A friend who teaches at the University of Toronto recently made me aware of what Ewan Goligher has written about rights of conscience in the context of the legalization of physician assisted death in Canada and the push by many there to require physicians provide effective referral for physician assisted death. Dr. Goligher is an academic physician who specializes in internal medicine and intensive care medicine in Toronto. He has expressed quite well the reasons why he is unable in good conscience to participate in or make referrals for physician assisted death in a letter to members of the Canadian Parliament and in an article in the National Post which I would recommend that you read.
Among the points that Dr. Goligher makes two strike me as being most significant. One is that a physician should only do those things that are both legal and morally right. Being legal is not sufficient reason to believe that something that a patient requests is the right thing to do. Physicians owe a duty to their patients not to do something that the patient requests if what is requested would be harmful to the patient. We should respect patients’ ability to make decisions about their own lives and should not force patients to do something they do not want to do, be we should not cause harm to patients even if they request it. Our duty is to the good of the people we treat and not just a duty to do what they request.
The second is his explanation for why making an effective referral for physician assisted death is wrong in the same way that prescribing the means of death is wrong. He makes his point by making an analogy to making a referral for female genital mutilation. Like all analogies it cannot be taken too far since physician assisted death under the Canadian law is presumed to be based on the free decision of the one making the request to die and genital mutilation is being requested by someone who has surrogate decision making authority for the one being acted upon, but the analogy holds well in showing that in such a case making a referral can easily be seen as being wrong in the same way as doing the act.
My thanks goes to Dr Goligher for his well-written expression of why physicians should have the freedom to refuse to participate in or refer for procedures they understand to be immoral. If you are reading this and happen to be in the Toronto area, Dr. Goligher will be speaking on this issue in a talk at Wycliffe College on October 27 at 7 PM sponsored by the deVeber Institute for Bioethics and Social Research.