Conscripting Doctors

Do Harm—Or Else Original Article

Should anyone outside the military be forced to kill? Most people would say no. But with the ubiquitous availability of abortion—and the push to legalize assisted suicide and euthanasia—doctors may soon find themselves required to take lives or risk being booted from the medical profession.

Let’s call this threat “medical martyrdom.” Laws today generally protect doctors from being conscripted into the culture of death. But there is concerted effort to override the preferences of doctors who object to killing.

A “Consensus Statement on Conscientious Objection in Healthcare,” published recently by the University of Oxford’s Practical Ethics, is a case in point. In the statement, prominent bioethicists claim that existing legal protections shielding medical doctors from forced participation in abortion and assisted suicide (where legal) are “indefensible.” They urge that the laws be amended to require all doctors either to perform legal medical procedures or, if conscientiously opposed, be compelled to refer to a doctor the dissenter knows is willing. In circumstances where such a doctor cannot be found or reasonably reached by the patient, the statement declares that objecting doctors should be forced to “perform the treatment themselves.”

That’s not all. The statement advocates establishing “tribunals” before which objecting doctors would be forced to appear to demonstrate the sincerity and depth of their objections. If excused from, say, performing euthanasia, the doctor would be required to perform community service, as if he had been convicted of a crime:

Healthcare practitioners who are exempted [by the tribunals] from performing certain medical procedures on conscientious grounds should be required to compensate society and the health system for their failure to fulfill their professional obligations by providing public-benefitting services.

As for medical students, unless they are willing to be trained in killing techniques, they had better find another profession:

Medical students should not be exempted from learning how to perform basic medical procedures they consider to be morally wrong.

And don’t forget the reeducation camps! “Healthcare practitioners should also be educated to reflect on the influence of cognitive bias in their objections.”

The Consensus Statement is not an outlier in bioethics advocacy. An article just published in the Journal of Medical Ethics similarly laments the existence of legal protections for medical conscience and urges that dissenting doctors be treated like military draft resisters, with tribunals (again) set up to determine whether they should be exempted from medicalized killing.

Two internationally influential bioethicists, Julian Savulescu and Udo Schuklenk, have also joined forces in the journal Bioethics to claim that “Doctors Have No Right to Refuse Medical Assistance in Dying, Abortion or Contraception.” First, they deconstruct what little is left of medicine as a learned profession by arguing that “the scope of professional practice is ultimately determined by society” and that the doctor’s own views on right and wrong do not matter a whit:

If a service a doctor is requested to perform is a medical practice, is legal, consistent with distributive justice, requested by the patient or their appointed surrogate, and is plausibly in their interests, the doctor must ensure the patient has access to it. It is then irrelevant how defensible the doctor’s own moral take on the patient’s actions is.

Such arguments are fast becoming a staple of bioethics discourse and would transform access to lethal procedures such as abortion and assisted suicide into a legally enforceable right—meaning the government and medical associations would have a duty to guarantee that all qualified patients obtain these interventions from a doctor when requested. To overcome resistance from the many doctors opposed to participating in these life-ending procedures, medical conscience protections would have to be repealed and dissenting doctors coerced by putting their medical licenses at risk.

Medical martyrdom has already started. Victoria, Australia, legally requires all doctors to perform abortions when asked or, if opposed to abortion, find a willing replacement. One doctor has already been professionally disciplined for refusing to refer for a sex-selection abortion.

After Canada’s Supreme Court conjured a right to euthanasia for patients with a diagnosed medical condition that causes “irremediable suffering”—as defined by the patient—provincial medical colleges (akin to our state medical associations) enacted the very kind of participate-or-refer policies advocated in the articles quoted above.

Meanwhile, in Vermont, where assisted suicide is legal for the terminally ill, state bureaucrats have interpreted a law requiring that doctors counsel dying patients in all palliative care options as a legal obligation to provide information about assisted suicide. That interpretation is now the subject of litigation brought by Alliance Defending Freedom.

The accelerating anti-medical conscience campaign in bioethics threatens to destroy the life-affirming values enunciated in the Hippocratic Oath that undergirded medical ethics for millennia. The ultimate goal is to force pro-life, orthodox Catholic, and other dissenting doctors either to kill or leave the profession.

Wesley J. Smith

Chair and Senior Fellow, Center on Human Exceptionalism
Wesley J. Smith is Chair and Senior Fellow at the Discovery Institute’s Center on Human Exceptionalism. Wesley is a contributor to National Review and is the author of 14 books, in recent years focusing on human dignity, liberty, and equality. Wesley has been recognized as one of America’s premier public intellectuals on bioethics by National Journal and has been honored by the Human Life Foundation as a “Great Defender of Life” for his work against suicide and euthanasia. Wesley’s most recent book is Culture of Death: The Age of “Do Harm” Medicine, a warning about the dangers to patients of the modern bioethics movement.