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Expounding further on a theme I began yesterday: Western culture is profoundly—and I think on several important bioethical issues. implacably—split about what is right and what is wrong. These issues range from abortion, to euthanasia, to embryonic stem cell research, to removing feeding tubes from people with cognitive disabilities, to personhood theory, to human exceptionalism.

The intellectual elites and the holders of the leverages of political power (generally) support these agendas and activities, while opponents (again generally) tend to be from Main Street, faith communities, and constitute a minority within the health care professionals. Some disputants take their stand based on religious belief—or lack thereof—while others (including this writer) are adamant that universal human rights are literally at stake.

One potential way of co-existing in such a splintered moral milieu is to permit conscientious objectors to refuse to participate in what they (and I) believe is an emerging culture of death. And indeed, the issue of “conscience” is likely to become one of the most heated bioethical controversies in the years to come.

The USA is one of the prime battlefields over conscience clauses—as in the fight over Bush Administration plans to protect conscience rights of health care workers to not participate abortion. But the issue also is heating up around the globe. Case in point: A recent Italian court ruling permitted a father to remove the feeding tube of his daughter who has been in a diagnosed PVS for more than 15 years. But the nuns who run the hospice where she resides want no part of the dehydration. From the story:

Last week the Court of Cassation court upheld a ruling in July by a lower court in Milan allowing for the removal of feeding tubes connected to Eluana Englaro, who has been in a coma since a 1992 car accident in the northern city of Lecco in Lombardy.

However no Italian doctor has yet agreed to remove the feeding tubes, including staff at the hospital in Lecco where she is cared for. Roberto Formigoni, President of the Lombardy region, warned that doctors performing such a procedure would face disciplinary action for “failing to honour commitments to the well-being of their patients.”

Medical authorities and health officials in other northern regions such as Piedmont and Friuli—where the Englaro family comes from—have also refused. Vladimiro Kosic, head of health for Friuli-Venezia Giulia, said “Our hospitals are places of life, not death”.
Here’s another example that just came to light: In Serbia, an abortion doctor named Stojan Adasevic found religion, (the particulars of which are beyond our scope here). After participating in a particularly gruesome procedure, he refused to perform any more abortions. There was hell to pay. From the story:
After this experience, Adasevic “told the hospital he would no longer perform abortions. Never before had a doctor in Communist Yugoslavia refused to do so. They cut his salary in half, fired his daughter from her job, and did not allow his son to enter the university.”
Similar acts against dissenting medical professionals—although not their families—are now threatened throughout the West. Indeed, the issue of conscience is quickly coming to a head. Expect increasing attempts in coming years to pass laws and promulgate regulations designed to coerce dissenting health care professionals to be complicit in death-causing procedures under threat of loss of professional employment, with the intention, I believe, of driving people of certain faiths and moral persuasions out of the health care professions. This aggression has already begun. Australia has already passed such a law about abortion.

I strongly support the rights of conscience for health care professionals regarding elective procedures, that is procedures that are not necessary to save life or to prevent serious physical health consequences for the patient. Such accommodations would seem to be in keeping with a multicultural and tolerant society. But the culture of death is not about tolerance: It is about cultural hegemony. Once its supporters perceive they are in control, they will work hard to punish dissenters because refusing to participate sends a clarion message that certain activities are just plain wrong. And that is a truth spoken to power that they simply will not tolerate.

Expect the fight over conscience to become a political conflagration.

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