The Troublesome Intersection of Religious Conscientious Objection, Abortion, Ethics, and the Law
Lawrence Nelson, Ph.D., J.D., Department Chair & Associate Professor, Santa Clara University
It is very commonly claimed that the first ethical principle of medicine is “above all do no harm” and that this principle has ancient Hippocratic roots. However, this is actually a misconception: the true first ethical principle of medicine in the Hippocratic tradition is “above all be useful, or at least do no harm.” The enterprise of medicine rests at its foundation on the commitment and duty to be useful, to help, to cure, to care for, patients. Clinicians practice to benefit others entrusted to their care, not to benefit themselves. Physicians who perform a useless but benign procedure on a patient for their own gain have done wrong, as have physicians who deliberately fail to provide a standard of care medical intervention that will or is likely to benefit a patient.
Many persons embrace religious principles and beliefs which not only infuse their existence with meaning and purpose but also provide them with moral guidance in their personal and professional lives. For those in the Catholic faith tradition, for example, one of their fundamental commitments is to promote and defend human dignity by respecting the sacredness of every human life from conception to death. Consequently, they consider the deliberate and direct killing of any innocent person, unborn or born, to be an intrinsically evil act that radically contradicts the good of that person who is made in the image of God; other motives of the agent causing the death and the circumstances of the case are irrelevant.
Pregnant patients sometimes emergently need an abortion to save their lives, such as Savita Halappanavar and the unnamed woman in Phoenix in 2009, and transfer to a non-objecting provider seriously endangers the patient’s life of health. If clinicians adhere to a religious commitment, Catholic or otherwise, never to directly end an innocent unborn human life, they are compelled not to terminate the pregnancy, and this can lead to the death of the woman and her prenatal human.
Such a choice contradicts medical professionals’ ethical commitment to being useful to their patients and doing no harm. Clinicians are obligated to put their patients’ very lives and their welfare above their self-interest and personal beliefs, even deeply and sincerely held religious beliefs. They choose this commitment in the character of their profession and their area of practice. In non-emergent situations, their duty is different.
The choice to refuse to provide an abortion in an emergency also triggers legal implications. First, the criminal law of homicide prohibits a clinician from deliberately refusing to provide a life-saving treatment even for conscientious reasons. Second, the constitutional guarantee of the free exercise of religion does not excuse persons from compliance with laws prohibiting conduct the State is entitled to regulate, and the State is certainly entitled, indeed obligated, to protect every person’s right to life. Third, so-called “conscience clause” statutes that exempt clinicians from participating in abortion are unenforceable when applied to give clinicians immunity from their ethical and legal duty to preserve patients’ lives.
It is very commonly claimed that the first ethical principle of medicine is “above all do no harm” and that this principle has ancient Hippocratic roots. However, this is actually a misconception: the true first ethical principle of medicine in the Hippocratic tradition is “above all be useful, or at least do no harm.” The enterprise of medicine rests at its foundation on the commitment and duty to be useful, to help, to cure, to care for, patients. Clinicians practice to benefit others entrusted to their care, not to benefit themselves. Physicians who perform a useless but benign procedure on a patient for their own gain have done wrong, as have physicians who deliberately fail to provide a standard of care medical intervention that will or is likely to benefit a patient.
Many persons embrace religious principles and beliefs which not only infuse their existence with meaning and purpose but also provide them with moral guidance in their personal and professional lives. For those in the Catholic faith tradition, for example, one of their fundamental commitments is to promote and defend human dignity by respecting the sacredness of every human life from conception to death. Consequently, they consider the deliberate and direct killing of any innocent person, unborn or born, to be an intrinsically evil act that radically contradicts the good of that person who is made in the image of God; other motives of the agent causing the death and the circumstances of the case are irrelevant.
Pregnant patients sometimes emergently need an abortion to save their lives, such as Savita Halappanavar and the unnamed woman in Phoenix in 2009, and transfer to a non-objecting provider seriously endangers the patient’s life of health. If clinicians adhere to a religious commitment, Catholic or otherwise, never to directly end an innocent unborn human life, they are compelled not to terminate the pregnancy, and this can lead to the death of the woman and her prenatal human.
Such a choice contradicts medical professionals’ ethical commitment to being useful to their patients and doing no harm. Clinicians are obligated to put their patients’ very lives and their welfare above their self-interest and personal beliefs, even deeply and sincerely held religious beliefs. They choose this commitment in the character of their profession and their area of practice. In non-emergent situations, their duty is different.
The choice to refuse to provide an abortion in an emergency also triggers legal implications. First, the criminal law of homicide prohibits a clinician from deliberately refusing to provide a life-saving treatment even for conscientious reasons. Second, the constitutional guarantee of the free exercise of religion does not excuse persons from compliance with laws prohibiting conduct the State is entitled to regulate, and the State is certainly entitled, indeed obligated, to protect every person’s right to life. Third, so-called “conscience clause” statutes that exempt clinicians from participating in abortion are unenforceable when applied to give clinicians immunity from their ethical and legal duty to preserve patients’ lives.