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Proposed International Code of Medical Ethics threatens to undermine doctors’ right to conscientious objection

A new draft of the International Code of Medical Ethics aims to severely curtail the rights of doctors to conscientiously refuse the administration of certain drugs and procedures.

The World Medical Association (WMA) adopted the International Code of Medical Ethics (ICoME) in 1949 as a complement to the Declaration of Geneva. Both documents were formulated as responses to atrocities committed by doctors during the Second World War, and seek to ensure that doctors are aware of their obligations to patients including respect for their life and their autonomy.

Now, however, the right to conscientious objection is being undermined. The new paragraph in the draft ICoME reads:

“Physicians have an ethical obligation to minimise disruption to patient care. Conscientious objection must only be considered if the individual patient is not discriminated against or disadvantaged, the patient’s health is not endangered, and undelayed continuity of care is ensured through effective and timely referral to another qualified physician”.

Doctors can refuse procedures not patients

Provisions to ensure that patients are not discriminated against by a doctor’s personal beliefs have long been in place in the UK, and physicians are already not permitted to refuse to treat a patient based on any particular characteristic of that patient. 

However, physicians are permitted to refuse to perform or prescribe procedures or services to which they have a conscientious objection, as long as suitable provision is made for the patient to receive the procedure or service elsewhere.

Pro-life medical professionals, however, are likely to be concerned about the new paragraph in the ICoME because the burden of proof is shifted to the conscientious objector who must justify his/her objection. The new paragraph also indicates that pro-life doctors could be forced to participate in the abortion process by referring a patient to another doctor who will perform the abortion.

The new draft of the ICoME is currently under public consultation.

“I  will  maintain  the  utmost  respect  for  human  life,  from the time of its conception”

Both the ICoME and the Geneva convention were created to limit the power of doctors over their patients and to prevent the kind of abuses witnessed during WWII. Both documents have undergone a series of revisions since their inception but most significantly, from its creation in 1948 until 1994, the Geneva Convention contained the clause:

“I  will  maintain  the  utmost  respect  for  human  life,  from the time of its conception, even under threat”.

This statement was revised in 2017, and has since read: “I will maintain the utmost respect for human life”.

Right To Life UK spokesperson, Catherine Robinson, said: “International conventions and agreements, particularly in regard to medical ethics, are often reduced to a battle over certain words and phrases. The difficulty with the draft ICoME arises out of the vagaries of much of its language and the burden it places on conscientious objectors. Regarding abortion in particular, surely one of the great matters of contention arises not only from what constitutes a danger to the patient’s ‘health’, but also who exactly the patient is”.

“In treating a pregnant woman, after all, the doctor is really treating two patients: mother and baby. The pro-life doctor refuses to cast aside the health and well-being of the baby, whereas pro-abortion doctors do just that”.
“Furthermore, the code contradicts itself. What would happen if euthanasia or assisted suicide were to become legal in this country, for example? If a doctor refused to administer euthanasia or assisted suicide due to their conscientious objection, this doctor would presumably be forced to find another doctor who would end the life of his or her patient. Of course though, as far as most doctors are concerned, euthanasia itself would be directly opposed to respecting the ‘dignity and life’ of the patient, as demanded by the very same International Code of Medical Ethics”.

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