Protection of Conscience Project
Protection of Conscience Project
Service, not Servitude

Service, not Servitude

Re: The Limits of Conscientious Refusal in Reproductive Medicine

ACOG Committee on Ethics Opinion No. 385: November, 2007

Attacking the conscience rights of their own members

Ethics, Culture and Policy
Reproduced with permission

Paul Adams*

Like the National Association of Social Workers, which released a statement last May 2010 attacking the conscience rights of its members and subordinating them to client autonomy, the American College of Obstetricians and Gynecologists (ACOG) has reaffirmed its notorious 2007 Ethics Committee position #385 on the limits of conscientious refusal in reproductive medicine.

Odd that they persist in describing the killing of unborn children as a part of "reproductive medicine" since abortion seldom has anything to do with treating illness, and is never about doing no harm, or reproduction, and violates the Hippocratic Oath!

In a forthcoming piece in the Journal of Social Work Values and Ethics, I conclude:

In the case of the life issues, the issue at stake is the fundamental moral proscription on the intentional taking of innocent human life. This has been a basic principle of ethics for millennia, an exceptionless norm which binds the consciences of all in societies where the conscience is recognized at all. To kill justly requires at least that the person is not innocent (as in capital punishment or enemy soldiers in a just war); or is not a fully human person (as has been argued in the case of Blacks, Jews, and unborn babies); or that killing is not the intent but an unintended side effect (as with deaths of nearby civilians from the bombing of a military target).

Of course, moral relativists, situationists, consequentialists, and ethical emotivists may deny the existence or binding nature of such a proscription on the killing of innocents. I will not take up here the objections to these stances in moral philosophy, but simply note that if it is wrong to kill a person, then it is also wrong to get someone else to do it. If it is, as I believe, a grave evil for me to murder my spouse, it is no less wrong to hire someone else to do it for me.

None of this has anything to do with imposing my views on the client, as anti-exemptionists and militant secularists often claim. Patients and clients have an uncontested moral right to informed consent and informed refusal. But this is not the issue, as Pellegrino (2008) argues. The client may find abortion morally permissible and it is certainly legally permissible in the United States. I respect her right under law to decide to have an abortion and will not condemn, moralize, or argue with her. But this is not the issue. "Conscientious objection, " as Pellegrino (2008) says, "implies the physician's right not to participate in what she thinks morally wrong, even if the patient demands it. It does not presume the right to impose her will or conception of the good on the patient" (p.299).