Medical Assistance in Dying and Conscientious Objection

Recently in Canada it has become legal for those suffering from “grievous and irremediable medical conditions” (i.e., terminal illnesses) to consent to have their lives ended by a physician. Even more recent is a paper by Julian Savulescu and Udo Schuklenk arguing that healthcare professionals should not have the right to conscientious objection. Below are some notes I took while reading the paper:

  • They are right that paternalism (e.g., “shut up, I’m the doctor, I know what’s best for you”) in medical care is bad.
  • But their paper is paternalistic toward healthcare professionals. Their argument relies on turning the government into the ultimate authority, which only stubborn doctors would refuse to follow. To their credit, they admit that there are current cases where they think the law is wrong, but they say doctors should still follow the law in these cases!
  • The paper appeals to the will of the majority when it’s convenient: “if society thinks contraception, abortion and assistance in dying are important, it should select people prepared to do them, not people whose values preclude them from participating. Equally, people not prepared to participate in such expected courses of action should not join professions tasked by society with the provision of such services.” But earlier, while trying to explain why their arguments have failed to persuade lawmakers, they said the reason is “the influence of organized religion in society. The more religious a society is, the more religious values are imposed on people.” So it’s wrong for societies to impose their will when religious, but it’s alright for them to do so when they are pro-contraception, etc. Also, it’s clear that current society, while approving of contraception, abortion, euthanasia, etc., also thinks the right to conscientious objection is important.
  • A good thing about the paper is that it recognizes that such debates (about medical assistance in dying, abortion, etc.) can only be fully resolved by figuring out if these things are evils or goods – but they go on to just assume that they are good without really arguing for it.

After reading the paper, I also found out that Brandon Watson had written a blog post on a similar document. I think he is right to say that responses to conscientious objections often act as though what a doctor’s judgment is about the morality of euthanasia, abortion, etc. is purely a “personal view” and so it does not have the same right as an objection to a medical treatment that the doctor sees as harmful. But in fact, both types of objections are about what is good for the patient. Furthermore, despite use of phrases like “personal views,” such ethical views are often supported by arguments that can be publicly evaluated.

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