Tuesday, August 16, 2011

Catholic Medical Ethics

Q - Proper training for a health care practitioner requires many weeks of OB/GYN-related clinical work/experience. In that period of time the students are advised (by attending physicians, PA's, NP's) on appropriate treatment plans and protocols. Suppose a student is advised to give "treatment" that is contradictory to church teaching, and personal conviction. How can the student approach the situation, express their concerns in the treatment plan, and maintain a sufficient environment in which to learn, all while following the teachings of the church?
Here are some examples (you don't have to address all):
  • An attending physician advises you to write a prescription for RU-486 (the morning after pill) to a 19 year old in the emergency room
  • You are doing a 6 week rotation with a private-practice Obstetrician. He gives you a prescription pad and asks if you can take care of all the patients who need re-fills on their monthly oral contraceptives
  • The office you spend 8 weeks in for women's health gives planned parenthood brochures to all their new patients.
  • Your professor tells you that you must give ALL options for your young pregnant patient (including the option to receive an abortion)
A - Thanks for the question. Being a faithful Catholic medical practitioner is not as easy as it once was. The problems are legion, as you point out. I don't want to get into too specific an answer, but rather I would like to give some guiding principles that should be able to help you and then point you to other resources.

Principle #1 - you should never do anything that violates your conscience. From the encyclical Evangelium Vitae by John Paul II:
Abortion and euthanasia are thus crimes which no human law can claim to legitimize. There is no obligation in conscience to obey such laws; instead there is a grave and clear obligation to oppose them by conscientious objection. (EV 73)
Then from the Catechism:
Man has the right to act in conscience and in freedom so as personally to make moral decisions. "He must not be forced to act contrary to his conscience. Nor must he be prevented from acting according to his conscience, especially in religious matters. (CCC 1782)
Principle #2 - Life is always valuable.
"Human life is sacred because from its beginning it involves the creative action of God and it remains for ever in a special relationship with the Creator, who is its sole end. God alone is the Lord of life from its beginning until its end: no one can under any circumstance claim for himself the right directly to destroy an innocent human being." (CCC 2258)
Principle #3 - Contemporary medical ethics is off-base in many ways, because of the separation from morality based on the dignity of all human life, which is found in our creation in the image an likeness of God and redeemed by Christ.
Choices once unanimously considered criminal and rejected by the common moral sense are gradually becoming socially acceptable. Even certain sectors of the medical profession, which by its calling is directed to the defence and care of human life, are increasingly willing to carry out these acts against the person. In this way the very nature of the medical profession is distorted and contradicted, and the dignity of those who practise it is degraded. (EV 4)
Principle #4 - By refusing to participate in an act that violates your conscience, you are not "imposing" your beliefs on another person.

This is quite contrary to what our modern culture teaches. You cannot impose your belief on another person by refusing to participate in what you deem is immoral. In fact, if you don't refuse to act when your conscience guides you to do so, you allow others to influence you and are sinning.

I know that I didn't directly answer your questions, but I would have to write a book to do so, and others have already done that. What I will do is pray for you. May God's wisdom guide you and the Holy Spirit fill you. Thank you for your service to the world!

-National Catholic Bioethics Center (an excellent resource for the issues listed above)
-A Catholic Guide to Medical Ethics by Eugene F. Diamond, MD

St. Luke, patron of medical workers, pray for us!

1 comment:

Emily said...

My husband and I are in school to be health care professionals and have had many incredibly interesting discussions about this very topic.

In our experience, interestingly, NFP is barely addressed in the classroom and when it is, the information is often wrought with error.

During our clinical experience, I was never asked to write prescriptions for birth control but always wondered how I would have handled the situation. Most health care professionals (especially in OB-GYN) would probably think you were crazy for not believing in birth control, as it is viewed as something requiring no more thought than popping a Tylenol. However, in the hospital, I did see many complications of birth control, such as blood clots in the legs and lungs in young women with no other risk factors besides oral contraceptives.

During obstetrics, however, we were told by the faculty that we were never "forced" to participate in any procedure that went against our morals. I did observe many tubal ligations just after C-sections.

During our schooling, my husband and I couldn't be more convinced that NFP is truly something instituted by God. Despite all the "best" most available birth control methods in our country, about 50% of all pregnancies are unintended. Truly there is more to the solution than a simple pill, piece of latex or surgical procedure.