Sunday, August 5, 2018
Today, I'll take a break from controversy. Let's talk about literature.
In 2003 the President’s Council on Bioethics published an anthology about bioethical dilemmas. It was a surprising contribution by a government committee. Such bodies are better known for generating reports which are dismal, dull, dreary and destined for pulping.
The selections in the anthology ranged from J.M. Barrie’s Peter Pan to Plutarch. Not only were they thought-provoking, but also enjoyable. At the time I thought it was the last word in the literature of bioethics, but since then I have discovered other texts.
One of these, which I highly recommend, is the Japanese novel The Sea and Poison, by Shusaku Endo, who, like Graham Greene, was a perpetual also-ran for the Nobel Prize. Endo is better known in the West as the author of Silence, which Martin Scorsese recently made into a film.
Silence was a 1966 historical novel about the apostasy of a Catholic priest in 17th Century Japan. The Sea and Poison, an earlier work published in 1958, is also about tormented consciences. It is based on an incident which happened shortly before the end of World War II, when Japanese doctors vivisected several American POWs. The focus of the story is not the gory procedure, which is described very briefly at the end of the novel, but the inner lives of the doctors and nurses. How could they have allowed themselves to participate in something which was so clearly evil? It’s extraordinarily insightful – and very relevant at a time when we are debating conscientious objection.
The Sea and Poison is out of print in English, but can easily be obtained second-hand on the internet. It’s well worthwhile for anyone teaching bioethics.
In 2003 the President’s Council on Bioethics published an anthology about bioethical dilemmas. It was a surprising contribution by a government committee. Such bodies are better known for generating reports which are dismal, dull, dreary and destined for pulping.
The selections in the anthology ranged from J.M. Barrie’s Peter Pan to Plutarch. Not only were they thought-provoking, but also enjoyable. At the time I thought it was the last word in the literature of bioethics, but since then I have discovered other texts.
One of these, which I highly recommend, is the Japanese novel The Sea and Poison, by Shusaku Endo, who, like Graham Greene, was a perpetual also-ran for the Nobel Prize. Endo is better known in the West as the author of Silence, which Martin Scorsese recently made into a film.
Silence was a 1966 historical novel about the apostasy of a Catholic priest in 17th Century Japan. The Sea and Poison, an earlier work published in 1958, is also about tormented consciences. It is based on an incident which happened shortly before the end of World War II, when Japanese doctors vivisected several American POWs. The focus of the story is not the gory procedure, which is described very briefly at the end of the novel, but the inner lives of the doctors and nurses. How could they have allowed themselves to participate in something which was so clearly evil? It’s extraordinarily insightful – and very relevant at a time when we are debating conscientious objection.
The Sea and Poison is out of print in English, but can easily be obtained second-hand on the internet. It’s well worthwhile for anyone teaching bioethics.
 Michael Cook Editor BioEdge |  |  |  |
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A difficult and controversial ruling viewed from a lawyer’s perspectiveAbortion activists unveil strategy for attacking conscientious objection
by Michael Cook | 4 Aug 2018 | 1 comment
An “expert group” of abortion activists has launched a strong attack on the concept and practice of conscientious objection (CO) in healthcare. “The practice of refusing to provide legal and essential health care due to a doctor's personal or religious beliefs is a violation of medical ethics and of patients' right to health care,” says the International Women's Health Coalition in conjunction with Mujer y Salud en Uruguay.
A 46-page report, Unconscionable: When Providers Deny Abortion Care, argues that “the practice of refusing to provide legal and essential health care due to a doctor's personal or religious beliefs is a violation of medical ethics and of patients' right to health care”. The conclusions of the report are based on a meeting held in Montevideo, Uruguay, last year which brought together 45 participants from 22 countries, including the leading theorist of the attack on CO, Udo Schuklenk, of Queen’s University, in Canada.
To counter-attack against the growth of CO, the report recommends four avenues:
Reframe and rename. Reframe the debate to clarify and emphasize that “conscientious objection” is a misnomer that subverts the ethics, obligations, and standards of the health care profession.Reclaim the concept of conscience. Do not cede the term “conscience” to those who prioritize individual beliefs over professional conduct and the right to access or provide health care. Shine a light on the harmful health consequences of conscience claims in the context of abortion care. Emphasize the “conscientious commitment” and professional conduct of health care providers who prioritize patients’ rights.Quantify the costs incurred by health systems due to claims of “conscientious objection” to abortion. Managing conscience claims can be costly and can create inefficiencies in the allocation of scarce health care resources. Quantifying the costs would fill a gap in our understanding of the consequences of refusal to provide abortion care due to conscience claims.
Renaming is an important part of the activists’ campaign. Instead of “conscientious objection”, they suggest that it be called "refusal to provide services," "denial of services," or even "dishonourable disobedience".
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