aefenglommung (aefenglommung) wrote,

Conscience and the practice of medicine

I read a post online recently that said that those who refuse to offer medical care because of some personal belief of theirs have no business in medicine and should be barred from practicing it. I think I know what the poster was thinking about when that was written, but bear with me for a bit.

Let’s think about amputation. All of us would agree that there are times when amputation of a limb is the right thing to do; however, it is never a thing that one should want to do. The decision must come as a last resort. All doctors should be reluctant to recommend or perform amputations except in certain circumstances. Yet there are people out there, right now, who think that amputations should be elective surgery. They posit an identity for themselves as amputees, for whatever reason, and they see doctors denying them a safe and sanitary amputation as prejudiced against their amputee identity. Most people think that this is wrong, and they wouldn’t allow amputation of healthy limbs for aesthetic or psychological reasons absent any pre-existing injury, deformity, or disease process.

Ah, but it was just yesterday that it was understood without question that doctors did not take their patients’ lives. One comes to the point, of course, where one no longer tries extreme measures merely to prolong life, and palliative care for the dying is part of the doctor’s duties. Yet there are people who want doctors to actively take life – at the patient’s request. As this view has gained credence in our society, laws and ethical codes have been adjusted so that doctors may do for patients what they once would have been horrified to contemplate. The results have been, first: that the right of the patient to ask to be made dead is increasingly not contingent upon a terminal medical diagnosis; people who are merely depressed, or old, may ask to be made dead, and doctors will be bludgeoned into complying with their request. Second: the right to die is increasingly becoming the duty to die, and the decision when to end someone’s life, whether they want it or not, is being taken by doctors. You may want to live, even be able to state that you want to keep trying to live, and in some places, your doctor may decide that you’ve lived long enough, and – kill you. And that is becoming normal in one corner of Western society after another.

And, of course, we have had legalized abortion now for over forty years in this country. Abortion was made legal as a last resort, too. Even many of those most strenuously opposed to it could think of at least some situations in which it might be warranted. And it was said that no woman wants an abortion, that abortion was something different from birth control. Despite this, surveys show that the vast majority of abortions are performed simply because the mother wants one – and that there are many women who have had multiple abortions. Abortion has become, simply, birth control.

There is a trend here. Abortion is now so readily available that any doctor who refuses to perform one, or recommend someone to a clinic for one, is not a serious impediment to a woman seeking an abortion. Yet the drumbeat goes on: no one must be allowed to refuse service for reasons of personal belief; everyone must participate, or else. Aid in dying (the latest euphemism for killing by doctors) is becoming more widespread, and again, the pressure is on: a doctor who refuses to kill, or recommend someone to another willing to kill, stands to lose his medical license in some places. It is only a matter of time until doctors will start facing the loss of jobs and licenses for failing to amputate a healthy limb on the patient’s say-so. Anyone who recommends psychological evaluation or counseling in the face of the sovereign patient’s desire for what I want will face severe consequences.

And I haven’t even gotten into sex-reassignment surgery and the prescription of puberty blockers and hormones for those who identify as transgender – or whose parents say their minor children are. There are many things that may be lawful, but which a conscientious medical provider might think are not good in themselves, or at least, not good for this person at this time. When you remove independent judgment, you make doctors mere robots operated by – whom? the omnicompetent State? the reigning ideology? the sovereign patient? Well, this I know: the sovereign patient doesn’t always know what is best for oneself; furthermore, the sovereignty of the patient won’t last any longer than the independent judgment of the doctor in the face of the omnicompetent State and its reigning ideology.

We need people who will give us their best judgment, even when it’s not what we want. We need people who will speak the truth as they know it, without fear of what the government or the mob want. We need people who will say to us, in the words of Oliver Cromwell, “I beseech you . . . think it possible that you may be mistaken.” And remember: a regime that takes away the power of anyone to tell you NO will ultimately not listen to you, even when you scream “NO!” at the top of your lungs.

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