The Coming of Medical Martyrdom

Source: First Things

By Wesley J. Smith

Christ Healing the Paralytic

Christ Healing the Paralytic

Doctors don’t take the Hippocratic Oath anymore, and haven’t for several 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 in order to comport with modern sensibilities. Still, despite abortion’s ubiquitous legality and the accelerating push to normalize assisted suicide, space remains for dissenting doctors to practice their art in the traditional Hippocratic manner.

But that space is diminishing. Today, “patient rights” are paramount; the competent customer is always right and, hence, held to be entitled to virtually any legal procedure from “service providers” for which payment can be made—be it abortion, assisted suicide, or, someday perhaps, embryonic stem cell therapies and products made from cloned and aborted human fetuses.

Hippocratic-believing professionals, such as faithful Catholics and Muslims, are increasingly being pressured to practice medicine without regard to their personal faith or conscience beliefs. This moral intolerance is slowly being imbedded into law. Victoria, Australia, for example, legally requires all doctors to perform—or be complicit in—abortions: If a patient requests a legal termination and the doctor has moral qualms, he is required to refer her to a colleague who will do the deed.

Such laws are a prescription for medical martyrdom, by which I mean doctors being forced to choose between adhering to their faith or moral code and remaining in their profession. Some have already suffered for their beliefs. During a speaking tour of Australia in 2010, I met doctors who had moved from their homes in Victoria to escape the abortion imposition. I asked them what they would do if Victoria’s law were to go national. “Quit medicine,” they all said, or move to another country.

Canada is heading in the same direction regarding euthanasia. Quebec legalized doctor-administered death last year and allows no conscience exemptions along the lines of Victoria’s abortion law. Meanwhile, the Canadian Supreme Court just made access to euthanasia a Charter right 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 twelve 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. The College of Physicians and Surgeons of Saskatchewan recently published a draft ethics policy that would force doctors morally opposed to providing “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.”

In the United States, doctors are currently protected against forced participation in abortion and assisted suicide (in the few jurisdictions where it is legal). But these professional safeguards are generally opposed by the medical establishment. As just one example, the American College of Obstetricians and Gynecologists (ACOG) published an ethics-committee opinion in 2007 strikingly similar to the Saskatchewan College’s in its intolerance of Hippocratic adherence:

conscientious refusals should be limited if they constitute an imposition of religious and moral beliefs on patients. . . . Physicians and other healthcare 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. . . . In an emergency in which referral is not possible or might negatively impact a patient’s physical ormental health, providers have an obligation to provide medically indicated requested care

The “mental health” wording is key, for it could mean (as in abortion jurisprudence) that the emotional anxiety of a woman denied an abortion could be enough to force the doctor’s compliance, despite his moral objections.

Trying to push society even deeper into the denial of religious conscience, some of the world’s most prestigious medical and bioethics journals have published articles arguing that nursing homes should be legally required to withhold spoon feeding from incompetent Alzheimer’s patients when the person’s written advance directive so instructs. A lawsuit toward that end is currently pending in British Columbia. Imagine: If this proposed policy is implemented, nurses will be required to starve some of their patients to death—even if the care receiver eats willingly or begs for food.

If these trends continue, twenty 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 Patient’s Rights Council. 


  1. M. Stankovich says

    Take this as you will, but I believe these are some of the few issues that I trust the conservation Republicans to manage. A “forced abortion procedure” (“medically indicated requested care?”) in a community hospital in Jackson, Mississippi? See you in court. Secondly, when I was a resident in NYC, a quiet request of a nurse to not be involved with elective Medicaid abortion patients (e.g. pre-surgical physicals, etc.) was mirrored by a friend 20+ years later in a larger university medical center without ruffling any feathers. The fact of the matter is that, judging by the 2014 Medscape Annual Ethics Survey of physicians, 44% of responding US physicians indicated they would perform an abortion even if it were against their personal beliefs, and 54% supported physician-assisted suicide [You may need to establish an account to view the survey]. There are plenty of individuals who would do you the favour. I believe one’s trouble begins when exiting large systems.

    As a mental health practitioner, social pressure has already impacted the law. In California, for example, if I were to address the issue of sexual orientation with anyone under the age of 18 – even if they specifically initiated the conversation – I would be subject to criminal charges as well as ethical charges. With “on-line customer service,” there are examples of my colleagues who refused patients out of their competency or for “ethical exemption” – both offering to refer to competent colleagues – and both received complaints to the licensing board for “discrimination.” Both cases were ultimately dismissed, but having to answer illegitimate complaints (including, “How might this case have been better resolved?”) was disconcerting.

    There is, for example, a blanket ethical ban in the US on research – even with voluntary adult subjects – regarding the issue of the permeability of sexual orientation by the APAs (psychiatry & psychology), National Assoc. of Social Workers, Family Therapists, etc. without any empirical evidence that such research would necessarily cause harm. This is an unprecedented action prompted solely by social influence alone. While none of these organizations are “licensing” bodies, nor is membership necessary for practice, they are lobbyists who attempt to influence funding & social values. Research is the core to scientific discovery and frequent solutions; how is it possible that “scientific bodies” could ban research without some evidence of suspected harm? This, I believe, is the greatest danger of the coming “martyrdom”: the inability to challenge by empirical investigation. We are then victims of any popular “movement” of the time.

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