Gol'denberg MA The principle of freedom of conscience and its clerical
interpreters. Soviet Sociology, Summer, 1984.¤
- In the contemporary ideological struggle, problems of human rights and
freedom of conscience have become increasingly acute in recent years.
Bourgeois ideologists, who call the capitalist world the "free world" or
the "world of democracy," try to insist upon the notion that freedom and
democracy are absent in socialist countries. It is no accident that in
the stream of such falsification, the Marxist-Leninist principle of
freedom of conscience and its realization in the socialist countries is
notably distorted. Clerical writers take advantage of the fact that
although religion is in a state of crisis, it continues to have an effect
on the broad masses. Naturally, many believers in the West are inclined
to react with oversensitivity to daily assertions that in the Soviet
Union the freedom of conscience of adherents of various religions is
subject to systematic repression. . .
J Med Ethics 1984 Dec;10(4):171-2, 190 (Editorial) Conscience, virtue,
integrity and medical ethics. PMID: 6520848 ¤
- It is sometimes claimed that 'new fangled' philosophical medical
ethics is unnecessary and indeed that it is positively disadvantageous,
leading too often 'to abstract and inconclusive intellectual argument -
neither conducive to postprandial reflection nor necessarily relevant to
the insistent demands on the busy practitioner throughout his day'.
Particularly in medical education, as Osler so quaintly put it, 'What
have bright eyes red blood quick breath and taut muscles to do with
philosophy?' Rather, clinicians so often claim, all that's needed for
medical ethics is a sound conscience, good character, and integrity.
First, and vitally, it is important to affirm that few if any moral
philosophers, let alone those who are specifically interested in medical
ethics, would deny that sound conscience, good character and integrity
are essential to moral life in general and medicomoral life in
particular. But as soon as attempts are made to explain what is meant by
these claims the need for some sort of critical philosophical analysis
becomes apparent. . .
Langslow A. Duty and conscience. Aust Nurses J 1984 Aug;14(2):56-8 PMID: 6566561 ¤
- This interesting letter, written by a nurse, arrived recently: "A
50-year-old comatose male patient was admitted and a diagnosis of
diabetic ketoacidosis was made. A Jehovah's Witness, he wore a
bracelet stating his desire not to receive blood. After five days of
intensive care, his haemoglobin level was found to be only seven, and
the decision was made to give him three units of blood. This was done
at night with relatives absent but the patient died two days later
without having gained consciousness. Should nursing staff refuse to
hang blood knowing the orders given by doctors to be ethically wrong?"
. . .
Canavan F. Hum Life Rev 1983 Fall;9(4):21-4
On being personally opposed. PMID: 11655591
Connelly J.E. Paternalism and the
physician's conscience. Ann Intern Med 1983 Aug;99(2):276-7 (Letter) PMID: 6881786
Julia E. Connelly
- I read Dr. Thomasma's article with skepticism. All models for the
doctor-patient relationship are shortsighted as they do not acknowledge
systems of relationships beyond that of the physician and the patient.
Despite this inherent shortcoming, Thomasma's model contains two
characteristics that distinguish it from other such models. Both the
strength of his physician conscience model and its greatest limitations
exist in these two characteristics. First, his model requires that
physicians assess beliefs, attitudes, and emotions they recognize in
response to their patients in an effort to determine how these factors
influence the health care they provide. Second, his model requires
bidirectional communications between patients and physicians. In neither
the autonomy nor the paternalistic model are these features essential. .
Curtin LL. A nurse's conscience. Nurs Manage 1983 Feb;14(2):7-8
Leah L. Curtin
. . . In 1919 the noted American jurist Harlah Fiske Stone; put it th is
way; " ... liberty of conscience has a moral and social value which makes
it worthy of preservation at the hands of the state. So deep is its
significance and vital, indeed, is it to the integrity of man's moral and
spiritual nature that nothing short of the self-preservation of the state
should warrant its violation; and it may well be questioned whether the
scate which preserves its life by a settled policy of violation of the
conscience of the individual will not, in face, lose it by the same
process." Thus, legal space was created for conscientious objectors to
military service even in times of war, and federal and state statutes
were passed to protect health professionals who have conscientious
objections to certain procedlires (abortion a'nd sterilization). . .
- Abstract: When a woman above age 35 even a
multiparous women asks her obstetrician about the necessity or
desirability of a genetic amniocentesis the obstetrician is obliged to
inform the patient comprehensively about the risks of amniocentesis and
the advantages of amniocentesis. Advantages are detection of chromosomal
abnormalities, risks are premature rupture of the membranes or abortion.
The obstetricians contract obliges him to recommend or not recommend
such tests. If the obstetrician does not give the information to the
patient because he is not familiar with the newest scientific standards
or because his personal conscience is against amniocentesis because of
the possibility of a subsequent eugenic therapeutic abortion the
obstetrician must refer the patient to another obstetrician. If the
obstetrician does not inform the parents he is liable for the total cost
of maintaining a mongoloid infant.
David C. Thomasma
- Medical paternalism lies at the heart of traditional medicine. In an
effort to counteract the effects of this paternalism, medical ethicists
and physicians have proposed a model of patient autonomy for the
physician-patient relationship. However, neither paternalism or
autonomy are adequate characterizations of the physician-patient
relationship. Paternalism does not respect the rights of adults to
self-determination, and autonomy does not respect the principle of
beneficence that leads physicians to argue that acting on behalf of
others is essential to t heir craft. A model of physician conscience is
proposed that summarizes the best features of both models-paternalism and
A question of conscience.
Nurs Times 1982 Mar 3-9;78(9):349-51PMID: 6917236
W. Bingley, L. Gostin
Nursing with conscience. RNABC News 1982 Jan-Feb;14(1):12 PMID: 6916453
Durham WC, Wood MA, Condie SJ. Accommodation of
conscientious objection to abortion: a case study of the nursing profession.
Brigh Young Univ Law Rev 1982;1982(2):253-370 PMID: 11655680 ¤
W. Cole Durham Jr., Mary Anne Q. Wood, Spencer J.
- For the most part, controversy surrounding the abortion issue has
focused on the characters with the leading roles in the drama: the
pregnant woman, the state,' and to a lesser extent, the consulting
physician.' Scant attention has been paid to the rights of the background
figures and stagehands-the residents, hospital administrators, nurses,
and other medical personnel who may be confronted either during their
training or as professionals with difficult decisions about participation
in abortions.3 This Article explores the attitudes of the largest single
subclassification of medical personnel-the nursing profession-toward
such issues. Our effort has been to measure as accurately as possible the
attitudes of nurses toward participation in abortion procedures;4 to
identify the areas in which the greatest practical difficulties occur,
both for the nurses themselves and for those under or with whom they
work;5 and to evaluate the adequacy of existing legal protections and
institutional accommodation practices in light of the findings.' . . .
Darrel W. Amundsen
Darrel W. Amundsen
M.C. Sheehan, J.G. Munro, J.G. Ryan
- Abstract: Sixty-seven per cent of medical
practitioners registered in Queensland responded to a survey on their
attitudes to the laws relating to abortion and sterilization in that
State. Of all respondents, 79 per cent wanted some degree of
liberalization of abortion laws. Personal characteristics such as age,
sex and religion practised (if any) were found to influence doctors'
opinions. Practice characteristics also influenced opinions; general
practitioners were more in favour of liberalization than were
specialists, and self-employed doctors were more in favour than were
doctors working in hospitals or other institutional settings.
Conscience and responsibility.
Br Med J 1980 Dec 20-27;281(6256):1687-8 PMID: 7448574
- Those of us who have followed the editorial policy of the British
Medical J7ournal during the past decade will have noticed increasing
emphasis on ethical problems. They are posed by the changing character of
medical practice in response to rapid technological advance, the
pressures of public opinlion ultimately reflected in more liberal
legislation, and the deficiencies of a comprehensive National Health
Service grappling with the problem of finite resources and infinite
demand which confront the doctor with conflicting moral choices. . .The
problem is that while the doctor is bound by that code to act responsibly
towards his patient, the patient, whose expectations have been
immoderately fuelled by the media operating under a code determined by
the contemporary mores of our increasingly profane society, is under no
obligation to reciprocate. Therein lies the doctor's moral dilemma
between his conscience and his responsibility. . .