Conscientious objection has been a hotly debated topic in bioethics for several years. Yet recent contributions to the literature have been particularly strident. A series of new articles in the American Journal of Bioethics strongly criticise healthcare professionals and institutions who object to abortion, effectively telling them to exit the profession or face punitive measures.
The target article for the edition -- a legal perspective on the conscientious objection written by Santa Clara University philosopher and legal scholar Lawrence Nelson -- argues that conscientious objectors may be guilty of no less than murder if they fail to help a woman in need of an emergency abortion. Nelson suggests that religious liberty is no justification for refusal to participate in abortion, and he suggests that any laws permitting such conscience based refusals are unconstitutional. He concludes his article by exhorting state authorities to prosecute healthcare professionals and administrators who wilfully deny women access abortion:
"...if the American criminal justice system is to honor its constitutional duty to give women the equal protection of the laws, it should prosecute those who fail to honor their legal duty to provide an abortion when a woman’s life depends on it."
Several other contributors argue that that there is no moral justification for conscientious objection to the provision of basic medical services. Bioethicists Udo Schuklenk and Benjamin Zolf argue that conscience based refusals put the physician interests before patient welfare, and thus violate one of the basic goals of medical practice. Mark Wicclair, an adjunct professor of medicine at the University of Pittsburgh, argues that conscience based refusals should only be permitted where they do not impede a patient’s timely access to healthcare services.
Rosamond Rhodes (Mount Sinai School of Medicine) and Michael Danzinger (SUNY Downstate Medical Center College of Medicine) argue that both doctors and hospitals are failing to fulfill a moral duty when they refuse to provide medically indicated treatments, such as abortions, for their patients:
“...Doctors who expect patients to suffer affront, inconvenience, or physical harm, so that they may avoid fulfilling their moral duty, act in a way that is incompatible with being a doctor because being a doctor involves the commitment to putting the welfare of patients before one’s own…”
They effectively state that religious healthcare providers that refuse to provide “accepted medical procedures” should exit the health sector:
"...If any religious group finds the performance of legal and professionally accepted medical procedures to be in opposition to their core religious beliefs, they can get out of the hospital business…"
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