Conscience. Ethics 89, no. 4 (1979): 315.
James F. Childress
- Unfortunately the phrase "appeals to
conscience" is ambiguous. First, it may indicate an appeal to another
person's conscience in order to convince him to act in certain ways.
Second, it may mean the invocation of one's own conscience to interpret
and justify one's conduct to others. Third, it may indicate the
invocation of conscience in debates with oneself about the right course
of action, conscience being understood as a participant in the debate, a
referee, or a final arbiter. Although it is possible to distinguish these
three meanings of "appeals to conscience," they are usually intertwined
in our moral discourse. Nevertheless, I shall concentrate on the second
meaning, referring to the other two only when it is necessary to fill out
the picture. Appeals to conscience in the second sense raise
important issues of justification and public policy which can be
considered apart from the other meanings of appeals to conscience. . .
Unspeakable ethics, unnatural
law. Duke Law Journal, Vol. 1979, No. 6, Symposium on Law and
Ethics (Dec., 1979), pp.1229-1249
Arthur Allen Leff
- I want to believe-and so do you-in a complete, transcendent, and
immanent set of propositions about right and wrong, findable rules
that authoritatively and unambiguously direct us how to live righteously.
I also want to believe-and so do you-in no such thing, but rather that we
are wholly free, not only to choose for ourselves what we ought to do,
but to decide for ourselves, in dividually and as a species, what we
ought to be. What we want, Heaven help us, is simultaneously to be
perfectly ruled and perfectly free, that is, at the same time to discover
the right and the good and to create it. . .
- Like its predecessors, Mr. John Corrie's Bill to amend the Abortion Act
reflects the continuing opposition to "abortion on request" among some
MPs and members of the public. The Bill's main proposals include changing
the upper age limit for termination from 28 to 20 weeks, altering the
wording of the clause on conditions from "risk" to "grave risk" to the
life of the pregnant woman, widening the conscience clause, and licensing
pregnancy advisory services. So yet again time is being found by the
House of Commons for a private member's Bill though it has yet to debate
the careful examination of the working of the Act by Mrs Justice Lane's
committee. . .
K.P. Roche, Jonathan Gould
- Although we do not support the principle underlying the Abortion Bill
of 1967, we most warmly welcome any mitigation of its misuses,
including the currently proposed modification of the social clauses. Thus
we would in this sense support the proposals contained in Mr Corrie's
amending Bill. The conscience clause applies, in our opinion, to all
doctors, not only to those engaged in obstetrics and gynaecology.
Equally it applies to all nurses, both in operating theatres and wards,
where many abortions may now be accomplished effectively. . .
Gingras G. Doctors; conscience, care and
pay. Can Med Assoc J 1978 Apr 8;118(7):853-4 PMID: 638916
- Salaried physicians equal incompetent doctors? Certainly not! Quality
medical care depends on a practitioner's conscience, not the compensation
Among the members of the great family of health workers, only
physicians are not all salaried. I readily understand that lawyers
who, for the time being, are the most influential group among our
political masters, would be all too happy to promote the concept of
physicians' salary. . .
Lindheim BL, Cotterill MA. Training in induced
abortion by obstetrics and gynecology residency programs. Fam Plann Perspect 1978 Jan-Feb;10(1):24-8 PMID: 620766
Barbara L. Lindheim, Maureen A. Cotterill
- Between 1970 and 1976, the annual number of legal abortions reported in
the United States increased from 193,000 to 1.1 million. As a result, legal
abortion is now the most commonly per- fomed of all nondiagnostic adult
surgi- cal procedures.' Obstetrician-gynecolo- gists have primary
responsibility for women s reproductive health care, and they perform the
majority of abortions. . .
appeals to conscience. The Journal of Value
Issue 4, pp 296-300
Kenneth R. Seeskin
- This article is written in response to a recent paper by my former
colleague Carl. R. Kordig appearing in this journal, Kordig denies that
the dictates of one's conscience are always either obligatory or morally
permissible. With this thesis I have no quarrel. The recognition that a
person's conscience can be mistaken, sometimes dangerously so, is at
least as old as Hobbes and has been maintained by philosophers as
diverse as Hegel, Royce, and Nowell- Smith. Still, people do appeal
to conscience in moral disputes and, as I will attempt to show, do so in
a manner that is philosophically justifiable. My goal is not so much to
attack what Kordig has said as it is to argue that his discussion is
incomplete: some appeals to conscience are bogus but some are not.
Conscience. J Med Ethics 1977 Jun;3(2):98-9 PMID: 874985
- Historically, systematic thought about conscience arose from attempts
to unravel the knotty problem of what was called 'the erroneous
conscience': if conscience commands something which God's law forbids,
what is the position ? St Augustine, early in the fifth century,
gave a famous answer: 'The command of a subordinate authority is not
binding if it runs counter to the command of his superior; but
conscience has no authority except that which it receives as God's
delegate; if, therefore, conscience commands something which is against
God's law, we are bound not to follow it'. . .
Ruth Faden, Alan Faden
- May a doctor treat a patient, despite that patient's refusal, when in
his professional opinion treatment is necessary? This is the dilemma
which must from time to time confront most physicians. An examination
of the validity of such a refusal is provided by the present authors who
use the case history of a patient refusing treatment, for cancer as well
as for a fractured hip, to evaluate the grounds for intervention in
such circumstances. In such a situation the patient is said to have a
'false belief' and it is the doctor's duty to try to change that belief
in the patient's interest. The false belief is considered here in
terms of the liberty principle, the patient's mental competence and on
what is called the 'harm principle' (harmn to other individuals or to
society). Finally the concept of paternalism is examined. The authors
conclude that the doctor must attempt to change a false belief, and if
this fails he must examine the patient's mental competence to make the
decision to refuse treatment. But in the last analysis the doctor may
be under an obligation to respect the patient's refusal.
M.D. Hoyos, E.R. Walrond
- A postal questionnaire was sent to a representative sample of
Barbados' doctors, nurses and social workers requesting their opinions on
the liberalisation of the country's 108-year-old Abortion Law, and the
possible effects of this. The survey showed that there were very few
conscientious objectors. Eighty-five per cent of doctors and social workers
thought the law should be liberalised, as against thirty per cent of nurses.
Eighteen per cent of doctors and social workers felt that women would lose
interest in family planning as a result of a liberalised law, while sixty
per cent of nurses were of this view. Ninety per cent of nurses and sixty
per cent of doctors and social workers held reservations about abortion on
demand. These statistically significant differences of opinion between
doctors and social workers on one hand and nurses on the other show that
there is a need for advanced planning and education to minimize problems
which may arise out of any Abortion Law Reform (AU)
J Am Pharm Assoc 1977 Nov;17(11):673 (Editorial)
A matter of law and
conscience. PMID: 925285
Schweiker RS. Consideration of
applicants to medical schools with respect to their views on abortion.
Congr Rec (Dly Ed) 1977 Nov 4;123(181):S18859-61 PMID: 11663926
Schweiker RS. Support for Schweiker
medical school admissions bill. Congr Rec (Dly Ed) 1977 Sep 21;123(147):S15310-3 PMID: 11663921
Sykepleien 1977 Jun 20;64(10):579-90 [Freedom of conscience as a
principle] [Article in Norwegian] PMID: 586862
J.M. Alston, Lillian Versteeg
- Alston: The article by Mr R Walley (12 June, p 1456) is of the very
greatest importance to the public and to the medical profession. The
account which Mr Walley gave of the pressure put on him to agree to carry
out abortion against his conscience is a more fully explained example
of this method of appointing consultant gynaecologists than others
recorded before. The Department of Health must make sure that women
know how and where they can obtain, at the right time, an abortion if
they wish to have one, and if the Department requires more abortions than
its gynaecologists are able and willing to supply it must supplement
them by the appointment of regional or area medical abortionists. . .
- Versteeg: Mr R Walley's "Personal Paper" (12 June, p 1456)
shocked me profoundly. Those of us who recall the policy of appointing to
mental institutions in Nazi Germany only those doctors prepared to take
part in "euthanasia" of mentally defectives must recoil from the
implications of the policy he encountered.
Diamond EF. Do the Medical Schools
Discriminate Against Anti-Abortion Applicants? Linacre Quarterly 29, 30_31 (1976)
Eugene F. Diamond
David Hooker, W. Lindesay Neustatter
- Hooker: I think Dr R Salm (26 June, p 1593) has got his thinking a
little out of focus. The "will of the people, as expressed through
Parliament," does not make abortion right any more than bashing old
ladies on the head would be if made "legal" in this way. . .
- Neustatter: May I endorse Dr R Salm's cogent reply (26 June, p 1593)
to Mr R Walley's article (12 June, p 1456) on a question of conscience
in regard to performing abortions? While I respect Mr Walley's sincerity,
like Dr Salm I question his logic. . .
- White: I hope you will permit me to correct the
inaccuracies in the letter from Dr R Salm (26 June, p 1593). He
writes: "The will of the people as expressed through Parliament now
lays down that certain abortion facilities shall be provided in the
NHS." Parliament lays down no such thing. The Abortion Act of 1967
lays down that where certain conditions are complied with a doctor
who performs an abortion will not have committed an illegal act.
The Act, as David Steel repeated, is permissive, not mandatory. . .
John M. Hudson, Herbert H. Pilling, R. Salm,
- Hudson: Mr R Walley's remark (12 June, p 1456) concerning the absence
of public support for him in the columns of the medical journals cuts
me to the quick and I feel, therefore, in spite of my disinclination to
write letters about anything, that I must write to you. Dr R Salm's
letter (26 June, p 1593) saddened me because in it he fails to make clear
that he understands the grave injury that Mr Walley and many others have
suffered. . .
- Pilling: Some of your correspondents on this subject seem to be
ignoring the fact that the NHS Acts and Regulations impose upcn all
doctors employed in the Health Service a duty to make available to their
patients any treatment which their condition may warrant, and in
certain cases one such treatment is the termination of pregnancy. These
cases are defined in the Abortion Act 1967 and the clear implication
of section 1 (1) of that Act, taken in conjunction with the general duty
outlined above, is that a doctor must consider whether any patient
requesting a termination of pregnancy falls within the criteria set out
in the Act, and if so he must make the appropriate treatment available to
her. He need not, however, participate in the treatment. . .
- Salm: Shorn of legal niceties the position is that since the passage
of the Abortion Act a restricted abortion service has been provided in
this country under the NHS. In my previous letter (26 June, p 1593) I was
not concerned with the rights and wrongs of abortions . . .
Carl R. Kordig
- "Appeals to conscience" loom large in moral and political philosophy.
Many consider action in obedience to conscience to be morally necessary or
at least morally permissible. For many these are reasons for ethical and
I will here criticize pseudo-appeals to conscience. I will criticize the
view that the dictates of one's conscience are always either obligatory
or permissible. Such pseudo-appeals are untenable. They result in an
indefensible moral relativism. They lead to totalitarian intolerance. . .
Salm R. A question of conscience. (Letter) Br Med J 1976 Jun 26;1(6025):1593
- R. Walley's article (12 June, p 1456) makes sad reading, for he is both
illogical and, if I may say so, a little selfish. I admire and indeed
I share his respect for human life, but in my opinion his only genuine
grievance is that the rules were changed while he was in training, his
conscience preventing him from adapting to the new service requirements.
However, he is illogical in complaining that he is being discriminated
against. The will of the people, as expressed through Parliament, now
lays down that certain abortion facilities shall be provided in the NHS,
and the area health authorities have the duty to see that this
regulation is implemented. . .
A question of conscience.
Br Med J 1976 Jun 12;1(6023):1456-8 PMID: 953536
- It was indeed a surprise to be informed by an eminent professor, after
a hospital interview, that as a Roman Catholic gynaecologist "there is no
place for you to practise within the National Health Service." One had
always assumed, quite naively it seems, that the British "system" is
based on fair play and, above all, respect for the individual conscience.
It soon became quite obvious that in order to stay in the specialty in
Britain I would have had to change a conscientiously held abhorrence to
the direct taking of human life. I chose to leave country, home, and
family in order to practise medicine in full freedom of conscience. . .
J.B. Ideasy, C.S.S. Slorach, G.W. Theobald
- Dr. J. B. Ideasy (Bradford) writes: As a member of (the B.M.A. I wish
to dissociate myself entirely from the views expressed in your
leading article (17 May, p. 352).... You must be aware of the large body
of opinion in the profession which is opposed to abortion on social
grounds . . .
- Dr. C. C. S. Slorach (East Kilbride) writes: I cannot allow your
leading article (17 May, p. 352) to pass without comment. You are
highly critical of Mr. James White's Abortion (Amendment) Bill, at
present being considered by a select committee of the House of
Conmons. . .
- Mr. G. W. Theobald (Eastbourne) writes: . . . In your leading article
(17 May, p. 352) you do not seem to be concerned with the freedom of
gynaecologists, guaranteed by the 1967 Abortion Act, to refuse to be
involved in "legal" abortions. It is fast becoming evident that no man
or woman whose conscience prevents them from engaging in this practice
can in future contemplate specializing in obstetrics and gynaecology,
and this would apply to many practising Christians, not merely Roman
Catholics, and presumably to orthodox Jews. . .
- On re-reading my letter to you (19 July, p. 160) I can understand how
Dr. J. B. Clarke (9 August, p. 373) has misunderstood me, but I do not
believe that it will support Dr. C. B. Goodhart's conclusions (19 July,
p. 160). Both writers' deductions rest on the assumption that I have
confused my terms.
A "moral action" can result only from a free choice of the best
available alternative and may be legal or illegal (I defined "best" in
my letter of 19 July). A "legal action" is an actior in accordance with a
code laid down by some authority and may be moral or immoral. . .
- In a recent editorial in Science (Changing climate for medicine. Science
188:975, Jun 6,1975) Philip H. Abelson gives a masterly review of a
"Changing Climate for Medicine." He calls attention once again to the fact
that the essence of the practice of medicine is in the interaction between
patient and physician. He notes that medicine will always remain an inexact
science, that the best physicans are highly motivated and highly intuitive,
and that much in patient care depends upon the motivation and conscience of
the physician. . .
W.L. Neustatter, J.B. Clarke, C.B. Goodhart
- Dr. W. Lindesay Neutstatter (London W.1) writes: It is gratifying to
see the stand the B.M.A. is making about the new Abortion Bill.
Leaving aside the wider implications, it is most unsatisfactory that the
very sensible phrase that the risks to the mother's life and health could
be greater if the pregnancy continued than if it was terminated, which
allowed for clinical judgement of weighing the pros and cons, should
be replaced by an exercise in semantics as to where "grave" and
"serious" risks begin . . .
- Dr. J. B. Clarke (Wirral) writes: I wish to thank Dr. Isabel G. Smith
and the Reverend J. B. Metcalfe (19 July, p. 160) for their honesty
in being so explicit with their opinion that there is no ethical
distinction between the prevention of conception and abortion. One may
enter into debate as to when new life begins, but surely one cannot
ignore the physiological fact of conception. . .
- Dr. C. B. Goodhart (Cambridge) writes: The Reverend J. B. Metcalfe (19
July, p. 160) thinks that "it is the job of the legislators to specify
an age after which abortion is deemed murder. This is not a moral
decision but a political one based on what society will accept and what
is enforceable." . . .
Pilpel HF, Patton DE.
Abortion, conscience and the Constitution: an examination of federal
institutional conscience clauses. Columbia Human Rights Law Rev 1975 Fall-Winter 1974-75;6(2):279-305 PMID: 11663597
Harriet F. Pilpel, Dorothy E. Patton
- In January, 1973 the United States Supreme Court ruled for the first
time on the constitutionality of state criminal abortion statutes. In Roe v.
Wade the Court held that statutes which prohibited all abortions except
those done to save the life of the woman unconstitutionally violated the
woman's right of privacy. In the companion case, Doe v. Bolton, the Court
invalidated a number of abortion-restricting statutory regulations.
Congress reacted swiftly. Eight days after Roe and Doe were handed down,
an abortion-prohibiting constitutional amendment was introduced in the
House of Representatives; subsequently, Congress considered other
amendments to the Constitution and to federal laws. Although the 93rd
Congress adjourned without acting on any of the proposed Constitutional
amendments, it did enact several abortion-limiting laws. Some of these
laws took the form of "entity conscience clauses." Such clauses in effect
state that where abortion or sterilization are against the "conscience"
of a hospital or other entity, that entity may refuse to perform these
medical procedures. For many women and families such laws may constitute
a barrier which limits the constitutional right which the Supreme Court
recognized in Roe to decide whether or not to terminate a pregnancy.
This article discusses the recently enacted entity conscience clauses and
examines them in terms of constitutional rights. . .
Stern MD. Abortion conscience
clauses. Columbia J Law Soc Probl 1975 Summer;11(4):571-627 PMID: 11663680
Marc D. Stern
- Introduction: This paper considers some of the
conflicts between competing constitutional rights which have developed as
a result of the Supreme Court's decisions in Roe v. Wade and Doe v.
Bolton, cases involving the power of states to limit abortion. In Roe and
Doe, laws prohibiting abortions were held to infringe the fourteenth
amendment guarantee of personal liberty. State regulatory power was not
completely denied, but was greatly restricted.
Despite the rulings in Roe and Doe, physicians, nurses, and
denominational hospitals opposed to abortions have continued to refuse to
perform them. . . .
- I was somewhat disquieted by the letter from Dr. Louise F. W. Eickhoff
(12 July, p. 99). To refuse to terminate a pregnancy on a matter of
conscience is both legally and ethically acceptable, as is a refusal
in the absence of the requisite medical, psychiatric, and social
indications. But to refuse a termination because the continuation of
the pregnancy is held to be a valid means of managing a behavioural
disorder, "promiscuity," is a more questionable matter. . .
M.B.H. Wilson, G.S. Banwell, Angela M.H. Lynch
- Wilson: Dr. N. A. Chisholm writes (28 June, p. 748) that he is
weary of reading letters on the "right of conscience" to abstain from
giving medical help in abortion. Many would insist on the right and the
duty to avoid terminating a particular pregnancy or taking steps
likely to lead to a termination, but the duty to give medical help is
implicit in the relationship between doctor and patient. . .
- Banwell: . . . Doctors who decline to abort a woman in early
pregnancy and who do not plead conscientious objection are liable to
criminal prosecution under the current Act, and protagonists of
abortion on request have been enabled to point an accusing finger at
N.H.S. gynaecologists. Plainly the Lane Conmittee was correct in pointing
out deficiencies in the N.M.S., since it is meant to be providing an
abortion iservice in early pregnancy for all women. Are any women not
"entitled"-to quote from your leader? . . .