Another Perspective

A Right of Conscience

Must professionals be required to abide by liberal nostrums on issues of life and death?

By 7.27.06

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Important issues abound in the nation's capital, but the "moral" ones tend to be the most difficult to resolve. It is hard to compromise on abortion, stem cell research, and gay marriage.

Yet the answer often is easy, if not obvious. Government should just do nothing.

Consider the battle over stem cell research. I don't claim to know the value of embryonic stem cell research. Given the wonders of modern medicine, new discoveries are likely to emerge. However, those who would benefit from bountiful federal subsidies have an incentive to oversell their cause.

Surely opponents are right to raise a moral alarm. We should be particularly careful in how we treat the human person.

Yet for life to arise, implantation is necessary. The moral status of an isolated embryo is not obviously the same as that of a fetus.

What to do? The President has it right. Although media coverage tends to glide over the details, George W. Bush has merely barred federal funding. Private (as well as state and foreign) research can proceed unmolested.

In short, in a case where the moral equities are complex, a significant portion of the population objects strongly, and the program does not reflect an essential public role, keep the government out of it.

That doesn't work for, say, the defense budget (though a volunteer military appropriately preserves choice in that sphere). But stem cell research need not be federalized.

The same rule should apply to the range of controversies now surrounding the "right of conscience" for health care workers. Should hospitals be forced to provide abortions? Should medical schools force doctors to learn the procedure?

Should physicians be required to provide artificial insemination for lesbians? Must doctors assist in sterilizations? Should physicians and nurses accede to a patient's desire to end life-extending treatment?

Must doctors prescribe Viagra for single men? Should pharmacists have to fill those prescriptions, as well as ones for birth control pills and abortifacients?

Even the seemingly mundane has become an issue. Must an ambulance driver deliver a patient to an abortion clinic?

On the one hand are those who would force everyone to do everything. Several states mandate that pharmacies fill all prescriptions. Many jurisdictions require abortion training in medical schools.

Argued attorney R. Alta Charro: "As soon as you become a licensed professional, you take on certain obligations to act like a professional, which means your patient comes first. You are not supposed to use your professional status as a vehicle for cultural conquest."

But the fact that the state licenses professionals does not eliminate the role of individual conscience. And a patient comes first only if he or she is acting morally.

The real "cultural conquest" comes from those who believe that there is no moral code by which anyone is bound. Or, more accurately, who believe that everyone should be bound by their code of moral relativism.

Still, even a finely tuned conscience will not lead everyone to come out the same on controversial issues. Many moral judgments are judgments.

Issues like sterilization and birth control will divide even Christians. Acts that primarily affect the individual (sex by an unmarried) and another person (abortion) have different moral consequences. Some roles are indirect, diminishing any moral culpability, such as driving someone to an abortion clinic rather than performing an abortion, for instance.

Other than a unique circumstance where one's refusal might risk a life -- perhaps a Jehovah's Witness physician unwilling to perform a blood transfusion -- there is no reason to force people to act contrary to their conscience. If state licensing is valid, it is to promote quality, not suppress morality.

Yet, the moral-minded have no right to trump their employers. Professionals have been seeking statutory protection for their right to refuse to perform and have been suing companies when dismissed for refusing to perform.

But a firm should be free to demand that those it hires to provide certain services actually provide them. A good employer is likely to try to accommodate conscience-stricken employees.

There is no reason, however, to assume that doing the right thing will always be costless. Indeed, one reason we laud people who make tough moral decisions is that they are willing to pay the price for doing so.

The public square has become a brutal battleground over conflicting moral visions. The worst thing to do is to politicize issues that could be left private.

Over some issues there is no compromise -- ultimately, our society must decide the legal status of the unborn, for instance. But many other questions, such as who prescribes Viagra and who fills the prescription, should be left to people to sort out voluntarily. The result might be messier, but we will be freer and our society will be healthier as a result.

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About the Author
Doug Bandow is a senior fellow at the Cato Institute. A former Special Assistant to President Ronald Reagan, he is the author and editor of several books, including The Politics of Plunder: Misgovernment in Washington (Transaction).