The subtle line between conscientious objection and sabotage

The Washington Post recently reported the news of a dozen of nurses from a New Jersey hospital who claimed the right not to assist a patient before and after an abortion.                                                                                                                                                                   Although conscience clauses are very common worldwide, they usually allow the health care personnel to refuse to perform abortions (or other morally controversial treatments) but not to refuse to assist a patient before and after the abortion. For this reason, the request put forward by the New Jersey nurses is particularly interesting.One of these nurses declared to the newspapers “I’m a nurse so I can help people, not help kill, and it just doesn’t seem right to me”. Now, it is hard to understand how someone who takes care of a woman who just had an abortion is somehow helping to kill. The care these nurses are refusing to provide involves feeding and washing the patient, maybe giving her pain killer drugs, but certainly not helping to kill, because the killing happens during the abortion, not before or after.

If there is one valid argument in favour of conscientious objection, it is based on the refusal to be an accomplice in abortion, that is a refusal to make the abortion somehow possible, participating directly or indirectly to the causal chain of events that will bring to that precise outcome. So for example, someone who strongly encourages a woman to have an abortion can be considered an accomplice, just like someone who gives her RU486. Although I do not consider complicity in wrongdoing a valid argument to justify the refusal to perform an abortion, I consider it a reasonable argument for someone who refuses  to become a doctor, or a nurse on this basis. By this I mean that whoever does not feel like being involved in activities she considers immoral, but which are legal, safe and beneficial, should opt for a career that does not require her to be an accomplice of a patient who needs such a treatment. Therefore, people who do not want to perform abortions should not become gynaecologists or obstetricians, but could become dentists or geriatricians etc. Nevertheless, I was interested in understanding why these nurses were refusing to take care of patients before and after the abortion, and then I remembered that, at least according to the Catholic Church, an accomplice is also a person who does not prevent someone from doing something “wrong”. This seems to explain why the New Jersey nurses refuse to assist patients before and after the treatment. It can be that they feel a moral obligation to boycott abortion  as such, regardless of their actual complicity, making it more difficult both psychologically and practically. These nurses maybe want to express their disapproval of this treatment by refusing to have anything to do with women who choose it (something that could make feel women like they do not deserve to be taken care of), and they also try to make it practically more difficult to realize it because the hospital needs to find willing nurses.  So the question, in this case, is not “should nurses be entitled not to be accomplices in abortion?”  (which is the classic question related to conscientious objection in medicine) but rather “should nurses be entitled to sabotage abortion just because an activity they consider immoral?”.In the first case nurses ask to be allowed to refuse to take part in abortions, but in the second case they ask to be entitled to sabotage it.

I cannot find a valid reason for allowing a nurse to sabotage abortion by refusing to assist patients before and after the treatment itself. Nurses are there to help, as they seem to know, not to thwart anybody’s plans or to impose their personal views to their patients. If they think that sabotaging abortion is their moral duty then they should be legally required to resign and opt for a different career.

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7 Responses to The subtle line between conscientious objection and sabotage

  • Theo says:

    I think I also mentioned this in the last conscientious objection post: some sensitive professions, such as those in the army, health care and high rank political offices, must have their rules for CO reviewed.

    If a nurse can do what those did, I don't see any legal hindrance for a soldier doing the same as regards killing enemies, or a president giving a veto on abortion laws approved by the senate. This extends also to teachers denying to present the theory of evolution and cooks refusing to prepare meat dishes.

    In a world where religious and ideological positions are not only increasing in variety, but are also becoming more and more untouchable by the law, addressing the issue of conscientious objection and putting limits to it is indeed an important matter.

    As for the morality of the problem: nurses and doctors are hired to do their jobs. Whether their agree with it or not must not affect their work. If they do not agree with the procedures, they should have chosen a professional field in which their religious allegiances would not be put into question, such as gardening (no offense intended. I like gardening myself). Such actions should not even be allowed in a secular society.

  • G. Owen Schaefer says:

    Francesca, is your objection A) complicity in wrongdoing, in general, cannot justify refusing to carry out professional duties; B) complicity in something one believes to be wrong cannot justify refusing to carry out professional duties; or C) neither A nor B are generally/universally true, but there is something particular about abortion that makes complicity arguments unsound? Option A seems problematic; it would seem to imply that professional duties trump moral ones. It commits one, e.g., to permitting soldiers to assist with massacres when ordered, or factory workers to dump toxic sludge into rivers when required by their superiors. I think it is still implausible if we restrict it to legally permissible professional duties; it may be, e.g., that due to a corrupt/ineffective legal system, the sludge-dumping is not illegal.

    B is rather plausible; it helps rule out the sort of cases Theo mentions like teachers refusing to teach evolution. But if B is true while A is not, the central question becomes – are the nurses correct in their judgment that abortion is wrong? Perhaps this is the crux of the whole conscientious objection debate anyway. Something similar could be said of teachers’ refusal to teach evolution (or refusal to omit teaching creationism); compare this to a teacher’s refusal to teach creationism/intelligent design. The latter, many of us would think, is not at all problematic, while the former is. This is because we (or at least many of us) view evolution to be a valid scientific theory, while creationism not scientifically plausible, or scientific at all – it is essentially a religious theory (and teachers should only teach valid scientific theories, not religious ones, in science class).

    If C, it would be useful to know what makes abortion (or perhaps healthcare) unique, and how the argument goes.

  • Francesca says:

    I wrote a long reply but something went wrong uploading it. I basically said that I agree with the second option. If treatments are safe and beneficial they should be performed, because in these cases professional duties should trump moral ones. I agree that if someone were asked to e.g torture a patient, she would be entitled to refuse, because the treatment is not beneficial or safe.

    • Julia says:

      I don't think the litmus test should be whether the procedure is safe and beneficial, since that judgement is subjective. What makes professional duties to perform abortions trump moral ones is how the people and the courts have ruled on this issue, and the law says women have a right to abortion. If these nurses are opposed to abortion, they should become anti-abortion activists and try to pass laws outlawing abortion. They should not take advantage of their private professional positions to obstruct women accessing their state sanctioned rights.

      • Theo says:

        "What makes professional duties to perform abortions trump moral ones is how the people and the courts have ruled on this issue".

        I had never thought on the matter in this way, thank for the insight! I actually solves a lot of problems.

  • Peter Wicks says:

    I don't agree that the nurses aren't helping to kill by assisting patients after the abortion. By doing so they are encouraging a practice that they consider to be immoral, and indeed murderous. Knowing that you are going to be assisted by nurses after the abortion presumably makes the whole idea more palatable, so it is perfectly reasonable for the nurses to claim that they are helping to kill. It seems to me disingenuous to reassure them on the grounds that the baby is already dead.

    Mor am I convinced that the fact that "the people and the courts have ruled on this issue" can be considered a conclusive argument in the context of an ethical debate. Ethicists are also peopleand we may wish to influence people's judgement – and by extension the laws of the land and behaviour of the courts – on this matter. I am not saying that the hospital was wrong to change it's policy (though I would be interested to know why it did), but it does seem to me that it is reasonable to want to be a nurse or doctor without wanting to take part in certain practices, and that it's at least not bad for society to try to accommodate this where reasonable. Nor is the analogy with soldiers killing people a fair one: killing is obviously an integral part of being a soldier, in a way that assisting with abortions is not an integral part of being a nurse or doctor. There are plenty of other things one can do and still be a nurse or doctor – even a gynaecologist.

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