Julian Savulescu states emphatically that "values are important parts
of our lives....but they should not influence the care an individual
doctor offers to his or her patient," and "when the duty is a true duty,
conscientious objection is wrong and immoral."
These statements, on a superficial reading, seem sensible and fair.
However, at closer examination of his article I would wholeheartedly
disagree with its message, which I believe is a very dangerous one.
As examples of possible dilemmas we are given two radically different
ones: 1. Termination of pregnancy for serious handicap or for social
reasons; and 2. An infectious disease specialist refusing to treat
patients with bird flu because "she valued her own life more than her duty
to treat her patients." One cannot place these two dilemmas in the same
category, for the principles and morals concerned are totally different.
Savulescu says "the primary goal of a health service is to protect
the health of its recipients." Is this really so for the foetus who is the
"recipient" of this termination of its life? An obstetrician who values
the care of his patients more than his chances of promotion, reputation,
or popularity-may well come to the conclusion that the best care he can
give his patient is to preserve life, not destroy it. Surely, to "compell"
that obstetrician to act against his conscience in this way, is dangerous
and immoral. It may not be too long before assisted suicide and euthanasia
are on our statute books; are we going to force doctors to comply with
what goes totally against their ethical and moral code? This is surely not
acceptable.
As for the infectious diseases consultant who refuses to treat her
patients because of fear for her own life. Of course, it is expected that
doctors will act in the patients' interests whenever possible, and even at
great cost...and that should be every doctor's stance. However, we from
our detatched theoretical position may find it easy to criticise and
condemn her "lack of care." But...which one of us carries the right to
tell another that they must be ready to face any risk to themselves, for
the sake of another.
Every doctor has a "duty to care" and should fulfil his obligations
to improve the health of his patients. These issues are crisp and clear in
many illnesses and situations. For me to neglect a child who has acute
appendicitis because it is late at night and I am tired, is clearly a
breach of contract and negligence. But we cannot extrapolate that argument
to the many grey areas which Savulescu highlights in his article. We must
protect the individual freedom and rights of doctors who wish to refrain
from procedures and practices which are not necessarily preserving health
and life.
It is a dangerous thing for society to remove the freedom to act in
accordance with an individual's conscience. I do fervently hope that
Savulescu's message is rejected by the overwhelming majority of doctors.
Competing interests:
None declared
Competing interests:
No competing interests
08 February 2006
Alasdair H B Fyfe
Consultant Paediatric Surgeon
The Royal Hospital for Sick Children,Yorkhill, Glasgow G3 8SJ
Rapid Response:
"Conscientious objection...wrong and immoral"?
Dear Sir,
Julian Savulescu states emphatically that "values are important parts
of our lives....but they should not influence the care an individual
doctor offers to his or her patient," and "when the duty is a true duty,
conscientious objection is wrong and immoral."
These statements, on a superficial reading, seem sensible and fair.
However, at closer examination of his article I would wholeheartedly
disagree with its message, which I believe is a very dangerous one.
As examples of possible dilemmas we are given two radically different
ones: 1. Termination of pregnancy for serious handicap or for social
reasons; and 2. An infectious disease specialist refusing to treat
patients with bird flu because "she valued her own life more than her duty
to treat her patients." One cannot place these two dilemmas in the same
category, for the principles and morals concerned are totally different.
Savulescu says "the primary goal of a health service is to protect
the health of its recipients." Is this really so for the foetus who is the
"recipient" of this termination of its life? An obstetrician who values
the care of his patients more than his chances of promotion, reputation,
or popularity-may well come to the conclusion that the best care he can
give his patient is to preserve life, not destroy it. Surely, to "compell"
that obstetrician to act against his conscience in this way, is dangerous
and immoral. It may not be too long before assisted suicide and euthanasia
are on our statute books; are we going to force doctors to comply with
what goes totally against their ethical and moral code? This is surely not
acceptable.
As for the infectious diseases consultant who refuses to treat her
patients because of fear for her own life. Of course, it is expected that
doctors will act in the patients' interests whenever possible, and even at
great cost...and that should be every doctor's stance. However, we from
our detatched theoretical position may find it easy to criticise and
condemn her "lack of care." But...which one of us carries the right to
tell another that they must be ready to face any risk to themselves, for
the sake of another.
Every doctor has a "duty to care" and should fulfil his obligations
to improve the health of his patients. These issues are crisp and clear in
many illnesses and situations. For me to neglect a child who has acute
appendicitis because it is late at night and I am tired, is clearly a
breach of contract and negligence. But we cannot extrapolate that argument
to the many grey areas which Savulescu highlights in his article. We must
protect the individual freedom and rights of doctors who wish to refrain
from procedures and practices which are not necessarily preserving health
and life.
It is a dangerous thing for society to remove the freedom to act in
accordance with an individual's conscience. I do fervently hope that
Savulescu's message is rejected by the overwhelming majority of doctors.
Competing interests:
None declared
Competing interests: No competing interests