When the Law Demands Doctors Do What They Believe is Wrong, Bad Things Happen
Even some doctors say this: Doctors must do anything legal the patient asks for. If a woman wants an abortion, they insist the pro-life doctor abort her child. He has no right to serve people according to his own deepest beliefs. He must do something he thinks very wrong.
He does not and he should not, says prominent legal scholar Michael Quinlan. Denying doctors the right to follow their conscience will hurt them and their patients. They will be better doctors if allowed to do what they think right.
The following is a shortened version of an interview with Quinlan. He’s the dean of the law school at the University of Notre Dame Australia. The whole interview, conducted by Mercatornet, can be read here.
Quinlan talks mainly about doctors, but nurses and pharmacists face the same threats. Mercatornet’s questions and summaries of Quinlan’s answers appear in italics.
The Doctors’ Damaging Moral Distress
Mercatornet opens the interview by noting that some ethicists and even some doctors argue that a doctor who exercises his conscience and doesn’t do what his patient wants is unethical.
Quinlan responds that forcing doctors to do something they think wrong hurts them, their patients, and medicine. Doctors who do something they believe wrong can feel “moral distress.” He explains:
Moral distress can adversely impact on self-respect, self-esteem, patient care and job satisfaction. Feelings of helplessness, frustration, guilt, sorrow and anxiety can manifest in physical and mental illness. Moral distress can cause burnout and early retirement from the profession. It can also lead to desensitzing of one’s conscience and to increased risk of doctors developing indifference to patients and a weakening of their ability make ethical decisions.
The interviewer suggests that a doctor may object to abortion simply because the thinks it’s bad health care for the mothers. Quinlan agrees, noting the harm women who’ve had abortions can suffer.
The Limits to Conscience
The interviewer says: “Conscientious objection must have some limits. Can a Jehovah Witness doctor refuse to do blood tranfusions? Or a Muslim doctor refuse to examine women?” Quinlan answers:
In a multi-faith, multi-racial and multi-cultural pluralist country like Australia I think that it is generally reasonable to accommodate positions held by medical professionals — and other citizens — as much as possible. Some issues may be able to be accommodated in some but not other circumstances.
Perhaps in a large public hospital with sufficient staff it might be possible for patients to be well cared for without requiring a doctor who has a conscientious objection to blood transfusions or to examining particular patients to be accommodated. Of course there do need to be some limits on conscientious objection. As Professor Iain Benson has observed “[a]ny legal regime is necessarily involved in line drawing and there is nothing inherently offensive about that.”
Protecting Doctors’ and Patients’ Rights
One reason for protecting doctors’ conscience rights, Quinlan says, is protecting the rights of patients. Pro-life patients want doctors who will not push them to abort a baby with Down Syndrome, for example.
Patients have a right to obtain medical treatment from doctors who understand their religious worldview and who share that viewpoint. Policies and legislative provisions that discourage “pro-life” doctors from joining or remaining in the profession may deprive patients from access to the services of health practitioners who share their views about the value of embryonic human life. …
Such patients want their doctors to support them in their decisions and to give them and their children wholehearted and supportive medical care. Provisions which force doctors out of the profession act to reduce — not to increase — patient choice.
Patient Autonomy, Especially on Abortion
Mercatornet notes that some secularists demand that doctors do whatever their patients want as long as it’s legal. “Essentially,” Quinlan explains, they make patient autonomy “a governing principle.” Doctors have to do this “because society gives them something of a monopoly.” He notes:
This sort of argument actually tends only to be made in relation to abortion services. Elective surgery is not normally something that doctors must do. So, for example, many pediatric doctors refuse to perform circumcisions on baby boys. …
In fact, Quinlan continues,
We expect — we want — we need — doctors to be ethical people who are not driven solely by profit. We need doctors to refuse to carry out medical procedures which might earn them money but which they think would not be best for their patient’s health and wellbeing. We don’t expect and we don’t actually want our doctors to give us antibiotics that we don’t actually need. We want them to tell us what they think is actually in our best interests even though our Google inspired medical view conflicts with theirs.
We don’t expect doctors to subordinate their interests to those of their patients generally. We don’t expect them to work for free or to make house calls or never to take holidays at their patient’s request. Those who want all doctors to provide abortion services must be honest in their arguments. If they want to argue that all doctors must provide abortion services — but not other medical services — they must explain what exactly makes abortion different and overcome the powerful arguments against such compulsion.
The interview appeared on Mercatornet and is used here with permission.