BLOG on the Reading Down of Conscience Protection

Responding to: R. Alta Charo, J.D., The Celestial Fire of Conscience - Refusing to Deliver Medical Care N Eng J Med 352:2471-2473; 24, June 16, 2005
Reproduced with permission

Iain T. Benson*

A pharmacist who has been doing excellent work trying to shine light into some of the more restrictive corners of the Pharmacy profession in Canada - - Cristina Alarcon, who gave a presentation at the Centre/Simon Fraser Conference recently, sends an interesting article from the recent issue of the New England Journal of Medicine.

After commenting that at least 45 States have conscience clause legislation (badly needed across Canada), the author makes the following statement:

For health care professionals, the question becomes: What does it mean to be a professional in the United States? Does professionalism include the rather old-fashioned notion of putting others before oneself? Should professionals avoid exploiting their positions to pursue an agenda separate from that of their profession? And perhaps most crucial, to what extent do professionals have a collective duty to ensure that their profession provides nondiscriminatory access to all professional services? R. Alta Charo,"The Celestial Fire of Conscience - Refusing to Deliver Medical Care" NEJM (Volume352:2471-2473) June 16, 2005].

Short quiz. What do you see to be the central assumption made in the above passage?

Did you answer: "the assumption that there is one "professional standard" ?

If you did, then you are right. This is the standard line from those who wish to frustrate the proper accommodation of conscience and religion. Resist accommodation by insisting on "one standard" and "non-discriminatory access" to the "service" sought.

It is our old friend "convergence pluralism" again - - this time in medical ethics. Hey, remember Frank Archer a few years back? He was the "ethicist" advising the Canadian pharmacists that they could not impose their views of "emergency contraception" (morning after pill - - an abortifacient such as used to be rejected by the Hippocratic Oath as against medical ethics until some modern ethicists decided to reject that part of the oath….so things progress). Anyway, Frank Archer (just google him if you want to see the responses written to his infamous Canadian Pharmaceutical Journal article), took the same line.

It boils down to "One size fits all." This may be great for summer beach towels, but hardly works where society has controversial ethical matters and supposedly seeks to protect them. One says "supposedly" because articles like this one in the NEJM and the one by Frank Archer a few years ago show that "one size fits all" is the latest attempt to force the views of some on everyone and that is, itself, discriminatory, totalitarian and unethical itself.

These folks completely fail to see that there are two autonomies involved - -provider of the "service" as well as the seeker of the service; they do this to get their dominant view forced through and their approach is simply wrong - - even if it is now getting prominent billing in prestigious medical journals.