Appeal to sound medicine, not conscience rights: expert

Defenders of life called to polish arguments for the right to life

BC Catholic

Deborah Gyapong

U.S. physician and theologian is warning appeals to conscience rights may no longer be effective because they appear to pit physicians against their patients.

Instead, defenders of conscience rights must polish their rhetorical arguments in defence of good professional judgment and sound medicine, said Dr. Farr Curlin March 16. He was giving the annual Weston lecture sponsored by Augustine College.

A palliative care physician and co-director of the Theology, Medicine and Culture Initiative at Duke University in Raleigh, NC, Curlin has been called as an expert witness in the case of five Ontario doctors who are challenging the College of Physicians and Surgeons of Ontario’s policy that would force physicians to make effective referrals on abortion, euthanasia, and other procedures they may find morally objectionable.

“The policy is outrageous and unprecedented,” Curlin said. “It’s also incoherent.” . . . [Full text]

 

US primary care physicians’ opinions about conscientious refusal: a national vignette experiment

Abstract:

Objective: Previous research has found that physicians are divided on whether they are obligated to provide a treatment to which they object and whether they should refer patients in such cases. The present study compares several possible scenarios in which a physician objects to a treatment that a patient requests, in order to better characterise physicians’ beliefs about what responses are appropriate.

Design: We surveyed a nationally representative sample of 1504 US primary care physicians using an experimentally manipulated vignette in which a patient requests a clinical intervention to which the patient’s physician objects. We used multivariate logistic regression models to determine how vignette and respondent characteristics affected respondent’s judgements.

Results:
Among eligible respondents, the response rate was 63% (896/1427). When faced with an objection to providing treatment, referring the patient was the action judged most appropriate (57% indicated it was appropriate), while few physicians thought it appropriate to provide treatment despite one’s objection (15%). The most religious physicians were more likely than the least religious physicians to support refusing to accommodate the patient’s request (38% vs 22%, OR=1.75; 95% CI 1.06 to 2.86).

Conclusions:
This study indicates that US physicians believe it is inappropriate to provide an intervention that violates one’s personal or professional standards. Referring seems to be physicians’ preferred way of responding to requests for interventions to which physicians object.

Brauer SG, Yoon JD, Curlin FA  US primary care physicians’ opinions about conscientious refusal: a national vignette experiment.  J Med Ethics. 2016 Feb;42(2):80-4. doi: 10.1136/medethics-2015-102782. Epub 2015 Jul 1.