Conscientious Objections

The Secular Medical Forum (SMF) is concerned that patient care is being increasingly compromised by health care workers with conscientious objections to a wide range of medical activities. These include family planning, prevention of infection and medical education. Some practitioners have made moral judgments as to which types of patients they will or will not treat.

The SMF considers that people with strong objections to offering normal medical care and activities should responsibly choose to work in a speciality which does not bring their personal views into conflict with patient care.

The SMF would like to see the relevant regulatory bodies offer explicit guidance to health care workers and to health care provider organisations. The Forum considers that, where patient care is adversely affected, objections to providing such services are not acceptable.

In the interim, the SMF thinks it imperative that patients are made aware of relevant personal views at the earliest opportunity. All health care professionals who invoke conscientious objections to avoid what is normally required of their profession, must always refer everyone seeking the specific services to which they object, to others in the same profession who do not have such personal difficulties, as quickly as possible. This position has been adopted by the GMC, the regulatory body for doctors in the UK. The Forum would like for there to be a register of these people, centrally kept by the appropriate professional bodies to which they belong, which can be open to the public.

Individual professionals invoking conscientious objections should prominently display a notice to enable patients to make informed decisions before the point of contact. The information should also be on websites and information leaflets.

The following are some of the problems currently experienced by patients:

  • Women attending their GP for consideration of termination of pregnancy may have their treatment delayed or even refused.
  • Women are disadvantaged by some pharmacists refusing to sell/dispense emergency contraception. Unfortunately, the Royal Pharmaceutical Society appears to endorse this behaviour if grounds for refusal are religious or moral beliefs. In April 2010, the General Pharmaceutical Council (GPhC) will be formed. The SMF has asked the GPhC to place the needs of patients above the wishes of pharmacists who have freely chosen their profession. We do not think that pharmacists should be allowed to exercise a veto over a carefully considered prescribing decision made by a doctor in consultation with their patient.
  • Some medical students consider infection-control guidance to go ‘bare below the elbow’ immoral, rather than good practice.
  • Some doctors have refused to treat patients they regard as immoral. Such patients might include sex workers or those whose need for care may have resulted from the use of alcohol.
  • Some practitioners and teachers refuse to talk about condom use. By adopting this position, they are exposing vulnerable people to the risks of unwanted pregnancy or sexually transmitted infections such as HIV/AIDS.