Medical Ethics and the Faith Factor: The Endangered Right of Conscience

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  • ACOG assumes that matters of conscience for the professional are matters of personal opinion rather than matters of divine or ecclesiastical authority. For a physician to acquiesce to parental refusal of analgesics for a suffering child is not a personal opinion. It would be a violation of both the basic tenets of medicine and the divine obligation of compassion.
  • ACOG states that a prima facie value can and should be overridden in the interest of other moral obligations that outweigh it, but they are unwilling to grant that trumping weight to moral obligations with which they disagree.
  • Some individuals of faith and a few faith-based organizations have strongly objected to ACOG’s Opinion #385[18].  In March, 2008 ACOG released a statement saying because of “uncertain and mixed interpretations” their Ethics Committee would hold a special meeting to reevaluate its position.


    It has been assumed for centuries that healthcare professionals are moral agents who have the right to refuse to provide requested services that conflict with their religious beliefs.  This assumption is being challenged.  This ancient right should be defended by all of society, and it must be defended by people of faith.

    [1] Thomas Percival’s Medical Ethics, 1803; American Medical Association’s first “Code of Ethics,” 1846

    [2] Allen Verhey and Stephen E. Lammers, eds.  Theological Voices in Medical Ethics. Grand Rapids, MI:  Edrdmans, 1993

    [3] Rights of Man, 1791

    [4] “The rights of conscience we never submitted, we could not submit.  We are answerable for them to our God.”  Notes on Virginia,Q.XVII, 1782.  “No provision in our Constitution ought to be dearer to man than that which protects the rights of conscience against the enterprises of the civil authority.” Speech to New London Methodists, 1809

    [5] “The Civil Rights of none shall be abridged on account of religious belief or worship, nor shall any national religion be established, nor shall the full and equal rights of conscience be in any manner, nor on any pretext infringed.  No state shall violate the equal rights of conscience or the freedom of the press, or the trial by jury in criminal cases.”  First draft, 1 June 1789

    [6] “Congress shall make no law respecting an establishment of religion, or prohibit the free exercise thereof.”  Final draft, September 1789

    [7] e.g., end-of-life care (stopping ventilator support, dialysis, feeding tubes), prisoner interrogation, capital punishment, genetics, research (embryonic stem cells, cloning), writing or dispensing lethal prescriptions (Oregon), oral contraceptives (especially the “morning after pill”), and more

    [8] American Medical Association:  “…neither physician, hospital, nor hospital personnel shall be required to perform any act violative of personally held moral principles.  In these circumstances, good medical practice requires only that the professional withdraw from the case, so long as the withdrawing is consistent with good medical practice.”  H-5.995 Abortion

    [9] The Health Services, Medicare and Medicaid Acts all include protections for physicians unwilling to do abortions or sterilizations.

    [10] Forth-five states have right of conscience statutes.

    [11] European Convention on Human Rights, Article 9

    [12] World Medical Association’s Declaration of Geneva, 1948 & 1968:  “I will practice my profession with conscience and dignity; the health of my patient will be my first consideration”.  The World Health Organization’s Considerations for Formulating Reproductive Health Laws guarantees the right of conscience based on religious or philosophical beliefs.

    [13] Addressing issues of moral complicity:  When, where, why and other questions.  Dignity newsletter of the Center for Bioethics and Human Dignity, Spring 2003;9(2):1,5.  Available online at 2003-05-23