Having Conscience in a Culture of Death

Over the past fifty years, the purposes and practices of medicine have changed radically. Where medical ethics was once life-affirming, today’s treatments and medical procedures increasingly involve the legal taking of human life. The litany is familiar: More than one million pregnancies are extinguished each year in the United States, thousands late-term. Physician-assisted suicide is legal in Oregon, Washington, and, as this is written, Montana via a court ruling (currently on appeal to the state supreme court). One day, doctors may be authorized to kill patients with active euthanasia, as they do already in the Netherlands, Belgium, and Luxembourg.

The trend toward accepting the termination of some human lives as a normal part of medicine is accelerating. For example, ten or twenty years from now, the physician’s tools may include embryonic stem cells or products obtained from cloned embryos and fetuses gestated for that purpose, making physicians who provide such treatments complicit in the life destruction required to obtain the modalities. Medical and bioethics journals energetically advocate a redefinition of death to include a diagnosis of persistent vegetative state so that these living patients—redefined as dead—may be used for organ harvesting and medical ­experimentation. More radical bioethicists and mental-health professionals even suggest that patients suffering from BIID (body-integrity identity disorder), a terrible compulsion to become an amputee, should be treated by having healthy limbs removed, just as transsexuals today receive surgical sexual reassignment.

The ongoing transformation in the methods and ethics of medicine raises profound moral questions for doctors, nurses, pharmacists, and others who believe in the traditional virtues of Hippocratic medicine that proscribe abortion and assisted suicide and compel physicians to “do no harm.” To date, this hasn’t been much of a problem, as society generally accommodates medical conscientious objection. The assisted-suicide laws of Oregon and Washington, for example, permit doctors to refuse to participate in hastening patient deaths. Similarly, no doctor in the United States is forced to perform abortions. Indeed, when New York mayor Michael Bloomberg sought to increase accessibility to abortion by requiring that all residents in obstetrics and gynecology in New York’s public hospitals receive training in pregnancy termination, the law specifically allowed doctors with religious or moral objections to opt out through a conscience clause.