Freedom of Conscience in Healthcare or Conscientious Objection in Healthcare is the right for health professionals to not be involved with procedures and services that are ethics contested or that may generate conflicts of conscience.

Areas where Freedom of Conscience in Healthcare is practiced include:

  • Abortion
  • Artificial reproduction
  • Assisted suicide and euthanasia
  • Eugenics
  • Execution
  • Tissue trafficking
  • Torture

In this section we focus on abortion as it is the most frequently exercised right to freedom of conscience in New Zealand and of most relevance to our member base and followers.

For full information on freedom of conscience for health professionals in New Zealand we recommend visiting the New Zealand Health Professionals Alliance (NZHPA) website – www.nzhpa.org . The NZHPA offer a wealth of information on this area and also provide support for students and health professionals who choose to exercise freedom of conscience.

Video Perspective: Dr Catherine Lennon on Conscientious Objection

Dr Catherine Lennon, (MBBS, FRACGP, IBCLC, NFPMC) is a GP specialising in women’s health, counselling and fertility problems. She discusses current legislation on abortion and the importance of providing the option of conscientious objection to such procedures as a basic worker’s right.

New Zealand:

In New Zealand, health practitioners have a lawful right to conscientious objection. This applies explicitly to requests for reproductive health services including advice. An example of such a request would be for referral for consideration for an abortion.

A  health practitioner can conscientiously object to the provision of such a request in accordance with S174 of the Health Practitioners Competence Assurance Act 2003.

In this setting, the health practitioner has a duty to inform the person that to obtain that service they can see another health practitioner or attend a family planning clinic. That is the maximum obligation. The health practitioner does not have to write a referral, arrange transport or otherwise engage in the provision of the service if he or she holds a conscientious objection.

How to Answer Critics:

Many people oppose the idea that health practitioners should be allowed to follow their conscience when doing their work. They argue that a health professional’s moral code should be kept private at all times. They say that public, professional behaviour must differ from personal beliefs.

However, this raises a fundamental question:

“Upon what universally accepted principle should individuals be forced to give up their own convictions and be made to act upon the contrary moral beliefs of an employer, union, professional association or state?”

Opponents of freedom of conscience must be confronted with this question. It should remain the focus for serious discussion.

Key issues to consider:

  • Correct science provides the indispensable basis for moral or ethical decision making;

  • Science may determine what it is possible to do, but cannot establish what ought to be done or what ought not to be done;

  • The decision that something ought to be done reflects a moral or ethical belief; that’s exactly the same kind of belief as a decision that it ought not to be done;

  • One cannot exclude belief from moral or ethical decision-making because all who exercise moral or ethical judgment are acting upon a belief of some sort;

  • Belief may be religious or non-religious;

  • To claim that only non-religious belief is valid in moral or ethical decision making reflects anti-religious prejudice, not sound reasoning.

An interesting opinion piece on freedom of conscience in healthcare.

Abortion is legal in New Zealand under certain criteria, and doctors exist to serve patients. So should a doctor be required to provide a service if women are legally entitled to it?

The ethicist Julian Savulescu equates the legality of an act with its justness in a passionate article against conscientious objection. History, however, tells us that such an argument does not stand. Doctors in Nazi Germany took part in the sterilisation of patients with epilepsy and schizophrenia and in the murder of old, disabled, and other burdensome patients, doing their duty under laws that sanctioned active euthanasia. Any praise we give to medics in that regime rightly belongs to the conscientious objectors.

Many of our present day counterparts around the world are placed in situations with which we might be profoundly uncomfortable. These include the death penalty and torture. If the law says that death is the appropriate penalty for certain crimes, should a state registered doctor be able to opt out of his duty to give the lethal injection? If torture is considered a reasonable way to extract information from a criminal, as it seems to be in Guantanamo Bay, should the medic treat a prisoner, patching him up enough for further interrogation? Most of us hope for the courage to conscientiously object in these situations.

Statutory law and moral law are not synonymous in content because statutory law can change with time. The Declaration of Geneva used to affirm the “utmost respect of human life from the time of its conception.” Since 1984 “from the time of its conception” has been absent. In 1983 the doctor who is against abortion is in agreement with the codified morals of his profession, but in 1984 it is a grey area. Ethics are surely not so fickle?

Conscientious objection in medicine is rarely an easy way out. It may add to paper work, complicate relationships with colleagues, and leave the doctor feeling vulnerable and isolated. However, history shows that rapid changes of law is reason enough to uphold the doctor’s right to raise conscientious objection. We may never all agree on what is the right thing to do in difficult clinical and moral situations. But we need more doctors, not fewer, who are willing to defend what they think is right.

For full information on freedom of conscience for health professionals in New Zealand we recommend visiting the New Zealand Health Professionals Alliance (NZHPA) website – www.nzhpa.org . The NZHPA offer a wealth of information on this area and also provide support for students and health professionals who choose to exercise freedom of conscience.

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