On 'conscientious objection' in medicine again

'Regulars' on this blog will know that I have been railing time and again against a nebulous concept going under the guise of 'conscientious objection' in medicine. It gives doctors a license to pick and choose the types of medical services that they wish to provide, and, indeed, to whom they provide them. The 'rationale' for this sort of unprofessional conduct has always been that we should respect doctors and nurses who might be unable to provide abortions (or assist in the provision of abortions, respectively) when they believe abortion is akin to murder, as many monotheistic ideologies want to us to believe. Well, a LOT is wrong with this 'concept'. For starters there doesn't seem to be any test at all as to the truth of the conscientious objection. It seems sufficient to feel strongly enough about something (or someone) or other for a doctor or nurse to be excused. What would prevent a doctor belonging to the KKK to refuse to provide health services to black patients? Nothing much, as long as their belief is strong enough (and, as anyone will know who has had the doubtful pleasure of having to face racists, their beliefs are certainly strong). The result of legal provisions permitting 'conscientious objections' is that, for instance in South Africa women are unable to execute their legal right to have abortions in public sector hospitals because too many doctors and nurses (usually driven by strong fantasies to do with 'God') waive their hands (or slap the patient) and declare a conscientious objection. Backroom abortions remain common place, and human lives (real human lives, as opposed to cell accumulations called 'persons' by the Roman Catholic Church) are lost due to conscientious objections by medical 'professionals' who are more concerned about their private beliefs than about their professional service delivery during working hours.

The UK doctors' statutory body, the General Medical Council proposes that in future doctors should be entitled to refuse to provide any kind of professional service if their consciences tell them to do so. In a remarkable twist, the UK doctors' trade union, the British Medical Association (BMA) thinks that that goes too far, and that there must be strict limitations on the types of conscientious objections doctors are entitled to. It goes without saying that 'God' features again prominently, and abortion is the prime target. It goes also without saying that this is utterly arbitrarily a line that is drawn in the sand there. Why abortion and not PAS or IVF for lesbians? Your guess (or 'God' or 'culture') is as good as mine.

But then, in the UK today, like in the USA, religions are ever more pervasively infiltrating public life. The government is setting up ever more faith based schools to ensure an ever growing compartmentalization of, and segregation within society. If the GMC gets its way, us patients will soon need to know which religious beliefs a particular doctor or nurse subscribes to in order to ascertain which types of professional misconduct he or she is likely to get away with by means of reference (hands raised to the sky) 'conscientious objection'... - Seeing that there is no truth to the matter of religious beliefs, little should prevent a medical professional from setting up her own religion if her particular dislike of certain medical services isn't already covered by existing religious balderdash. After all, the numbers (in terms of other believers) are no indication of the truth of a religion, so a one-person religion should also work nicely. I wonder whether it soon will be OK in the country for taxi driver belonging to religion XYZ to refuse to take certain passengers to certain locations as they disapprove of such locations.

One can only hope that the GMC comes to its senses sooner rather than later.

Some good news on the euthanasia front

Dr Michael Munro is a Consultant neonatologist in the UK. He administered a muscle relaxant drug to two dying children to relieve their distress. Munro used about 23 times the recommended dosage, leading to the suggestion that he actually committed an act of euthanasia. I have no doubt that this is precisely what he did. It is also beyond doubt that he did what he did with the children's best interest at heart. Surely, there is no point in keeping a dying baby alive while he or she suffers tremendously. If that is so, arguably there can't be much wrong with hastening the death of such a dying human being in order to end what is arguably a life that is not worth living.

Well, interestingly, the UK's statutory doctors' body, the GMC, concluded that the doctor's treatment was 'tantamount to euthanasia', and also, at the same time, that the doctor's fitness to practise was not affected by his actions. I think it is quite significant that the GMC has decided that this course of action was in the best interest of the children, and that the doctor's actions did not constitute sanctionable professional misconduct.

Here are some more details about the case from a story which appeared on the BBC News website.

'Consultant neonatologist Michael Munro, 41, gave 23 times the normal dose of a muscle relaxant at Aberdeen Maternity Hospital, medical watchdogs were told. ... Dr Munro was working in the neonatal unit of Aberdeen Maternity Hospital on 5 December, 2005, when a child - known only as Baby X - was born more than three months premature. The panel heard that the child suffered a brain haemorrhage and the decision was taken to withdraw treatment after its condition worsened. On 20 December, the baby's breathing tube was removed and doctors began a course of morphine to ease the child's suffering. As Baby X became weak it began to struggle to breathe. A normal consequence of treatment withdrawal, the condition is known as agonal gasping. Dr Munro told Baby X's parents he could give the child a drug but "it was on the verge of what society finds acceptable", the hearing was told. He then injected the child with 2,000mg of the drug which, he admits, hastened the death of Baby X. ... Despite telling investigators he had never before administered Pancuronium, the inquiry discovered he had injected a second child with the muscle relaxant six months earlier. Outlining the case for the GMC, Andrew Long said: "Dr Munro administered a muscle relaxant drug called Pancuronium to both babies which stopped them breathing and hastened their death. ... The GMC assert it was all of these things and tantamount to a form of euthanasia even though death was inevitable. The hearing heard both sets of parents "fully supported the doctor's actions and were grateful to him". '