Conscience Protections and Medicine

I teach a course on the history of Christian political thought to undergraduates. A few weeks ago, we discussed martyrdom in the context of Christian obedience to laws Christians know are unjust. I am fortunate to have a spirited group of students, one of whom mentioned the example of St. Lawrence, a deacon in ancient Rome who was martyred by being roasted alive. We went on to discuss contemporary possibilities for martyrdom, in the course of which I brought up everyday challenges to faith, including conscience issues faced with ever greater frequency and consequence by Catholic healthcare workers, pharmacists, and physicians.

It didn’t take long for the students to realize the personal stakes involved when men and women who have committed themselves to vocations of service find the professional expressions of those vocations perverted (there’s no better term for this) by societal trends, including current and proposed legislation. At least one student, however, was unsympathetic to the idea that (for instance) a pharmacist could conscientiously refuse to administer drugs or other means he thought morally objectionable. She said, “If he doesn’t want to give the ‘morning after’ pill, he should not have become a pharmacist.” Freedom of choice does have its limits, doesn’t it?

While the view my student represented was in the minority in my classroom, most of us know that support for her position grows daily in American society. For decades there has been concerted and consistent pressure on healthcare professionals and even lay people to acquiesce in immoral practices like abortion, in vitro fertilization (IVF), pre-natal eugenic screening, and contraception. To paraphrase my student’s view on such questions, those of us who object to such practices, particularly if we work in health and medicine, have an obligation to get out of the way. This pressure – rising to the level of coercion when used to prohibit people of conscience from becoming (or remaining!) pharmacists, doctors, or nurses – reflects the breadth and depth of our culture’s commitment to abortion and contraception on demand, and whatever it takes to keep them that way.

Conscience protections exist to allow people to heal the sick without having to kill the vulnerable. The vocal representatives of the entrenched pro-abortion, pro-contraception view propose legislation to overturn or amend “conscience protection” laws designed to permit Catholics (and others) to express in our wider society the commitments of their communities to the sanctity of life. Any attempts to advance conscience protections are presented as affronts to others’ potential freedoms, with little or no mention of the actual restrictions on the freedom of those interested in healing without killing. There is much discussion in our society about the content and limits of freedom. But freedom by any name should permit men or women of character to do what they know is right. In like manner, freedom is meaningless when a person is coerced to do what he knows is wrong.

Thus, for instance, The New York Times wrote this summer about a Bush administration proposal to require all recipients of aid under federal health programs to certify that they will not refuse to hire nurses and other health care providers who object to abortion and even certain types of birth control. In other words, the administration proposed to withdraw federal funding from programs that discriminated against nurses who refused to participate in abortions. Yet the venerable Times never even bothered to address the reasonableness of respecting conscientious disagreement; instead, two presidents of organizations committed to abortion pleaded that the legislation aims to restrict abortion and contraceptive access. Thus, Nancy Keenan, president of NARAL: “’Why on earth is the Bush administration trying to discourage doctors and clinics from providing contraception to women who need it?’” Is there some unlit and lonely corner remaining in the United States where needy women cannot find contraception? Of course not, and the people shouting the loudest know this as well as anyone. The real subtext here is not the rolling back of access to contraception, but concerted efforts to prohibit people from practicing medicine as only a healing, and not a killing, art. The mere permission to refrain from morally objectionable acts is being redefined as something akin to a threat to our constitutional order.

Conscience protections are important and necessary in this climate. They can seem like just additional instances of our social fracturing into millions of pieces, each with its own moral views. We shouldn’t be fooled, however, by appearances. In fact, conscience protections pertaining to medicine reveal a great deal about our views of conscience itself. The consciences needing protection today are not the subjective views of atomistic individuals; instead, these conscience claims are faint echoes of the communities that developed Western medicine. They call us to remember medicine as it was and as it once again should be.

Joseph Capizzi is associate professor of moral theology at the Catholic University of America.

(c) 2008 The Catholic Thing. All rights reserved. For reprint rights write to: info at thecatholicthing dot org