Doctors are ‘professionals’ and should leave religion out of it
by Michael Cook | 15 Sep 2019 |
As if to illustrate Rosamond Rhodes’s thesis (see other BioEdge article), Udo Schuklenk argues, also in the Journal of Medical Ethics, that doctors should not use religious language and considerations in their advice to patients. They are obliged to communicate “by means of content that is expressed in public reason-based language” because they are professionals.
Unlike public officials, doctors are part of a profession that is to a significant extent self-governing. This holds true for all professions. The medical profession’s rules of conduct are to a large extent self-given…Today, doctors’ professionalism charters are uncontroversially secular in nature. For instance, the European Federation of Internal Medicine, the American College of Physicians–American Society of Internal Medicine, and the American Board of Internal Medicine issued a joint physician professionalism charter, the values of which are based on secular ethics. It states unequivocally that ‘professionalism is the basis of medicine's contract with society.’… when doctors are seeing a patient in their professional role, the healthcare professionals’ private life, and that includes their ideological, non-professional commitments, should be kept out of their professional life and conduct.
It appears that Schuklenk and Rhodes share the same desire to shatter the “common morality” paradigm. As a profession, medicine has its own rules, its own governance and its own ethics.
Michael Cook is editor of BioEdge
Conscientious objection to procedures like abortion and euthanasia often features in BioEdge. There is a growing consensus that CO has no place in modern medicine. It’s often argued nowadays that a doctor’s duty is to carry out the wishes of patients, regardless of whether they agree with them or not.
I stumbled across an interesting hypothetical on the American Medical Association Journal of Ethics which makes me question this consensus. In it, three bioethicists analyse a situation involving a difficult patient with deep Christian convictions. He is refusing post-operative pain medication because he believes that he needs to suffer in order to atone for his life as an alcoholic. What should the physician do?
The bioethicists conclude that he should neither acquiesce nor refer the patient to another doctor who will acquiesce. Instead, the physician should “refuse to offer this course of action, regardless of the religious rationale for such a request”.
They go on to assert that “Indeed, as part of their professional commitment to the patient’s health, physicians have some obligation to respectfully challenge patients' refusals of medical care that the physician believes is needed. A sincere discussion—even a respectful debate—in no way denigrates [his] religious beliefs.”
Indeed, this makes good sense. But, viewed from another angle, the bioethicists are advising the physician to conscientiously object to a course of action determined by a lucid patient after serious consideration. They even counsel him to argue (respectfully) with the patient to convince him that he is wrong.
If this is so obviously the case, why is it wrong for a doctor to refuse to perform an abortion? I’m having trouble reconciling the ethical reasoning of the two situations. Can anyone help?
I stumbled across an interesting hypothetical on the American Medical Association Journal of Ethics which makes me question this consensus. In it, three bioethicists analyse a situation involving a difficult patient with deep Christian convictions. He is refusing post-operative pain medication because he believes that he needs to suffer in order to atone for his life as an alcoholic. What should the physician do?
The bioethicists conclude that he should neither acquiesce nor refer the patient to another doctor who will acquiesce. Instead, the physician should “refuse to offer this course of action, regardless of the religious rationale for such a request”.
They go on to assert that “Indeed, as part of their professional commitment to the patient’s health, physicians have some obligation to respectfully challenge patients' refusals of medical care that the physician believes is needed. A sincere discussion—even a respectful debate—in no way denigrates [his] religious beliefs.”
Indeed, this makes good sense. But, viewed from another angle, the bioethicists are advising the physician to conscientiously object to a course of action determined by a lucid patient after serious consideration. They even counsel him to argue (respectfully) with the patient to convince him that he is wrong.
If this is so obviously the case, why is it wrong for a doctor to refuse to perform an abortion? I’m having trouble reconciling the ethical reasoning of the two situations. Can anyone help?
 Michael Cook Editor BioEdge |  |  |  |
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