QED

When the Prescription is a Lynching

noose doc smallIt comes as a surprise to see a group of philosophers demanding that doctors be forced to “provide public-benefitting services”. Philosophers? Telling doctors to do something useful?

The context of this extraordinary piece of advice is a ‘Consensus statement on conscientious objection in healthcare’, issued by a group of fifteen philosophers and bioethicists. It builds on a long campaign by one of them, Julian Savulescu, to ban from the public health system doctors and nurses who conscientiously object to performing certain procedures, such as abortion and euthanasia (reported in the August 25 edition of the Sydney Morning Herald beneath the headline ‘Bioethicist calls for a ban on doctors’ conscientious objection’).

The essence of the document’s reasoning is contained in its opening paragraph:

“Healthcare practitioners’ primary obligations are towards their patients, not towards their own personal conscience. When the patient’s wellbeing (or best interest, or health) is at stake, healthcare practitioners’ professional obligations should normally take priority over their personal moral or religious views.”

That states the issue in exactly the wrong way. The opposition “patient’s interest” versus “personal conscience” is a false one, because the conscientious objectors take a different view of what is in the patient’s best interest, and they have reasons for doing so. Like any doctors, they are motivated by a desire to help patients. They believe that the procedures they refuse to perform are destructive of the patients’ interests, sometime destructive of the patients themselves. So they refuse to perform those operations. To contrast their concern for patients with “personal moral or religious views” is to wilfully misunderstand their motivations.

In the present environment, as codified in documents such as the Australian Nursing and Midwifery’s policy on conscientious objection, health professionals who object do not have an easy time but their position, in theory, is protected from retribution. The “consensus document” criticises the present “cost-free environment” and proposes the imposition of sanctions. That is where the demand that objecting doctors should compensate society by “providing public-benefitting services” comes in. They should also face tribunals to “test the sincerity, strength and the reasonability of healthcare practitioners’ moral objections”. Hiring authorities should be able to favour non-objecting doctors.

It is true that objectors should give some substantial reason for their refusal to perform procedures. “I don’t like it” or “It’s against my religion” won’t cut it. But everyone knows who the objectors mostly are – they are Catholics and other Christians who rely on a developed natural law philosophy of the intrinsic and irreducible worth of persons. It’s a debatable philosophy, but mere “personal belief” it isn’t. The reasons for it are public and long defended, and the tribunals that Savulescu demands to enforce conformity can consult the reasons instead of interrogating the recalcitrant doctors one by one.

The talk of tribunals and sanctions for “failure to fulfil professional obligations” prompted some excitable commenters on the blog post of the “Consensus Document” to reach for Nazi analogies. That is unhelpful, and in any case there are more contemporary analogies available that give an insight into why conscientious objection by doctors has its merits. Certain societies regard is as a professional obligation on doctors to perform genital mutilations; other societies, to remove usable organs from condemned “criminals”. Certain doctors object that those “obligations” conflict with the point of being a doctor, which is to benefit patients. Those doctors are given a hard time. It should not be allowed to happen here.

It would be easy to dismiss the group claiming a “consensus” as a crackpot fringe. Indeed, two of the signatories are Alberto Giubilini and Francesca Minerva, who created a stir in 2012 with their article defending “after-birth abortion”, whileSavulescu himself has advanced such “daring” theses as that it is morally obligatory to clone embryos for spare parts. Those ideas have not gained traction and are not likely to. But two of the other signatories are Jeanette Kennett, president of the Australasian Association of Philosophy, and Justin Oakley, for many years director of Monash University’s Centre for Human Bioethics. Savulescu is editor of the Journal of Medical Ethics. This is serious.

The “consensus document” ends with one last condescending piece of advice: “Healthcare practitioners should also be educated to reflect on the influence of cognitive bias in their objections.” (I am rational, you exhibit cognitive bias.) If the authors had engaged in some of that reflection themselves, they would not have so misrepresented the doctors they propose to bully.

James Franklin set up the Australian Database of Indigenous Violence

10 comments
  • nfw

    Isn’t funny, when “progressives” want something, somebody else has to do their dirty work? “Progressives” don’t bully, they lead Les Deplorables to better brighter futures. I’m sure that’s what Stalin and Lenin had in mind when murdering millions and having public works constructed by “criminals” in the gulags.

  • RayB

    You can bet your life savings on the fact these same bioethecists would be very strongly supporting conscientious objectors if it came to drafting young men into the armed forces.

  • Meniscus

    While you may think it’s excitable, the similarities between this doctor and the Mengele/Eichmann operation are there – compelled death. We are quickly forgetting the lessons of the past:

    https://themarcusreview.com/2016/09/19/how-quickly-we-forget/

  • gary@feraltek.com.au

    Are they saddened by their own mother’s decision?

  • pawelek@ozemail.com.au

    It is interesting to compare the state of things with the story of Stanislawa Leszczynska, who was a prisoner of Auschwith-Birkenau and worked there as a midwife (one check “The Report of a Midwife from Auschwitz”), who stood up to her superior (one must not kill any baby, he should know best, as a doctor you made an oath ) defied orders and did not perform even a single abortion, assisted at/delivered around 3000 babies in A-B, not a single death. Most died later, only about 30 survived under the of their mothers’ care, a couple of hundred were sent away to be germanised (these blond, blue eyed…).
    Oh, this superior’s name was: Mengele.
    She died in early seventies, now on the way to (Catholic) sainthood.
    So, today, how do we compare?

    • acarroll

      Hang on, Auschwitz was an extermination camp, was it not? I’m surprised that they even allowed any women to give birth at all — that’d be a total waste of time? Likewise a hospital!

      Confused!

  • Salome

    I think ‘It’s against my religion’ should be sufficient–as long as you can then demonstrate that the objection is indeed consistent with the teachings of that religion. I don’t expect a doctor to be a philosopher or theologian. Where the doctor belongs to a church group that has a wishy washy policy on these issues, however, it may require a bit more for the doctor to demonstrate that his or her view is deliberately and consciously ‘orthodox’ or ‘old-fashioned’. Further, just about any branch of medical or surgical endeavour that is the subject matter of bioethics should be open to conscientious objection. The objections, however, should be on the table so that such a practitioner is, in the ordinary course, never approached to perform the procedure. For example, with the iniquitous Victorian law that not only did away with the crime of child destruction, but also made it compulsory for medical practitioners to participate in the abortion industry by referring patients to a provider, there should have been an option of advertising ‘we don’t do abortions or refer to abortion providers–if you require such services please consult Dr X at [address]’ (and a requirement not deliberately to lead prospective patients in circles from one objector to the next and so on). But, no, if you want to practice medicine in Victoria, you’ve got to be part of the abortion industry, even if only by referral.

  • kingkate@hotmail.com

    You forget science. The Catholic Church has always opposed abortion but it hardened in line with science. The evidence that the unborn is a person is fairly strong – it has its own DNA, and at 22 weeks can survive if born premature etc. There is much more to the evidence than those points… What doctors are being asked to do is turn their backs on science (the science is that the unborn is a human life which when disposed of have their own gender), as well as their conscience. BTW it is morally wrong to murder someone and this is reflected in NSW and Queensland legislation where abortion is considered a criminal act. The above decree removes the notion of science taking the medical profession back to the dark ages. As for the philosophy…well that is highly debatable particularly when it comes to human life. “I think therefore I am”. Abortion is a tragic example where shakey philosophy has trumped truth and science.

  • mags of Queensland

    I wonder whether these crackpots sit around all day,dreaming up some other ridiculous fantasy that is swallowed by the gullible. The main game is the survival of the species. These days, life is just trivialized in the quest for some other means of getting a high.

    As for the abortion argument. Why do Australians have to go overseas to get a child when there are women, for whatever reason and too stupid to practice birth control, who want to abort their babies – some late stage pregnancy. Had these women one ounce of humanity they would give that child up for adoption to someone who wants it. Pandering to the argument that a woman has control of her body neglects to add that she is therefore responsible for what happens to it – no one else!

  • whitelaughter

    Perhaps instead remove the right to refuse to perform a vivisection on Savulescu and friends would be more useful? And then order it performed by any doctor who supports the removal of freedom of choice?

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