The Role of Conscience — Vocation of Catholic Health Care Professionals? (Part 2)

CL26 - hbratton notxt

©Heidi Bratton Photography

How are Catholic health care professional to act, morally and professionally, in a culture where legislative mandates diminish the exercise of the moral conscience of the clinician and threaten human dignity and freedom?  The following principles are offered to guide moral action of health care professionals when confronted with a decision to disregard mandated unethical legislation in the care of others:

1. Assuring respect and protection for the dignity and freedom of the person seeking care and in response to the promise of the clinician to help and to heal, no person should be ever be abandoned because of their preferences for treatment which may be contrary to Church teaching or to the moral principles of the clinician.  Explaining to the patient the ethical principles that govern the moral actions of the clinician can help the patient come to a better understanding of the foundation of human dignity that is the foundation of trust and the promise that the clinician has made to the patient in his presence. In this particular clinical encounter the health care professional continues to affirm the intrinsic dignity of the patient without having to agree to engage in treatments or referrals contrary to his conscience or Church teaching.

2. Health care professionals have the obligation as members of society to work to eliminate existing legislative mandates, or to limit the harm done by them, which violate the dignity and freedom of all persons, themselves and especially the sick, the vulnerable, those who care for them and to act according to a properly formed conscience built from the natural law and the moral teaching of the Church.

3. In the cases of intrinsically unjust laws, such as laws, for example, permitting abortion, euthanasia, physician assisted suicide, prescribing medications to terminate pregnancies, use of federal tax dollars for ethical research protocols, it is never licit to obey them, or to take part in a propaganda campaign in favor of such laws, or vote for them.  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, n. 73).

4. Health care professionals (and all Christians and other people of good will) are called upon under grave obligation of conscience not to cooperate formally in practices which, even if permitted by civil legislation, are contrary to God’s law.  From the moral standpoint, it is never licit to cooperate formally in evil (EV, n. 73).  Such cooperation can never be justified either by invoking respect for the freedom of others or by appealing to the fact that civil law permits it or requires it.

5. Each individual in fact has moral responsibility for the acts which he personally performs; no one can be exempted from this responsibility, and on the basis of it everyone will be judged by God himself (cf. Rom 2:6, 14-17).

In summary, Evangelium Vitae offers these additional principles to health care professionals facing legislatively mandated health care treatment decisions that are contrary to the natural law and the moral teaching of the Church:

To refuse to take part in committing an injustice is not only a moral duty; it is also a basic human right.  Were this not so, the human person would be forced to perform an action immediately incompatible with human dignity, and in this way human freedom itself, the authentic and purpose of which are found in its orientation to the true and the good, would be radically compromised. What is at stake therefore is an essential right that, precisely as such, should be acknowledged and protected by civil law. In this sense, the opportunity to refuse to take part in the phases of consultation, preparation ad execution of these acts against life should be guaranteed to physicians, health care personnel, and directors of hospitals, clinics and convalescent facilities. Those who have recourse to conscientious objection must be protected not only from legal penalties but also from any negative effects on the legal, disciplinary, financial and professional plane (n. 74).

As stated in the Catechism of the Catholic Church, moral conscience, presence at the heart of the person, enjoins him at the appropriate moment to do good and to avoid evil. It also judges particular choices, approving those that are good and denouncing those that are evil. It bears witness to the authority of truth in reference to the supreme Good to which the human person is drawn and it welcomes the commandants.  When he listens to his conscience, the prudent man can hear God speaking. As health care professionals, committed to promoting human dignity and freedom, let us continue our work of listening and then acting on the basis of a well-formed conscience!

Suggested readings:

Libreria Editrice Vaticana (1997). Catechism of the Catholic Church.  Washington, DC; United States Catholic Conference of Bishops, Inc. & Libreria Editrice Vaticana.

John Paul II  (1995).  Encyclical Letter-TheGospel of Life (Evangelium Vitae).  Boston: Pauline Books and Media.

Ratzinger, J. Cardinal. (2007). On Conscience.  San Francisco: The National Catholic Bioethics Center, Ignatius Press.

Ratzinger, J Cardinal. (2005). Values in a Time of Upheaval.  San Francisco:  Ignatius Press.

United States Conference of Catholic Bishops.  (2007). Forming Consciences for Faithful Citizenship.   Washington: United States Conference of Catholic Bishops.

Bro. Ignatius Perkins, O.P.)

Brother Perkins is a practicing registered nurse and holds graduate degrees in nursing and education and an earned doctoral degree in nursing from the Catholic University of America. He completed a post doctoral fellowship in primary care and clinical bioethics at Georgetown University’’s Center for Clinical Bioethics. He is a member of the National League for Nursing, the American Nurses Association and a Fellow in the American Academy of Nursing, the New York Academy of Medicine and holds certification in Catholic Health Care Ethics from the National Catholic Bioethics Center.