Tag: Julian Savulescu

Bioethicist calls for a ban on doctors’ conscientious objection

The Sydney Morning Herald

Cameron Atfield

Doctors working in the public system should be banned from refusing to perform certain procedures, such as abortions, because of their religious beliefs, a leading bioethicist will argue in Brisbane next week.

Oxford-based Australian bioethicist Julian Savulescu will make the argument at a public lecture at the Queensland University of Technology’s Australian Centre for Health Law Research next Tuesday.

In his lecture, Professor Savulescu will also argue doctors and health professionals should only enter medical specialities in which their values would not be in conflict with routine legal medical procedures. . . [Full text]

The unsettled status of conscientious objection in the UK

BioEdge

Michael Cook

What are the rights of doctors who have a conscientious objection to certain procedures in the United Kingdom? The slightly confusing status quo is the subject of an article in the Journal of Medical Ethics by a Cambridge University academic, John Adenitire.

Dr Adenitire sketches a gradation of hostility towards conscientious objection.

1. At the very top there are Julian Savulescu and others who have argued that conscientious objection is “a door to a Pandora’s box of idiosyncratic, bigoted, discriminatory medicine” and has little place in modern medical practice. This is not a widely shared view.

2. Then there is the British Medical Association (BMA), the profession’s “trade union”, which defends conscientious objection only in three specific scenarios. It “should ordinarily be limited to those procedures where statute recognises their right (abortion and fertility treatment) and to withdrawing life-prolonging treatment from patients who lack capacity, where other doctors are in a position to take over the care.”

3. And then there is the General Medical Council (GMC), the profession’s regulator in the UK, which allows conscientious objection, albeit with a number of caveats. According to its 2013 policy statement, Personal beliefs and medical practice: “You may choose to opt out of providing a particular procedure because of your personal beliefs and values, as long as this does not result in direct or indirect discrimination against, or harassment of, individual patients or groups of patients. This means you must not refuse to treat a particular patient or group of patients because of your personal beliefs or views about them.‡ And you must not refuse to treat the health consequences of lifestyle choices to which you object because of your beliefs.”

4. Most accommodating of all is a ruling of the European Court of Human Rights (ECtHR) in the British case of Eweida in 2013. It applied Article 9 of the European Convention on Human Rights to several cases of discrimination in the UK. Article 9 guarantees “the right to freedom of thought, conscience and religion”, “subject only to such limitations as are prescribed by law and are necessary in a democratic society in the interests of public safety, for the protection of public order, health or morals, or for the protection of the rights and freedoms of others”.

It is Dr Adenitire’s contention that the Eweida ruling “effectively provides that medical professionals have the right to conscientiously object to providing certain healthcare services well beyond the scope endorsed by the BMA”.

This implies that “Given the unsettled nature of the law on the topic, [National Health Service] employers will have to proceed very cautiously as it will not always be clear whether denying a request will be considered lawful by a court. This entails that NHS bodies may be at risk of expensive legal challenges by medical professionals whose requests have been denied.”

Dr Adenitire therefore believes that the BMA’s policy should be changed to align more closely to the Eweida ruling.

However, the law is still unsettled and Dr Adenitire is not necessarily hostile to proposals for legalised assisted dying which are currently being debated in the UK. In an unpublished paper he goes on to argue that in certain circumstances doctors already have a “conscience-based right to provide assistance in dying”.

cclicense-some-rightsThis article is published by Michael Cook and BioEdge under a Creative Commons licence. You may republish it or translate it free of charge with attribution for non-commercial purposes following these guidelines. If you teach at a university we ask that your department make a donation to BioEdge. Commercial media must contact BioEdge for permission and fees. Some articles on this site are published under different terms.

Genetic screening to improve intelligence

Writing in The Conversation, ethicist Julian Savulescu discusses recently published findings that indicate that children with two copies of a common gene (Thr92Ala) and low thyroid hormone levels apparently increase the likelihood of low IQ by a factor of four.  Since the “risk of low intelligence” depends upon both the genetic configuration and hormonal level, he suggests that such children could be treated with supplemental thyroid hormones “to enhance their intelligence.”

The “low intelligence” to which he refers is the 4 % of the U.K. population estimated to have an IQ of between 70 and 85.

“If we could enhance their intelligence, say with thyroid hormone supplementation,” he writes, “we should.”

Savulescu’s focus on intelligence in this case should not become a distraction.  Supplementing hormones seems to present no special ethical problems, since the goal in that case would not be eugenic perfectionism or enhancement, but therapeutic correction of a deficiency.  However, Savulescu goes beyond this to propose that IVF embryos be screened, and that embryos found to have two copies of the Thr92Ala gene not be selected for implantation.  What is unstated is that the ‘defective’ embryos should be killed.  This would be an ethical/moral problem for anyone who holds that deliberately killing human embryos is wrong.

 

Ethicist supports “positive” eugenics: likens current practice to Nazi policies

Julian Savulescu, an ethicist at the University of Oxford, argues that the current practice of using prenatal screening and abortion to eliminate embryos suspected of having disabilities or diseases is akin to Nazi eugenic policies, which were also directed at eliminating the ‘unfit.’  He supports the use of prenatal testing to identify and destroy embryos with disease or disabilities as long as it is understood that this implies nothing about the moral status of disabled people, but argues that people should also be able to select for desirable characteristics, like intelligence or sex.  His position is that “freedom of reproduction” can be restricted “for social purposes,” but only if the purposes are “uncontroversially good,” the restrictions are necessary, and that no less restrictive policies would be workable. [News Limited]