GESTIÓN EN SALUD PÚBLICA: A halfway house in the conscientious objection debate

sábado, 4 de marzo de 2017

A halfway house in the conscientious objection debate

A halfway house in the conscientious objection debate

by Xavier Symons | 4 Mar 2017 |

Conscientious objection has come under fire recently, and several leading bioethics journals have published articles criticising healthcare professionals who object to participation in controversial procedures.

The latest addition to the literature, an article published online first in the Journal of Medical Ethics this week, criticises “conscience absolutists” who suggest that even the most remote forms of cooperation in pregnancy termination constitute licit grounds for conscientious objection.

In his article “Conscientious objection in healthcare and the duty to refer”, University of Dublin bioethicist Christopher Cowley argues in favour of current UK abortion regulations, which permit conscientious objection, though only under certain conditions. NHS guidelines allow clinicians to abstain from participation in terminations, but nevertheless requires them to provide “reliable information” to patients about abortion services they could use.

Against “conscience absolutists”, Cowley argues that objecting doctors, as representatives of the NHS system, have a duty provide “reliable information” to patients about abortion services. Importantly, he argues that mere provision of information does not constitute formal cooperation in the procedure.

“the provision of information is not a necessary or indispensable link in the chain of actions leading to the abortion, since, after receiving the information, the patient leaves the NHS space and becomes a free agent, ready to make her...own decisions.”

Cowley argues that abortion is a “contestable” ethical issue, in the way that something like the Rawandan geocide was not.

In light of the reasonable disagreement that we have over abortion, conscientious objectors must acknowledge the rights of healthcare professionals and indeed patients, to act in accord with their ethical beliefs about pregnancy terminations.

“...the [objecting] GP also has to ﬁnd a way to embrace (not just tolerate) this pluralism if she is to cooperate fully with her non-objecting colleagues and managers, and if she is to treat her patients with her full concern despite their deep moral disagreement”.

While Cowley offers a criticism of conscience absolutists in this article, he has in the past criticised those who argue that doctors must refer patients to abortionists.

Parramatta is just 20 minutes west of the BioEdge office. It’s not a city which has made a huge mark on the world, although not long ago an ISIS-inspired teenager shot dead a police employee and ended up dead himself. It has a lot of historic buildings from the colonial era, surrounded by high rise office buildings, drab shops and a huge park.

A few weeks ago the park hosted Tropfest, billed as the world’s largest short film festival. The crowds watched the films on huge screens as they picnicked on the grass. I was amazed that the winner was a 7-minute film about euthanasia, “The Mother Situation”. With excellent acting and snappy dialogue, it is a brilliant black comedy. Three adult children are delighted to hear that their mother wants to be euthanised – but then she changes her mind.

The director, Matt Day, says that it is not an anti-euthanasia film, but I haven’t seen anything which illustrates more vividly the danger of elder abuse. Sure, it’s absurd and a bit unrealistic but it sends a powerful message. Check it out.