The international medical community has long maintained an ethical line against force-feeding. As infectious disease specialist Kent Sepkowitz has written, “Without question, it is the most painful procedure doctors routinely inflict on conscious patients… The procedure is, in a word, barbaric.”
Yet in Guantanamo Bay, it is daily procedure for a reported 18 hunger striking detainees. Every day medical professionals watch strapped-down inmates gasp, gag, and choke with streaming eyes as rubber tubes are snaked through sensitive nasal passages into empty stomachs. Despite urging from institutions including the American Medical Association and the New England Journal of Medicine, Gitmo prison medical staff continue to participate, all of them just following orders. All but one. [Full text]
Cuando la conciencia molesta a la ley
A finales de 2010, en la Asamblea Parlamentaria del Consejo de Europa (PACE) se presentó un informe de su Comisión de Asuntos Sociales, Salud y Familia en el que expresaba su profunda preocupación por el problema de la “objeción de conciencia no regulada” en Europa. El Comité propuso que los Estados adoptaran “una regulación integral y clara” para hacer frente a este problema. . .[aceprensa]
In late 2010, the Parliamentary Assembly of the Council of Europe (PACE) was presented with a report from its Social, Health and Family Affairs Committee expressing deep concern about the problem of “unregulated conscientious objection” in Europe. The Committee proposed to solve this problem by having states adopt “comprehensive and clear regulations” to address it.
The Council ultimately adopted a resolution that almost completely contradicted the premises of the report, but in 2011 the theme was resurrected by Dr. Leslie Cannold, an Australian ethicist. Dr. Cannold warned that, “[a]t best, unregulated conscientious objection is an accident waiting to happen,” and, at worst, “a sword wielded by the pious against the vulnerable with catastrophic results.” It was, she wrote, “a pressing problem from which we can no longer, in good conscience, look away.” . . .[Full text]
Those who, for reasons of conscience, refuse to facilitate morally contested procedures by referral or other indirect means should take note of the World Medical Association’s reaffirmation of its position against physician “participation” in executions, which now includes a statement that physicians must not facilitate executions by importing drugs for executions. Similarly, the British group, Reprieve, has embarked upon a campaign to have drug companies sign a Pharmaceutical Hippocratic Oath against the use of their products in executions. [Bioedge]
The Pharmaceutical Hippocratic Oath has been prepared by Reprieve, an organization in the United Kingdom that works to ensure fair judicial processes around the world. The group places special emphasis on cases involving capital punishment. The oath includes the following statement:
“We dedicate our work to developing and distributing pharmaceuticals to the service of humanity; we will practice our profession with conscience and dignity; the right to health of the patient will be our first consideration; we condemn the use of any of our pharmaceuticals in the execution of human beings.”
Some of the issues associated with the campaign it are relevant to freedom of conscience for health care workers, especially pharmacists. They include the problem of complicity, degrees of participation and the apparent appeal to a de facto corporate conscience.