Catholic Medical Quarterly Volume 66(4) November 2016
Practical Medical Ethics
Valuing the Right to Conscientious Objection. A Patient’s Perspective
In this article an anonymised author describes the fears and worries of a mother who values life being looked after by clinicians who perform abortions and do not value the unborn child in the same way.
Discussion about conscientious objection in the context of abortion seems to be mostly framed as a tension between the rights of medical practitioners and those of women seeking abortion. But these are not the only persons whom medical practitioners, including specialists, are there to serve. It is important also to consider the needs of those many men and women who continue to regard the life of the unborn human as of equal worth to that of the born human. Such people, when faced with difficult decisions arising from problems during a pregnancy, need to know that the advice they receive can be trusted to truly reflect the value placed upon that unborn child's wellbeing as to that of the mother.
In 1985, when I was apparently three months pregnant, I started to bleed. A scan showed a womb enlarged to a size consistent with my dates but apparently empty. We were told it was most likely a blighted ovum pregnancy and I was urged to agree to a D & C without delay in order to avoid risk to my own life. I explained that we wished to be advised on the basis of our view that while there was any possibility that our unborn child was still alive we should give as much weight to our child's life as to mine. However, from this point onwards and throughout what followed, the body language and phraseology informed us that the practitioners we encountered understood our position at an intellectual level only. They ‘respected' it but did not share it and, while paying lip service to our concerns for any unborn child, they clearly remained focused solely on my own wellbeing.
They agreed I might reasonably return home, take complete bedrest and see what happens. However, they advised that if I started to pass clots I 'must' return to the hospital and agree to a D & C at that point so as not to risk my own life. A few days later, respecting this instruction, I returned still unconvinced: wishing to let nature take its course and not intervene but yet aware that the possibility that the unborn child was still alive was likely very remote and that I also had a duty to myself. I reiterated my concern to the attending doctor. He seemed indifferent and asked permission to conduct an internal examination. In my vulnerability and naivety I agreed. As he removed his gloves post-examination he said, in a very matter-of-fact manner:
“Your pregnancy is over”
Now, and with the benefit of the internet, it is clear that this is no longer the protocol: Women are not pressured into a D & C but are free to let nature take its course. The dramatic accounts of imminent mortal danger are apparently no longer necessary. (Were they ever?) Nonetheless, the principle at stake here stands. We need advice we can trust but are systematically denied it. This is happening both through cultural and judicial erosion of the rights to conscientious objection and, anecdotally, because a potential practitioner who objects to abortion is steered away from the relevant specialities.
We used to regard the womb as synonymous with security. Deep down, naturally and instinctively we still know that we should nurture and protect our most vulnerable. But it is clear that instinct is eroded by involvement in abortion procedures. An exercise in rationalisation erodes the (perceived) moral worth of the unborn and the focus becomes solely the (perceived) needs of the pregnant woman. This has been starkly demonstrated recently by statements and edicts from the Royal College of Midwives of which you will, no doubt, be aware.
Valuing the right to conscientious objection
For the sake of patients – those whom medical practitioners are there to serve - the right to conscientious objection must be protected and interpreted broadly so as to require neither direct nor indirect complicity.
Practitioners who exercise this right should feel comfortable to identify themselves as such to their management. Then they could and should be valued as best (or arguably uniquely) able to advise and guide the many who still hold to these traditional and natural principles.