An “expert group” of abortion activists has launched a strong attack on the concept and practice of conscientious objection (CO) in healthcare. “The practice of refusing to provide legal and essential health care due to a doctor's personal or religious beliefs is a violation of medical ethics and of patients' right to health care,” says the International Women's Health Coalition (IWHC) in conjunction with Mujer y Salud en Uruguay.
A 46-page report, Unconscionable: When Providers Deny Abortion Care, argues that “the practice of refusing to provide legal and essential health care due to a doctor's personal or religious beliefs is a violation of medical ethics and of patients' right to health care”. The conclusions of the report are based on a meeting held in Montevideo, Uruguay, last year which brought together 45 participants from 22 countries, including the leading theorist of the attack on CO, bioethicist Udo Schuklenk, of Queen’s University, in Canada.
The IWHC is one of the best-resourced feminist NGOs, with links to other large NGOs and US$12 million in revenue in 2017. On its 24-member board sit a powerful group of philanthropists, merchant bankers and lawyers. It is active in lobbying in the United Nations and Capitol Hill. So the recommendations of its conference on CO are bound to resonate throughout the world of abortion activism, but especially in Europe, the United States and Latin America.
The IWHC view is that people who invoke their consciences are usually playing a power game and trying to impose their own morality on the desperate and vulnerable women who are seeking abortions. But the delegates to its conference could not quantify what it describes as “a worrisome and growing global trend”.
The report cites a 2013 white paper on CO which states that “Estimates of prevalence are difficult to obtain, as there is no consensus about criteria for refuser status and no standardized definition of the practice, and the studies have sampling and other methodologic limitations”. So we’re not even sure if a serious “problem” exists.
What is certain, though, is that the IWHC is determined to wipe out CO in the medical profession. Or at least to shunt all doctors for whom unrestricted abortion is not an article of faith into dermatology.
To counter-attack against the growth of CO, the report recommends three avenues:
Reframe and rename. Reframe the debate to clarify and emphasize that “conscientious objection” is a misnomer that subverts the ethics, obligations, and standards of the health care profession.
Reclaim the concept of conscience. Do not cede the term “conscience” to those who prioritize individual beliefs over professional conduct and the right to access or provide health care. Shine a light on the harmful health consequences of conscience claims in the context of abortion care. Emphasize the “conscientious commitment” and professional conduct of health care providers who prioritize patients’ rights.
Quantify the costs incurred by health systems due to claims of “conscientious objection” to abortion. Managing conscience claims can be costly and can create inefficiencies in the allocation of scarce health care resources. Quantifying the costs would fill a gap in our understanding of the consequences of refusal to provide abortion care due to conscience claims.
Orwellian Newspeak is an important part of the activists’ campaign. Instead of “conscientious objection”, they suggest that it be called “refusal to provide services,” “denial of services,” or even “dishonourable disobedience”.
The most bizarre aspect of the report is that it never defines what a conscience is or asks why some people might think that it is an important dimension of an authentic human existence. Conscience is a key element in the “medical ethics” that the report purports to defend. How can the IWHC possibly make the extraordinary claim that CO violates medical ethics without appealing to reason and evidence? Its argument, if it is an argument, is absurd.
But only one thing matters for the IWHC: unrestricted abortion rights. And it will fight to steamroller any health professional who objects.
Michael Cook is editor of MercatorNet.