In good conscience?
In his annual speech to the diplomatic corps with credentials at the Vatican, Pope Benedict XVI suggested that the conscience rights of healthcare workers were under attack.
“Christians are even required at times to act in the exercise of their profession with no reference to their religious and moral convictions, and even in opposition to them,” he said, “as for example where laws are enforced limiting the right to conscientious objection on the part of health care or legal professionals.”
Conscience rights have been in the news for a time now. There is an ongoing debate in the United States on the matter, with President Obama considering whether to retain the expanded conscience clauses that were put in place by President George W. Bush. In November, at the Council of Europe in Strasbourg, a reasonable attempt to clarify what rights patients and doctors have when it comes to the implementation of conscience clauses in medical settings was defeated by conservative Catholic members of parliament from Italy and Ireland. Patients’ rights to access services were damaged after the likely impact of a concerted lobby by conservatives was not foreseen by the progressive majority. It was a warning shot across the bows of those who support access to a full range of reproductive health services.
The Vatican’s attempts to influence debates over conscience clauses are indicative of their attempts to control what services are provided in hospitals, Catholic and non-Catholic alike. In a recent case in Phoenix, the local bishop, Thomas Olmsted, intervened when a local Catholic hospital provided a life-saving abortion on a pregnant mother of four. Despite the opinion of a number of Catholic theologians and Catholic members of the hospital staff that the abortion was vital to save the woman’s life, and therefore consistent with the health directives that govern Catholic hospitals, Bishop Olmsted stripped the hospital of its Catholic designation. Will such an event have a chilling impact on medical staff at other Catholic hospitals when they have to make life-saving decisions? Only time will tell.
The pope’s statement is part of a wider trend whereby the Catholic hierarchy–through the Holy See itself or its local bishops–has claimed that the consciences of medical professionals are routinely violated. In addition, bishops also work to expand the number of services covered by these exemptions–as they have done in the United States and elsewhere.
In addition, it is not the first time that the pope himself has intervened directly in such issues. In 2007, Pope Benedict XVI called upon pharmacists in Italy to refuse to dispense emergency contraceptives if they objected on moral grounds. However, Pope Benedict has taken a harder line on this issue than previous popes. Pope Pius XII noted that “out of respect for those who are in good conscience … and are of a different opinion, the church has felt herself prompted to act, and has acted, along the lines of tolerance.” This tolerance is not obvious in Benedict’s approach.
The Vatican encourages its bishops to intervene in the making of public policy on the basis taking the stance that its views reflect not only its own opinion, but also the views of Catholics in that country. However, there is ample evidence that few Catholics agree with the Vatican’s hard line on contraception and the provision of abortion.
Today, most Catholics exercise their conscience against some of the pope’s more well-known public policy pronouncements. Use of modern contraceptive methods is high in many predominantly Catholic countries. For women who are married or in a stable union, the figures for highly Catholic European countries are 77 percent in France, 66 percent in Spain and 63 percent in Portugal. In the US, Catholic women make up a quarter of the United States population and also represent a quarter of U.S. abortion patients.
Catholic teachings on conscience require due deference to the conscience of others in making decisions-meaning in this scenario that the pharmacist must not dismiss the conscience of the person seeking emergency contraception. In light of this, the public policy efforts of the hierarchy should take into account the experiences of individual Catholics as well as the beliefs of patients and healthcare providers of other faiths and no faith so that patients will not be refused any legal and medically appropriate treatment. Moreover, good practice should also compel a healthcare employer to make sure that the consciences of both the healthcare provider and the patient are accommodated by, for example, having policies in place that enable patients to receive whatever medications they are prescribed, or procedures they require.
There is no doubt that there are times when the conscience of an individual doctor, nurse or pharmacist may conflict with the wishes or needs of a patient. This often happens in cases related to abortion. In these situations, a woman seeking an abortion should not have to worry about the religious and moral beliefs of her providers interfering with the provision of the best possible care, so it is in their best interests that only medical professionals committed to providing such services do so.
When this is not possible, a reasonable ethical fallback is for the institution to provide meaningful referrals to ensure that patients receive continuity of care without facing an undue burden, such as travelling long distances or encountering additional barriers to obtaining the desired services.
For the Catholic hierarchy to lay claim to be the arbiter of any person’s good conscience is clearly disingenuous. When medical professionals refuse to provide legal reproductive health services, or provide timely referrals to other providers, they violate the right to conscience of the person seeking those services. This does not fall under anybody’s definition of a good conscience.
This article originally appeared in On Faith on WashingtonPost.com