"NO MORE CHRISTIAN DOCTORS"
Sean Murphy*
Abstract
Full Text
A 25 year old woman could not obtain a prescription for contraceptives at
a clinic because the physician did not prescribe them for reasons of
"medical judgment as well as professional ethical concerns and religious
values." She obtained the prescription at a clinic two minutes away. A
crusade was started against the physician and two colleagues with the same
views. Crusaders argued that in a 'secular' state health care system,
physicians should be forbidden to act on their moral or religious beliefs.
Physicians who refuse to prescribe contraceptives face a difficult
challenge, since aggressive contraceptive promotion has left most people
unaware of alternatives. Further, the social progress of women is widely
attributed to contraceptives, so that failure to provide them risks an
adverse reaction. Nonetheless, based on a respectful understanding of female
fertility cycles and other factors, plausible reasons can be given to
justify refusal to prescribe contraceptives and recommendation of Natural
Family Planning.
The Supreme Court of Canada has acknowledged that secularists are
believers, no less persons with religious beliefs. There is no legal warrant
for the idea that a secular state must be purged of the expression of
religious belief. The claim that a secular state or health care system is
"faith-free" is radically false. Both religious belief and secularism can
result in narrow dogmatism and intolerance, as demonstrated by the crusade
against the physicians.
Since the practice of medicine is an inescapably moral enterprise, every
decision concerning treatment is a moral decision. Since the practice of
morality is a human enterprise, the secular public square is populated by
people with many moral viewpoints. To discriminate against religious belief
is a distortion of liberal principles. Moreover, if religious believers can
be forced to do what they believe to be wrong, so can non-religious
believers. This would establish a destructive and dangerous 'duty to do what
is wrong.'
It is essential to maintain the integrity of physicians and well-being of
patients. After abortion was legalized, a difficult compromise emerged that
safeguards both, while protecting the community against a purported 'duty to
do what is wrong.' However, some people are trying to entrench that duty in
medical practice, moving from a purported duty to provide or facilitate
abortion to a duty to kill or facilitate the killing of patients by
euthanasia. It is unacceptable to compel people to commit or even to
facilitate what they see as murder, and punish or penalize them if they
refuse. It is equally unacceptable to insist that physicians must not act
upon beliefs, because it is impossible; one cannot act morally without
reference to beliefs. Such policies are inconsistent with the central place
occupied by individual conscience and judgment in a liberal democracy.
Freedom of conscience can be adequately accommodated in a society
characterized by a plurality of moral and political viewpoints if
appropriate distinctions are made. The first of these is the distinction
between the exercise of perfective freedom of conscience: pursuing an
apparent good - and preservative freedom of conscience: refusing to
participate in wrongdoing. The state can sometimes legitimately limit
perfective freedom of conscience by preventing people from doing what they
believe to be good, but it does not follow that it is equally free to
suppress preservative freedom of conscience by forcing them to do what they
believe to be wrong.
To force people to do something they believe to be wrong is always an
assault on their personal dignity and essential humanity, and it always has
negative implications for society. It is a policy fundamentally opposed to
civic friendship, which grounds and sustains political community and
provides the strongest motive for justice. It is inconsistent with the best
traditions and aspirations of liberal democracy, since it instills attitudes
more suited to totalitarian regimes than to the demands of responsible
freedom. Even the strict approach taken to limiting other fundamental rights
and freedoms is not sufficiently refined to be safely applied to limit
freedom of conscience in its preservative form. Like the use of potentially
deadly force, if the restriction of preservative freedom of conscience can
be justified at all, it will only be as a last resort and only in the most
exceptional circumstances.
That a young woman had to drive around the block to fill a birth control
prescription does not meet this standard.
Table of Contents
Abstract
Part 1: The making of a story
Part 2: Medical judgement and professional ethical concerns
Part 3: "Religious values"
Part 4: A difficult compromise
Part 5: Crossing the threshold
Part 6: Avoiding authoritarian ‘solutions’
APPENDIX "A"
APPENDIX "B"
APPENDIX "C"
APPENDIX "D" - STATISTICS
APPENDIX "E" - HUMAN FERTILITY CYCLES
APPENDIX "F" - THE DIFFICULT COMPROMISE
APPENDIX "G" - NOTICES TO PATIENTS