The clear and present danger of medical martyrdom

Will Catholic doctors who subscribe to the Church’s moral teaching against assisted suicide and abortion ever be forced to take human life? Until recently, such a prospect was unthinkable.

If trends continue, Catholic and other sanctity-of-life-believing doctors will be forced to choose between violating the Sixth Commandment and continuing in good stead in their chosen profession. I call this threat “medical martyrdom” — a potential authoritarianism that looms darkly in the coming decade because of two fundamental mutations in the ethics of medicine.

First, doctors don’t take the Hippocratic Oath anymore and haven’t for decades. The Oath’s ethical proscriptions against participating in abortion and assisted suicide cut against the contemporary moral grain, leading medical schools to dumb it down or dispose of it altogether. Second, “patients’ rights” have become the new mantra in health care where physicians are “service providers” and patients are, in essence, consumers. As such, many among the medical intelligentsia and in bioethics believe that the competent customer is entitled to virtually any legal procedure from “service providers.”

As a consequence, Hippocratic-believing professionals are pressured to practice medicine without regard to their personal faith or conscience beliefs. This moral intolerance is slowly being imbedded into law. In the U.S., such legal controversies have mostly swirled around. Elsewhere, the force of law has — or threatens to — force doctors to be complicit in abortion and euthanasia.

The first such law was passed several years ago in Victoria, Australia, where the local law requires all doctors to perform — or be complicit in — abortion: If a patient requests a legal termination and the doctor has moral qualms, the dissenting physician is required to find a doctor on behalf of the patient known to be willing to do the deed.

Canada is heading rapidly in the same direction regarding euthanasia. Quebec legalized doctor-administered death last year and allows no conscience exemptions. When palliative care centers and hospices balked, the Minister of Health called such resistance “inappropriate and unfortunate” because doctors must “adapt to the patient,” warning darkly that euthanasia “will be offered.”

Meanwhile, Canada’s Supreme Court just legalized euthanasia for those with a diagnosable medical condition that causes “irremediable suffering,” including “psychological pain.” Recognizing that some doctors will have moral qualms about “terminating life,” the Court gave Parliament 12 months to pass enabling legislation, stating that “the rights of patients and physicians will need to be reconciled” by law or left “in the hands of physicians’ colleges.”

That doesn’t bode well for medical conscience rights. Canada’s medical associations have low regard for conscientious objectors. Saskatchewan’s College of Physicians and Surgeons recently published a draft ethics policy that would force doctors to provide “legally permissible and publicly funded health services” — which now include euthanasia as well as abortion — to “make a timely referral to another health provider who is willing and able to … provide the service.” If no other doctor can be found, the dissenting physician will have to do the deed personally, “even in circumstances where the provision of health services conflicts with physicians’ deeply held and considered moral or religious beliefs.” Meanwhile, 79% of Canadian Medical Association delegates at a recent convention voted against a motion that would have supported conscience exemptions from participating in euthanasia.

U.S. doctors cannot be forced to participate in abortion and assisted suicide (in the jurisdictions where it is legal). But these professional safeguards are generally opposed by the medical establishment — at least as they apply to abortion. The American College of Obstetricians and Gynecologists (ACOG) published an ethics-committee opinion in 2007 strikingly similar to the Saskatchewan College’s:

“Conscientious refusals should be limited if they constitute an imposition of religious and moral beliefs on patients. Physicians and other health care providers have the duty to refer patients in a timely manner to other providers if they do not feel they can in conscience provide the standard reproductive services that patients request.”

If these trends continue, 20 years from now, those who feel called to a career in health care will face an agonizing dilemma: Either participate in acts of killing or stay out of medicine. Those who stay true to their consciences will be forced into the painful sacrifice of embracing martyrdom for their faith.

WESLEY J. SMITH is a senior fellow at the Discovery Institute’s Center on Human Exceptionalism and a consultant to the Patients Rights Council. He received Legatus’ 2014 Cardinal O’Connor Pro-Life Award for his work against assisted suicide.