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The weight of conscience


President Obama is about to rescind the “conscience rule” the previous president G. W. Bush had instituted. This clause allows health care workers to refuse to do anything that might conflict with their conscience. This means that doctors, pharmacists and other workers in this field refuse  to provide services or to give information about contraception, blood transfusions, abortions, vaccinations and anything else that they may find morally repugnant.

The new administration officials found the conscience rule too broad and are now trying to draw some boundaries. We will have to wait and  see where these lines will be drawn, but the issue raises many questions about a very controversial topic: to what extent can we allow an individual’s conscience to interfere with the lives of others?

Of course, it depends on many factors, but generally we could agree that it’s better if one’s conscience diktats do not harm or damage another person. So, for example, if to me it is morally repugnant to eat meat, I’m absolutely free to be vegetarian but I shouldn’t force other people not to eat animals as well. In the same way, a Jehovah’s witness is totally entitled to refuse a blood transfusion even if this means she will bleed to death, but I don’t believe she has the right to prevent someone else  having a blood transfusion.

But the problem becomes much more complicated when we talk about doctors and other people working in the health care context. These people, when in service, can be involved in morally controversial situations. So which conscience should weigh more when the doctor’s and the patient’s moral senses diverge?

The doctor can express his objection in different ways and with different degrees of intensity.

 Let’s assume for instance that a doctor that believes that the ‘morning-after pill’ is a moral crime and is asked to fill out a prescription for this drug.

He can fill out the prescription thinking to himself that the person in front of him is a murderer.         He can fill out the prescription, but telling the woman that he believes she is a criminal.                   He can refuse to fill out the prescription, referring the woman instead to a willing colleague.             He can refuse both to fill out the prescription and to refer the woman to another doctor.                  He can kidnap the woman for 72 hours, because after three days the morning after pill is ineffective.

In the first case, the conscientious disagreement doesn’t affect the patient at all, the second and the third are more annoying, the fourth is a relevant intrusion in the patient’s life and the last is absolutely unjustifiable.

Of course, many other examples of different levels of disagreement are possible and the last example is just a hypothetical option and not a real legal possibility. But doctors performing abortions have been murdered by pro life activists, proving that people can go to extremes when an issue as controversial as abortion is involved.

On the other hand, the patient  has other options if the doctor refuses to help her.  For example, she can ask another doctor for the prescription. But sometimes the patient has no chance and no alternative. A woman may even be unaware that emergency contraception is an option. So if the doctor refuses to inform her,the damage his conscience produces is immeasurable: he actually forces her to to have to choose an abortion later or to go on with a pregnancy she perhaps doesn’t want.  Alternatively, a woman may not be able to go to another doctor, if for example the surgery is too far from where she lives. Perhaps she doesn’t have the money to travel, or maybe she’s so seriously ill she cannot travel, and so on.

Allowing doctors to refuse to inform patients about contraception (and emergency contraception) and allowing refusal to refer patients to a willing colleague means allowing the doctor to effectively decide about something he cannot decide about.                                                                          Our own consciences weigh heavily when we make life changing decisions. But we should make our consciences as light as possible when we are dealing other people’s life changing decisions.










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2 Comment on this post

  1. Michelle Hutchinson

    I disagree with your point regarding vegetarians. If a person merely dislikes the idea of eating meat themselves, then it is just as you say an exclusively personal choice. However, if they genuinely believe that eating meat is wrong, whether because they think it is unjustifiable to harm innocent sentient creatures, or because they think the environment is greatly damaged by doing so, they should want vegetarianism to be extended to other people. At this point it is relevant what you mean by ‘force’. Perhaps the values that a vegetarian thinks are contravened by eating meat are not as important to them as the ones that would be contravened by using physical violence against people attempting to eat meat. But I would have thought that in many cases their conscience should prompt them to try to persuade others around them not to eat meat, and even to try to get laws enforced banning meat consumption, which would force others to comply with their conscience. After all, if eating meat is like murder, or is ruining the planet, surely it should be illegal?

    Also, you say that kidnapping the woman for three days so she can’t use the morning after pill is absolutely unjustifiable. While I fully agree that from my perspective this would be a ridiculous thing to do, I’m not sure it can be called absolutely unjustifiable. If the doctor believed that life began at conception, and that the morning after pill might stop implantation of a blastoplast, he could justify his abduction of the woman by saying that he was saving the life of the baby inside her. If a murderer could be stopped from murdering a person by abducting them for three days, most people would think doing so justifiable (if there were no other ways).

  2. Michelle, wanting vegetarianism (or anything else) to extend to other people, and forcing it upon them, are 2 very different things. My concern with the way things are going with the current administration is that we are losing, bit by by, our freedom to choose anything for ourselves, and instead must merely accept what those in places of power tell us.

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