During an election fought over the Obama administration’s health care law, the nature and limits of conscientious objection are lively topics. Not being an expert in these things, I thought that I had heard all the arguments on both sides. An editorial in a recent issue of the New England Journal of Medicine has proved me wrong.
Dr Lisa Harris, a feminist bioethicist, argues that conscientious provision is a seriously neglected topic. She paints a picture of heroic, dedicated abortion providers braving social stigma and the scorn of their colleagues.
“Moral integrity can be injured as much by not performing an action required by one’s core beliefs as by performing an action that contradicts those beliefs,” she writes. Doctors who break American abortion laws are just as heroic as anti-abortion protesters. Why should doctors who refuse to cooperate bask in the glory of being goody-goody two-shoes? Why not doctors who act in accordance with deeply held principles and provide abortions?
Not all abortion providers are saints. The name of Philadelphia doctor Kermit Gosnell springs to mind as loathsome blot on Dr Harris’s glowing hagiography. However, I can’t deny that there must be dedicated abortion providers who strongly believe that they are doing an honourable thing. But is this enough? Since when are our decisions validated by the sheer strength of our core beliefs? What about women who provide genital mutilation for young girls? They, too, have strong convictions about the necessity and righteousness of their craft.
Dr Harris’s arguments are weak, but they are straws in the wind. The debate about conscientious objection is changing. Until now the question has been: who is in the right? But her logic leads her to the nihilistic conclusion that right and wrong may no longer matter: the notion of conscience may be a nonsense which “leaves us all with no moral ground (high or low) on which to stand”.
I find this ominous. If moral questions cannot be settled with reason, they will be settled on arbitrary grounds by the power of the state — which is tyranny. Even more ominous, perhaps, is the fact that the NEJM esteemed her views so highly. Comments?
Are we heading towards ethical nihilism?
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