Why I avoid arguing that doctors shouldn’t do abortions based on ‘conscience’
The New England Journal of Medicine recently published an article that should compel pro-lifers to think seriously about how they frame the abortion debate. Dr. Lisa Harris writes,
“The exercise of conscience in health care is generally considered synonymous with refusal to participate in contested medical services, especially abortion. This depiction neglects the fact that the provision of abortion care is also conscience-based [emphasis added]. The persistent failure to recognize abortion provision as ‘conscientious’ has resulted in laws that do not protect caregivers who are compelled by conscience to provide abortion services…”
This is a very real reason why I avoid primarily arguing that a physician not do abortions on grounds of “conscience.” For what we’re now seeing is some physicians saying, “To stop me from doing abortions is to deny me my conscience rights that compel me to help women in crisis this way. If you believe in the right to your conscience, you have to give me the right to mine! My conscience compels me to do abortions.”
And so, in what should be a battle of right versus wrong, good versus evil, we’re now debating “my conscience versus yours,” which sounds very relativistic. Over emphasizing conscience is simply bad strategy and not done for other “medical” evils.
For example, a physician who objects to female genital mutilation will not do so on grounds of “conscience” but on the obvious grounds of it being savage, a betrayal of what the medical profession is about.
And so, the real issue with abortion is whether or not it is good medical practice. As is pointed out in A Physician’s Guide to Discussing Abortion, participation in abortion violates basic medical ethics, such as “do no harm.” In a medical world where doctors are asked to warn pregnant patients about smoking and drinking because of harm to their children, it is inconsistent to embrace a practice—abortion—which doesn’t merely harm but decisively destroys children.
In the Code of Ethics of The Canadian Medical Association it says, “Refuse to participate in or support practices that violate basic human rights.” There is no more basic of a human right than the right to life, which abortion obviously violates.
That’s an argument more difficult for Dr. Harris to rebut than an appeal to conscience. The latter invites her to say, “My conscience says otherwise; so you do what you believe and I’ll do what I believe.” But the former forces her to prove the pre-born of human parents aren’t human (a scientific impossibility) who thus don’t qualify for the right to life, or to reject the basic standard of civil societies and human rights doctrines and deny the right to life as a basic human right.
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Others might point out that it is important to emphasize conscience, but that in the conversation we properly define the term. Gaudium et Spes says, “Deep within his conscience man discovers a law which he has not laid upon himself but which he must obey. Its voice, ever calling him to love and to do what is good and to avoid evil, sounds in his heart at the right moment.” Perhaps some would argue that when conscience is defined by this standard, based on objective truths about good and evil, that “following one’s conscience” is properly understood and thus can’t be twisted to support injustices like abortion.
And yet, many people may associate conscience with perhaps a religious conviction or feeling that applies to the individual, not the society, and consequently dismiss a person’s view as subjective without application to society at-large.
Furthermore, if, at its core, the substance of an informed conscience is love, doing what is good, and avoiding evil, then why not talk clearly about those matters themselves?
The patient who listens to, “My conscience says I can’t refer for abortion,” may actually hear, “I personally object to abortion, but that’s just me. Your conscience may say something different.”
But the patient who listens to, “As a physician, I am called to do no harm, to respect persons, and to consider first the well-being of the patient. I care about you and your well being, and it would be negligent of me to not offer you the information I have about the harms of the abortion procedure,” may actually hear, “I know something you may not know, and it can hurt you and others. Do you want to know?”
Of course, in either scenario much more than a sentence or two needs to be said, but the point is, in the end, what is said is the “stuff” of conscience without the label that leads to the confusion like Dr. Harris proposes.
Reprinted with permission from Unmasking Choice