CONSCIENCE

Extracts from address given at the Conscience Laws in Healthcare Conference.

The exercise of conscience in medicine is everything.  It has been truly said “The obligation to practice conscientiously is the obligation on which all other medical ethics are built.”   (Dr Farr Curlin, MacLean Center for Clinical Medical Ethics, University of Chicago)

It underlies every aspect of good medical practice, to make good patient care our first concern and to practice medicine safely and effectively. It is conscience that must compel doctors to refuse to participate in treatments they believe to be un-ethical or that they consider not to be in the best interests of patients.  To do otherwise would undermine the very foundation of good medicine

The liberty to not be involved or complicit in matters considered to be unethical or inadvisable is critical for individual doctors and for the integrity and independence of the medical profession as a whole.  It is critical for individual doctors as it lies at the very heart of who we are – our integrity and self-identity.  To leave our conscience at the door and just become service providers is to turn us into soulless doctors.  For the medical profession to sacrifice conscience and be at the behest of a health bureaucracy concerned with service provision only is to turn us all into a soulless, mechanistic society.

It is obvious that I consider infringement of conscience to be the greatest challenge facing modern medicine.  Medical care must never be subject to degradation by governments in this age or any age to come.

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It has been said that requiring men to violate and disregard their conscience results in the loss of virtue and undermines the basis for self-government.  Surely we realise it was ethical failure that has caused our global financial crisis.  Do we expect an ethical conscience in our governments?  Do we want Codes of Conduct that are of a high standard in business, in accounting, in our legal professions, in sport?  I think we do and I think some recent events actually demonstrate and confirm that we – as an Australian people – do want such standards.

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