Doctors and conscientious objection

It has been authoritatively declared in the 1965 Conciliar document Dignitatis Humanae that nobody should be forced to act against his conscience, nor is anyone to be restrained from acting in accordance with his religious convictions. This is certainly true in any conflict between a practical dictate of conscience and a legislative or administrative decree of any superior. Everyone has a duty to obey his conscience; not just blindly but after doing his best to learn the truth about the moral norms which bind all people. It is not a matter of personal taste or preference. Some actions are good and others are bad, always and everywhere. No one is exempt from the duty of doing what is right and avoiding what is wrong.

There are norms which bind in every case, without exception. Consequently, everybody has the right to make decisions for himself and follow his conscience, freely.

The democratic State is expected to recognise this right to full freedom of conscience for all its citizens. The true function of political authority is to respect, protect and facilitate this freedom. The universal right of the human person to immunity from civil coercion of his conscience, in fact, has been recognised by many countries.

The problem of conscientious objectors has been discussed, particularly since the First World War. The term has come to signify an individual who, out of personal moral conviction, opposes war, and refuses to participate in armed conflict.

An objector, in order to sincerely follow his conscience, should make an honest effort to find out the moral implications of the action he has been asked to do before taking any decision. If he cannot persuade himself that it is licit, he must abstain from any participation in it.

At first, some mooted the idea that it was acceptable to force someone, through the imposition of penal sanctions, to take up military service. The excuse was that conscientious objectors were trying to shirk their duties towards their native country. But nowadays few people hold this opinion.

In the all-important issue of war and peace, all men are to follow their consciences. As a matter of fact, Vatican II has declared: "It seems right that laws make humane provision for the case of those who for reasons of conscience refuse to bear arms, provided, however, that they accept some other forms of service."

But the issue of conscientious objection is not limited to war. It may also arise in other spheres, such as those connected with medical practice.

A case in point is the objection to abortion on moral grounds. Legislation in several countries where abortion is legal carries a conscientious objection clause which permits doctors to refuse to take part in terminations, but they still have the duty to provide necessary treatment in an emergency when there is a risk to the woman's life.

There are other doctors, both Christian and Muslim, who have a conscientious objection to providing contraceptive advice or treatment and may chose not to provide such services.

The boundary between contraception and abortion has become blurred to a certain extent following the introduction of drugs taken after sexual intercourse which inhibit the process of pregnancy. For those who believe that human life begins at fertilisation, post-coital birth control is a form of abortion. Doctors who hold this view may feel a conscientious objection to post-coital treatment.

Other people have conscientious objections to sterilisation for contraceptive purposes, since, according to some religious beliefs, only therapeutic sterilisation is acceptable.

Another procedure that presents many problems, moral and medical, is surrogacy. For some doctors it is unacceptable. They are against it, either due to reasons of conscience or because its risks are so great that they do not wish to take responsibility for any form of surrogate pregnancy.

Last but not least, euthanasia poses a troublesome question for those who respect human life and believe it should be protected from conception to natural death. Even in this case, conscientious objection might be the only option for the doctor who believes euthanasia is morally unacceptable.

Pope Benedict XVI said last year in his address to the General Assembly of the Pontifical Academy for Life: "It is certainly necessary to speak about the moral criteria that regard these themes with professionals, doctors and lawyers, to engage them to elaborate a competent judgment of conscience, and if need be, also, a courageous objection of conscience".

There is no doubt that this remark was both important and timely.