BLOG on the Reading Down of Conscience Protection
Charo, J.D., The Celestial Fire of Conscience - Refusing to Deliver Medical
Care N Eng J Med 352:2471-2473; 24, June 16, 2005
Reproduced with permission
A pharmacist who has been doing excellent work
trying to shine light into some of the more
restrictive corners of the Pharmacy profession in
Canada - - Cristina Alarcon, who gave a presentation
at the Centre/Simon Fraser Conference recently,
sends an interesting article from the recent issue
of the New England Journal of Medicine.
After commenting that at least 45 States have
conscience clause legislation (badly needed across
Canada), the author makes the following statement:
For health care professionals,
the question becomes: What does it mean to be a
professional in the United States? Does
professionalism include the rather old-fashioned
notion of putting others before oneself? Should
professionals avoid exploiting their positions to
pursue an agenda separate from that of their
profession? And perhaps most crucial, to what extent
do professionals have a collective duty to ensure
that their profession provides nondiscriminatory
access to all professional services? R. Alta Charo,"The
Celestial Fire of Conscience - Refusing to Deliver
Medical Care" NEJM (Volume352:2471-2473) June
Short quiz. What do you see to be the central
assumption made in the above passage?
Did you answer: "the assumption that there
is one "professional standard" ?
If you did, then you are right. This is the
standard line from those who wish to frustrate the
proper accommodation of conscience and religion.
Resist accommodation by insisting on "one standard"
and "non-discriminatory access" to the "service"
It is our old friend "convergence pluralism"
again - - this time in medical ethics. Hey, remember
Frank Archer a few years back? He was the "ethicist"
advising the Canadian pharmacists that they could
not impose their views of "emergency
contraception" (morning after pill - - an
abortifacient such as used to be rejected by the
Hippocratic Oath as against medical ethics until
some modern ethicists decided to reject that part of
the oathâ€¦.so things progress). Anyway, Frank Archer
(just google him if you want to see the responses
written to his infamous Canadian Pharmaceutical
Journal article), took the same line.
It boils down to "One size fits all." This may be
great for summer beach towels, but hardly works
where society has controversial ethical matters and
supposedly seeks to protect them. One says
"supposedly" because articles like this one in the
NEJM and the one by Frank Archer a few years ago
show that "one size fits all" is the latest attempt
to force the views of some on everyone and that is,
itself, discriminatory, totalitarian and unethical
These folks completely fail to see that
there are two autonomies involved - -provider of the
"service" as well as the seeker of the service; they
do this to get their dominant view forced through
and their approach is simply wrong - - even if it is
now getting prominent billing in prestigious medical