Catholic Medical Quarterly Volume 72 (4) November 2022

Conscience, health care professionals, the World Medical Association and the General Medical Council

Scales of JusticeConscience has been an increasingly important issue in the CMQ of late. The erosion of conscience and the view that employees of health care organisations do what they are told has gained ground and many who support abortion and euthanasia seek to promote it.

Debate at the World Medical Association (WMA)

In August the WMA, in conjunction with the American Medical Association hosted a meeting of experts in Washington DC to discuss the International Code of Medical Ethics. Among other revisions to the code it was being proposed that the code include a paragraph on conscien­tious objection. To erode conscientious objection is to force health care professionals doctors to compromise on their basic duties of care to patients. We are bound, in our work to be moral agents and to ensure that, as well as following good guidance and pathways, we also do what is right and moral. The Nurenburg trails after the Second World War set that out very clearly indeed. Following orders is not an excuse for killing anyone. Of course conscience also applies in other situations where killing may not be involved. Examples would include contraception, but also perhaps resource allocation etc.

The Anscombe Centre brought together over 200 signatories and wrote to the WMA You can read the open letter to the WMA on page 10 and on the Anscombe Centre Website [1]

Happily we can report that at its meeting the WMA revised its proposal and a better text was produced. We hope very much that the improvement will persist. Paragraph 30 of the proposed revised code now reads "(former paragraph 28) “

This Code represents the physician’s ethical duties. However, on some issues there are profound moral dilemmas concerning which physicians and patients may hold deeply considered but conflicting conscientious beliefs.

The physician has an ethical obligation to minimise disruption to patient care. Physician conscientious objection to provision of any lawful medical interventions may only be exercised if the individual patient is not harmed or discriminated against and if the patient’s health is not endangered.

The physician must immediately and respectfully inform the patient of this objection and of the patient’s right to consult another qualified physician and provide sufficient information to enable the patient to initiate such a consultation in a timely manner.

Reviewing the General Medical Council guidance on Personal Beliefs and Medical Practice.

Meanwhile the GMC also consulted on its code of practice around Personal Beliefs and Medical Practice. This is the policy that also contains what the GMC say about conscience. Again, council members and others responded to the consultation emphasising the importance of conscience in medical practice (and of course health care in general).  It is clearly important to speak up for the rights and duties of those who conscientiously object to care when it involves things such as killing.

We wait to hear the outcomes of both consultations.