Refusal of Medical Treatment by Conscience

Return to Fall 2010 Critical Thinking Research Topics

Please post your research below, using the "Finding" template from the Research Topics main page. Just copy and paste it for each finding and fill in the information from your finding. Try to organize findings so that you can add headings later as things accumulate.

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Both Sides

May Pharmacists Refuse to Fill Prescriptions for Emergency Contraception?

Julie Cantor, & Ken Baum. (2004). The Limits of Conscientious Objection - May Pharmacists Refuse to Fill Prescriptions for Emergency Contraception? The New England Journal of Medicine, 351(19), 2008-12. Retrieved October 28, 2010, from Platinum Periodicals. (Document ID: 731163891). [1]

Mostly background info. Presents both sides of the argument as well as solutions to each side. There are some specific references to Plan B objections.

Madison

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Doctors Should Have the Right to Refuse Medical Care

Physician Refusal to Provide Info or Treatment- Conscientious Objections

Committee on Bioethics. "Physician Refusal to Provide Information of Treatment on the Basis of Claims of Conscience." American Academy of Pediatrics: Dedicated to the Health of All Children. N.p. 06 Dec 2009. Web. 27 Oct 2010. [2].

This article states that physicians SHOULD have the right to conscientious objection because violating one’s conscience is like going against one’s integrity, which can lead to undermining self-respect and feelings of guilt. The article says that if physicians refuse to do something for himself or herself, they have the moral right to not do it for others. The author realizes, however, that there are two sides to the argument and struggles with the idea that a doctor’s refusal to do something could ultimately hurt the patient.

Emily

When A Physician May Refuse to Treat A Patient

Katz, Laura & Marshall Paul. "When A Physician May Refuse to Treat A Patient." Physician News Digest. February 2002. Web. 28 Oct. 2010. [3]

This article is mainly directed towards physicians. It addresses all of the common situations where a doctor can refuse treatment, but informs them of the proper protocol. Specifically for moral/religous objection scenarios, doctors may object to treatment on religious objection but should discuss with the patient: why there is an objection, other resources for treatment, and recommending physicians or doctors that can help. The discussion must be recorded for medical charts as well.

Megan

Physician Refusal to Provide Information or Treatment on the Basis of Claims of Conscience -- Committee on Bioethics 124 (6): 1689 -- AAP Policy

Committee on Bioethics. "Physician Refusal to Provide Information or Treatment on the Basis of Claims of Conscience -- Committee on Bioethics 124 (6): 1689 -- AAP Policy." AAP Policy - Journal of the American Academy of Pediatrics. Ameircan Academy of Pediatrics, 06 Dec. 2009. Web. 08 Nov. 2010. [4]

This article states how a doctor's morals should be respected and how the doctor has the right to refuse to do procedures. It is better for the doctor and patient if the doctor works with their conscience and not against it. Doctors need to tell patients of all the available operations and procedures even the ones they do not perform. If a doctor refuses to work on a patient, the doctor is morally obligated to refer the patient to another doctor that will perform the procedure and has to send the new doctor the patient's transcripts.

Kelly

Commentary on Conscientious Objection in Medicine: A Moral Dilemma

Surbone, Antonella, Dr. "Commentary on Conscientious Objection in Medicine: A Moral Dilemma." Clinical Correlations. N.p., 5 June 2009. Web. 9 Nov. 2010. [5]

Dr. Surbone writes most of her commentary with an unbiased opinion presenting reasonable background and examples for both sides of the argument. She poses the question, "By whom and how is it decided what a reasonable or an appropriate wish is?" A woman can say she wants an abortion because she was raped or because she has three children at home and cannot afford to support a fourth child. However, she concludes her commentary with a personal experience and believes doctors should have the right to refuse medicinal treatment to patients, just as long as they help the patient find another physician in a reasonable amount of time who will help the patient out.

Jon

Rule Aims to Protect Health Providers' Right of Conscience

Gupta, Sanjay, and Val Willingham. "Rule Aims to Protect Health Providers' Right of Conscience." CNN.com - Breaking News, U.S., World, Weather, Entertainment & Video News. CNN, 18 Dec. 2008. Web. 10 Nov. 2010. [6]

This article is talking from Dr. Sandy Christiansen's POV. She doesn't do certain procedures and is for the new rule that the Bush Administration put forth. The regulation is to protect providers who refuse to participate in certain procedures. Health department rule withholds federal money for providers who violate law. However there are some critics who say existing laws already protect health-care professionals. The ability to refuse procedures strengthens the provider's right but in no way does it restrict the health-care provider from performing any procedures. Patients will still be able to receive the procedures they need, just from a different provider.

Kelly

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Doctors Should Not Have the Right to Refuse Medical Care

Doctors challenge right-to-die opposition

Adams, Stephen. "Doctors challenge right-to-die opposition." Telegraph.co.uk. N.p., 3 Oct. 2010. Web. 28 Oct. 2010. [7]

This article does not directly say whether or not doctors should be allowed to refuse medical treatment of the terminal ill. However, it hints that doctors should NOT be allowed to refuse medical treatment. If the patient has terminal cancer, he or she should be allowed to choose their death, if they want to to. This article does not discuss whether or not doctors should be allowed to choose whether an unconscious or vegetative person shall live.

Jon

Sentenced to death on the NHS

Devlin, Kate. "Sentenced to death on the NHS." Telegraph.co.uk. N.p., 2 Sept. 2009. Web. 28 Oct. 2010. [8]

Again, this article hints at the fact doctors should NOT be allowed to choose whether a person can continue living or not. There are too many stipulations that could go wrong making the diagnosis incorrect. For example, someone may be unresponsive, but if taken off "x" medicine, he or she may respond well. This information, however, is not always known. Therefore, doctors are in essence killing people who may not be as close to death as previously expected.

Jon

Doctor's Beliefs can Hinder Patient Care

Erdely, Sabrina. Doctor's Beliefs Can Hinder Patient Care: New Laws Shore Up Providers' Right to Refuse Treatment. Self Magazine. MSNCB. 2010. [9]

Lots of good info here arguing on the side of NO they should not be able to refuse. This would probably be considered an editorial. It was originally published in the womens' magazine Self. It has some specific incidents as well as background info and arguments. This article is taking the side that doctors should put their patients first -- not their morals. It has many pertinent examples including a woman seeking Plan B after she had been raped, a woman trying to refill her birth control, a woman seeking an abortion, and a single mother trying to adopt. In all cases the women were judged by their doctors and essentially turned away. It also mentions men seeking vasectomies, or homosexual couples seeking invitro fertilization. It then talks about the logistics of religiously affiliated medical centers, and new legislation that would make conscientious objection legal in some states.

Madison

Ethics: Conscientious Objection In Medicine

Savulescu, Julian. "Ethics: Conscientious Objection In Medicine." BMJ: British Medical Journal. Vol. 332, No. 7536 (Feb. 4, 2006), pp. 294-297. BMJ Publishing Group. Feb. 4, 2006. Web. [10]

Highly focused on the fact that it is a doctors job to provide for a patient, and conscientious objection is permissible only in situations where alternative care can be provided that does not jeopardize the patients care. Doctors should be aware of their responsibilities when they are entering the field.

Madison

Personal Morality and Professional Obligations

May, Thomas, and Mark P. Aulisio. "PERSONAL MORALITY AND PROFESSIONAL OBLIGATIONS." Perspectives in Biology & Medicine 52.1 (2009): 30-38. Academic Search Complete. EBSCO. Web. 11 Nov. 2010. [11]

This article talks about the issues concerning allowing physicians to impose their views on their patients and ends with the author siding with the fact that physician's moral views can't be more important than their patient's.

Emily

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Background

May Pharmacists Refuse to Fill Prescriptions for Emergency Contraception?

Julie Cantor, & Ken Baum. (2004). The Limits of Conscientious Objection - May Pharmacists Refuse to Fill Prescriptions for Emergency Contraception? The New England Journal of Medicine, 351(19), 2008-12. Retrieved October 28, 2010, from Platinum Periodicals. (Document ID: 731163891). [12]

Mostly background info. Presents both sides of the argument as well as solutions to each side. There are some specific references to Plan B objections.

Madison

Code of Ethics for Emergency Physicians

Code of Ethics for Emergency Physicians." Annals of Emergency Medicine 52.5 (2008): 581-90. MD Consult. Web. 9 Nov. 2010. [13]

This is a written up Code of Ethics for EMERGENCY Physicians. Part II.A.3 "Virtues in Emergency Medicine" is where you should focus reading. The main point is that doctors in the Emergency Room have to be the most unbiased physicians because they must be ready to treat any patient at a moments notice even when the patient challenges their moral compass. There is no time for Emergency Doctors to refuse treatment to a patient and refer them to a different doctor if it is a life/death situation.

Your Doctor's Rights Vs. Your Rights

Kotz, Deborah. "Your Doctor's Rights Vs. Your Rights." Health News Articles - US News Health. 22 Sept. 2008. Web. 28 Oct. 2010. [14].

This article talks about the controversy, in 2008, about the possible federal law that gave ALL healthcare providers the right to refuse reproduction or contraception treatment/procedures to a patient if it violated there morals. The law only would apply to healthcare providers funded by the Department of Health and Human Services. The broad rule applies to doctors, nurses, lab technicians, and even receptionists. Healthcare providers would be able to refuse treatments ranging from abortion to freezing eggs/sperm for cancer patients.

Megan

CARE welcomes protection of conscientious objection

"CARE welcomes protection of conscientious objection" Christian Today Society Page. October 13, 2010. Web. 4 Nov. 2010. [15]

Very quick read about EUROPEAN sentiments. "The Parliamentary Assembly of the Council of Europe voted down a resolution last week that sought to remove a safeguard on the right of medical practitioners to refuse to take part in procedures or services that went against their conscience." Details the importance of conscience and how restrictions or limits on the rights of conscience would doom the health system by damaging moral integrity. Sees conscientious objection as constitutional right.

Madison

Doctors' Conscientious Objection to Abortion Threatened

Townsend, Liz. "Doctors' Conscientious Objection to Abortion Threatened." National Right to Life. N.p., 8 Apr. 2008. Web. 9 Nov. 2010. [16]

This article presents both sides to the argument mostly arguing whether doctors should choose to refer a woman to another doctor for abortion, perform the abortion, or deny all abortion requests. It goes into detail about what the American Association of Pro-Life Obstetricians and Gynecologists believe is true. However, it mostly presents background information for both sides of the argument.

Jon

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Example Stories

When Doctor's Slam The Door

Jauhar, Sandeep. "When Doctor's Slam The Door - NYTimes.com." The New York Times - Breaking News, World News & Multimedia. New York Times, 16 Mar. 2003. [17]

This was from the New York Times magazine. It gives some examples of doctors who refuse to treat patients. It talks about how some doctors refuse to do prodecures on some patients because of how the patient treats himself. Some surgeons in Australis refused to give smokers surgery. It talks about how mandatory reporting mechanisms gives medical providers the incentive to refuse more difficult and complicated patients, other words abuse the conscience rule. A lot more doctors are refusing to treat high-risk patients to keep their records clean.

Kelly

Doctors Deny Lesbians Insemination on Moral Grounds

Chitale, Radha. "Doctors Deny Lesbians Insemination Procedure - ABC News." ABCNews.com - Breaking News, Politics, Online News, World News, Feature Stories, Celebrity Interviews and More - ABC News. ABC, 1 Oct. 2009. Web. [18]

This is an incident that happened last year. Lesbian moms sue doctors for discrimination after being denied intrauterine fertilization because it was against the doctor's conscience.

Kelly

Conscience Must Not Undermine Patients’ Autonomy and Access to Care

April, Carolyn W. “2009 Winning Essay Justice in Medicine- Conscience Must Not Undermine Patients’ Autonomy and Access to Care.” American Medical Association Journal of Ethics. N.p., Aug 2010. Web. 26 Oct 2010. [19].

This article begins with a scenario portraying a woman Melanie who was in a same-sex relationship and wanted to have a baby through in vitro fertilization or embryo implantation. A few days after her initial visit, her doctor’s office sent her a note telling her that she should find another doctor because her doctor, Dr. Boyle, couldn’t bring a child into this world if it had to live in a same-sex household. Melanie was outraged and claimed that this was a situation of discrimination. The article continues to say that in the US there are rights protecting physicians who opt out of performing medical services that go against their consciences. The author takes the stand that failing to do things, such as inform patients of all of their options in a situation could cause serious harm to patients and is therefore not acceptable. The author’s main point is that physicians have a duty in their line of work to treat anyone and everyone who would ever need any kind of medical assistance, and that their opinions or religious beliefs should NOT get in the way of doing their jobs.

Emily

Winnipeg Doctor Refuses to Treat Lesbian Couple

Rau, Krishna. "Winnipeg Doctor Refuses to Treat Lesbian Couple." Xtra.ca. Pink Triangle Press, 28 Jan. 2009. Web. 10 Nov. 2010. [20]

This article is from a gay and lesbian website in Canada. The article is about a doctor refused to treat a lesbian couple due to their sexual orientation. The docot had a problem with their sexual orientation because it is against her religion. The doctor says that she didn't refuse to treat them, but told them to find a doctor that would have more experience and will take those type of patients.

Kelly

Rights of Conscience vs. Civil Rights: Are Health Care Workers Obligated to Treat Gays and Lesbians?

"Rights of Conscience vs. Civil Rights: Are Health Care Workers Obligated to Treat Gays and Lesbians?" 3 June 2010. Web. 26 Oct 2010. [21]

This article is about whether or not health care professionals should be able to refuse to treat people based on their sexual orientation, including if this is considered discrimination or not. It shows many different cases of when gay people were discriminated against for their sexual decisions and whether or not doctors should have the right to say something if they are religiously or otherwise opposed to gays.

Emily