Medicine is a moral enterprise.
The practice of medicine is an inescapably moral enterprise precisely because physicians are always seeking to do some kind of good and avoid some kind of evil for their patients. However, the moral aspect of practice as it relates to the conduct and moral responsibility of a physician is usually implicit, not explicit. It is normally eclipsed by the needs of the patient and exigencies of practice. But it is never absent; every decision concerning treatment is a moral decision, whether or not the physician specifically adverts to that fact.
This point is frequently overlooked when a physician, for reasons of conscience, declines to participate in or provide a service or procedure that is routinely provided by his colleagues. They may be disturbed because they assume that, in making a moral decision about treatment, he has done something unusual, even improper. Seeing nothing wrong with the procedure, they see no moral judgement involved in providing it. In their view, the objector has brought morality into a situation where it doesn’t belong, and, worse, it is his morality. . . [Full Text]
An answer for a Dying With Dignity clinical advisor
I just can’t understand why as learned as you are, you tenaciously use the verb KILL to refer to MAD. You cannot ignore that this verb requires a non-consenting victim. It makes of you a malicious pro-lifer who does not mind lying. MAD must be requested ! Camus wrote: «To misname things amount to adding to the world’s misery»…in La Pléiade, Oeuvres complètes p. 908.
This message was left for the Project Administrator by a member of the Clinicians’ Advisory Council of Dying With Dignity (DWD) Canada after he/she had downloaded several papers from the Administrator’s Academia web page.
The downloaded papers do not challenge the legalization of euthanasia and assisted suicide (EAS). The substantive morality of the procedures and their legalization is outside the scope of Project advocacy. The papers simply defend practitioners unwilling to be parties to killing their patients by providing or facilitating EAS services.
Unfortunately, the DWD Clinical Advisor was exasperated by the description of euthanasia and assisted suicide as “killing.” This, he/she exclaims, is a malicious lie that adds to the world’s misery.
Such a cri de cœur calls for a thoughtful discussion of the question it raises.
Does providing euthanasia and assisted suicide entail killing — or does it not? [Full text]
The Globe and Mail
Dr. Jillian Demontigny keeps a rainbow bracelet wrapped around the stethoscope that she drapes across her neck. It’s her signal to any LGBTQ patient who arrives at her clinic: you are welcome here.
Dr. Demontigny is one of 13 physicians working at the Taber Clinic, a family medicine clinic in a southern Alberta town of 8,500 people. Over her 14 years in Taber, she has expanded her practice to offer extra supports for patients looking for the kind of health care that can be hard to access in this rural, conservative region, where anti-abortion billboards are posted along the highway. . . [Full text]
Mary Kathleen Deutscher Heilman, Tracy J. Trothen
Conscientious objection has become a divisive topic in recent bioethics publications. Discussion has tended to frame the issue in terms of the rights of the healthcare professional versus the rights of the patient. However, a rights-based approach neglects the relational nature of conscience, and the impact that violating one’s conscience has on the care one provides. Using medical assistance in dying as a case study, we suggest that what has been lacking in the discussion of conscientious objection thus far is a recognition and prioritising of the relational nature of ethical decision-making in healthcare and the negative consequences of moral distress that occur when healthcare professionals find themselves in situations in which they feel they cannot provide what they consider to be excellent care. We propose that policies that respect the relational conscience could benefit our healthcare institutions by minimising the negative impact of moral distress, improving communication among team members and fostering a culture of ethical awareness. Constructive responses to moral distress including relational cultivation of moral resilience are urged.
Heilman MKD, Trothen TJ. Conscientious objection and moral distress: a relational ethics case study of MAiD in Canada. J Med Ethics. 2020;46(2):123-127. doi:10.1136/medethics-2019-105855
Doctors who have ethical questions in the midst of treating a patient can check their phones for answers.
Catholic physicians who are concerned about the ethical implications of care and treatment decisions now have a new tool to help them, and it will fit right into their pocket.
The Catholic Medical Association has developed the Catholic Medical Conscience App for health care professionals who want help learning and applying the intellectual tradition of the Church in the health care setting. The app has a “nihil obstat,” an official Church approval, from the Archdiocese of Indianapolis. . . [Full text]