A chara, – Freedom of conscience is a very serious matter that has not been addressed in a genuine way by Minister for Health Simon Harris’s Bill. It is worth exploring the implications for doctors, nurses and all healthcare professionals if their rights of conscience are not respected in law.
Every person has a right to freedom of conscience, whereby they cannot be compelled to perform or facilitate an action which they believe to be morally wrong.
The right to freedom of conscience acknowledges the fact that we are responsible for our free actions and their consequences inasmuch as we can foresee them. It also acknowledges the fact that we cannot disclaim responsibility for our free actions simply because we are obeying the will of another person.
Because freedom of conscience is respected in a democratic society, there is also the right to refuse to perform or participate in an action with which the person does not agree.
Doctors, like everyone else, have the right to freedom of conscience. They are entitled to refuse to provide treatment which they consider to be morally wrong, because to provide it would make the doctor responsible for the outcome. They are also entitled to refuse to facilitate access to that treatment, because that too would mean the doctor shares responsibility.
In the case of abortion, many doctors have profoundly held convictions about the right to life of the unborn child and they have the right not to perform any procedure which would deliberately end the child’s life. They also have the right not to facilitate abortion by giving information about or contact details of abortion providers.
Furthermore, doctors have the right to refuse to refer patients for abortion procedures. This is because, when a doctor refers a patient to another doctor for treatment, the referring doctor is agreeing that the treatment is necessary and in the patient’s interest. This is usually because the referring doctor does not have the required specialist training and so has to request another doctor to look after the patient.
In the case of abortion, however, the referring doctor may have the required training but still object in conscience. Referral for abortion would be asking another doctor to do something which the referring doctor believes to be wrong.
It does not lessen the referring doctor’s responsibility for the outcome and so goes against his or her freedom of conscience.
Abortion legislation must recognise that doctors have the right not to perform abortions and the right not to refer or provide information.
Abortion legislation must also acknowledge the right of medical students and trainee doctors to refuse to participate in procedures which they do not intend to perform as professionals because of conscientious objection.
It is disingenuous to imply that because a doctor or nurse does not wish to participate in abortion, he or she is a “blocker” or “obstructer”. Abortion information should be in the public domain and not restricted to medical personnel. As healthcare professionals, we wish to provide compassionate care to all our patients and to give positive alternatives to abortion. We cannot claim to be a pluralist society if the professional is coerced into facilitating abortion.
Has Mr Harris considered the implications for the health services if GPs and nurses feel unable to practise and thus leave their professions?
What will the Minister for Health do for patients who are left without a GP?
Will he engage with GPs on the ground, three-quarters of whom (according to a closed online survey of over 900 GPs after the referendum) do not believe that abortion should be GP-led in the first instance? – Is mise,
Dr FIONA O’HANLON,
Cootehill,
Co Cavan.
Sir, – While the moral views of doctors may differ from those of their patients on the matter of abortion, this is far from the only scenario where such differences may arise. Some quite extreme perspectives on aspects of modern medicine have religious bases.
The opposition of Jehovah’s Witnesses to blood transfusion, or of Scientologists to obstetric pain relief and psychiatry, are well known, for example.
Others are more cultural – opposition to organ donation, or even to postmortem examination of bodies, are views expressed by certain populations, even in modern Ireland. The views of patients and families ought to be respected as much as possible.
Nonetheless it would appear unfeasible to allow a doctor to practice in our society if, by holding any of these views, they refused to even refer patients for such treatments or investigations.
Living in a society which has voted as we recently did, it must be accepted as a doctor’s duty to embrace the mores and values of that society rather than to oppose them. – Yours, etc,
BRIAN O’BRIEN,
Kinsale,
Co Cork.