Protection of Conscience Project Library
Service, not Servitude
Abstract
The duty of care is a fundamental principle of medicine that should be at the heart of the debate surrounding Planned Parenthood and fetal tissue research. And that duty includes taking advantage of avenues of hope for current and future patients.
Charo RA. Fetal Tissue Fallout. N Engl J Med. 2015 Sep 03;373(10):890-891. Available from:
Extract
Public health officials may have legitimate questions about the merits of HPV vaccine mandates, in light of the financial and logistic burdens these may impose on families and schools, and also may be uncertain about adverse-event rates in mass-scale programs. But given that the moral objections to requiring HPV vaccination are largely emotional, this source of resistance to mandates is difficult to justify.
Charo RA. Politics, Parents, and Prophylaxis — Mandating HPV Vaccination in the United States. N Engl J Med. 2007 May 10;356(19):1905-1908.
Extract
Conscience is a tricky business. Some interpret its personal beacon as the guide to universal truth and undoubtedly many of the health care providers who refuse to treat or refer or inform their patients do so in the sincere belief that it is in the patients’ own interests, regardless of how those patients might view the matter themselves. But the assumption that one’s own conscience is the conscience of the world is fraught with dangers. As C.S. Lewis wrote, “of all tyrannies, a tyranny sincerely exercised for the good of its victims may be the most oppressive. It would be better to live under robber barons than under omnipotent moral busybodies. The robber baron’s cruelty may sometimes sleep, his cupidity may at some point be satiated; but those who torment us for our own good will torment us without end for they do so with the approval of their own conscience.”
Charo RA. Health care provider refusals to treat, prescribe, refer or inform: Professionalism and conscience. Advance J ACS Issue Groups. 2007 Spring 1:119-135.
Extract
With regard to Dr. Lee’s comment that the proposed Wisconsin legislation does not eliminate a health care provider’s duty to provide a referral after refusing to perform a service, I would note that Assembly Bill 207 . . . specifically permits health care providers’ refusals to “participate in” services they find personally objectionable, with “participate in” specifically defined . . . as “to perform; practice; engage in; assist in; recommend; counsel in favor of; make referrals for; prescribe, dispense or administer drugs”.
Charo RA. (Correspondence) The Celestial Fire of Conscience: Prof. Charo Replies. N Engl J Med. 2005 Sep 22;353(12):1302.
Extract
Real medical care and services always respect human
life. No one should be forced to collaborate in abortion (even when it is achieved through the prevention of implantation), lethal research on embryos, euthanasia, or assisted suicide.
Castro O, Lombardo FA, Gordeuk VR. (Correspondence) The Celestial Fire of Conscience. N Engl J Med. 2005 Sep 22;353(12):1301.
Responding to: Charo RA. The Celestial Fire of Conscience – Refusing to Deliver Medical Care N Eng J Med 352:24, June 16, 2005
Extract
It is especially noteworthy that, in an essay about the exercise of freedom of conscience by health care workers, Professor R. Alta Charo has virtually nothing to say about freedom or conscience (The Celestial Fire of Conscience- Refusing to Deliver Medical Care. N Eng J Med 352:24, June 16, 2005). “Conscience clauses,” yes: conscientious objection, to be sure: and she mentions acts of conscience and the right of conscience. But nothing about freedom, and, on the subject of conscience itself, the most she can muster is, “Conscience is a tricky business.”
Murphy S. The Silence of Good People and Non-cooperation with Evil: A Response to Prof. R. Alta Charo [Internet]. Protection of Conscience Project; 2005 Aug 19.
Abstract
Apparently heeding George Washington’s call to “labor to keep alive in your breast that little spark of celestial fire called conscience,” physicians, nurses, and pharmacists are increasingly claiming a right to the autonomy not only to refuse to provide services they find objectionable, but even to refuse to refer patients to another provider and, more recently, to inform them of the existence of legal options for care.
Charo RA. The Celestial Fire of Conscience — Refusing to Deliver Medical Care. N Engl J Med.. 2005 Jun 16;352(24).