Bad, Bad Doctors (Religious, with Consciences)

The NEJM has a free on line article evaluating the results of a survey of doctors, "Religion, Conscience and Controversial Clinical Practices," which is a perfect example that far too much of the effort of "medical ethics" or "bioethics," goes into deciding who can be killed.

"In recent years, several states have passed laws that shield physicians and other health care providers from adverse consequences for refusing to participate in medical services that would violate their consciences. For example, the Illinois Health Care Right of Conscience Act protects a health care provider from all liability or discrimination that might result as a consequence of "his or her refusal to perform, assist, counsel, suggest, recommend, refer or participate in any way in any particular form of health care service which is contrary to the conscience of such physician or health care personnel." In the wake of recent controversies over emergency contraception, editorials in leading clinical journals have criticized these "conscience clauses" and challenged the idea that physicians may deny legally and medically permitted medical interventions, particularly if their objections are personal and religious. Charo, for example, suggests that the conflict about conscience clauses "represents the latest struggle with regard to religion in America," and she criticizes those medical professionals who would claim "an unfettered right to personal autonomy while holding monopolistic control over a public good." Savulescu takes a stronger stance, arguing that "a doctor's conscience has little place in the delivery of modern medical care" and that "if people are not prepared to offer legally permitted, efficient, and beneficial care to a patient because it conflicts with their values, they should not be doctors.""

"If physicians' ideas translate into their practices, then 14% of patients — more than 40 million Americans — may be cared for by physicians who do not believe they are obligated to disclose information about medically available treatments they consider objectionable. In addition, 29% of patients — or nearly 100 million Americans — may be cared for by physicians who do not believe they have an obligation to refer the patient to another provider for such treatments. The proportion of physicians who object to certain treatments is substantial. For example, 52% of the physicians in this study reported objections to abortion for failed contraception, and 42% reported objections to contraception for adolescents without parental consent."

Not surprisingly, these "controversial" "legal" practices are abortion "for failed contraception," giving "birth control to teenagers between the age of 14 and 16 if their parents do not approve," and "sedation to unconsciousness in dying patients." For some reason, the authors do not give results or even discuss the other "Controversial Issues in Medicine": Physician assisted suicide, withdrawal of artificial life support or abortion for congenital anomalies.



First, "elective" abortion is neither mandatory nor beneficial.

Second, I guess that the first discussion must be whether or not "legal" implies that a practice is necessarily "beneficial," moral, or required.

Third, the legality of providing contraceptives to minors under the age of consent, against their parents' wishes, is questionable, except in Federally funded clinics, where it is mandated under Title X funding for Family Planning clinics.

Fourth, it is illegal in most states to participate in "Physician Assisted Suicide."

And fifth, the "monopolistic control" is distraction. Are all professionals who are licensed by the government required to do whatever is demanded of them by whomever can use their services? Let's see: architects, engineers, all those media types?

If so, I'd like to ask Alta Charo - who, after all is a licensed lawyer, working for a State University that receives Federal funds - to give me some good, solid quotes that do not advocate the taking of human life or the defamation of those of us who act on our convictions.





Take a look at the survey and the article. Take the survey.

Do you agree with the "bioethicists" quoted in the introduction?