Conscientious objection is becoming more and more prominent in bioethical discussion, according to an article in the Washington Post. Growing religious fervour and the introduction of controversial new medical technologies are beginning to collide. “This issue is the San Andreas Fault of our culture,” said Gene Rudd of the Christian Medical & Dental Associations. “How we decide this is going to have a long-lasting impact on our society.”

Most conflicts are handled discretely, but often an explosive confrontation is possible, either because health care workers feel that they are being forced to act against deeply-held values or because they chafe under restrictions in a morally conservative institution.

Supporters of conscientious objection compare their view to conscientious objections to the Vietnam War and the recent refusal of anaesthetists in California to participate in executions. “Why is it that some people would have no compunction in forcing a doctor to participate in an abortion, but if it’s painful death by lethal injection, they suddenly find religion?” asked Lynn D. Wardle of Brigham Young University’s J. Reuben Clark Law School.

Referring patients elsewhere is always a tricky issue. Should a doctor who opposes abortions be forced to tell patients where they can get one? “Think about slavery,” said physician William Toffler of the Oregon Health and Science University in Portland. “I am a blacksmith and a slave owner asks me to repair the shackles of a slave. Should I have to say, ‘I can’t do it but there’s a blacksmith down the road who will?’ ”

However, bioethicists of a utilitarian persuasion argue that a health care worker’s first responsibility is do what they are asked. “As soon as you become a licensed professional, you take on certain obligations to act like a professional, which means your patients come first,” said R. Alta Charo, a bioethicist and lawyer at the University of Wisconsin at Madison. “You are not supposed to use your professional status as a vehicle for cultural conquest.”

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Michael Cook

Michael Cook edits BioEdge, a bioethics newsletter, and MercatorNet, an on-line magazine whose focus is human dignity. He writes from Sydney, Australia.

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