger N. Martin Luther at the Bedside. Hastings Cent Rep. 2007;37(2).

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.

Scope Note 46: Pharmacists and Conscientious Objection

Richard M Anderson, Laura Jane Bishop, Martina Darragh, Harriet Hutson Gray, Anita Nolen,Susan Cartier Poland

Extract
The literature and online resources cited below include (1) policy statements and codes by professional organizations; (2) review essays on conscientious objection in health care and articles on the current debate regarding the field of pharmacy; and (3) legal perspectives and cases.

Anderson RM, Bishop LJ, Darragh M, Gray HH, Nolen A, Poland SC. Scope Note 46: Pharmacists and Conscientious Objection. Kennedy Inst Ethics J. 2006;16(4):379-396.

Two Cheers for Conscience Exceptions

Adrienne Asch

Abstract
The pharmacist who wants her integrity and self-conception to be respected must accord respect to the woman whose views about sex, life processes, and parenthood differ from her own by courteously offering her own rationale and a referral.

Asch A. Two Cheers for Conscience Exceptions. Hastings Cent Rep. 2006;November-December):11-12.

Pharmacies, pharmacists, and conscientious objection

Mark R Wicclair

Abstract
This paper examines the obligations of pharmacy licensees and pharmacists in the context of conscience-based objections to filling lawful prescriptions for certain types of medications-e.g., standard and emergency contraceptives. Claims of conscience are analyzed as means to preserve or maintain an individual’s moral integrity. It is argued that pharmacy licensees have an obligation to dispense prescription medications that satisfy the health needs of the populations they serve, and this obligation can override claims of conscience. Although efforts should be made to respect the moral integrity of pharmacists and accommodate their claims of conscience, it is argued that the health needs of patients and the professional obligations of pharmacists limit the extent to which pharmacists may refuse to assist patients who have lawful prescriptions for medically indicated drugs.

Wicclair MR. Pharmacies, pharmacists, and conscientious objection. Kennedy Inst Ethics J. 2006;16(3):225-250.