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The Anscombe Bioethics Centre welcomes the decision of the World Medical Association (WMA) to uphold the right of conscientious objection in healthcare.
The final text of the International Code of Medical Ethics was agreed last week. It is a rejection of earlier proposals that doctors with a conscientious objection be required to make “effective referral” for such procedures. Instead, the WMA recognises that both patients and physicians “may hold deeply considered but conflicting conscientious beliefs”. Both need to be respected.
The final text of the Code is in line with the open letter to the WMA which was co-ordinated by the Anscombe Centre and was finally signed by almost four hundred professors and clinicians from across the globe: No doctor should be obliged to provide or facilitate a procedure that, reasonably and in good conscience, they judge to be harmful, discriminatory, unjust or otherwise unethical.
The open letter helped inform a key meeting between delegates of the WMA and the American Medical Association in Washington on 11-12 August 2022. It was at this occasion that the text was finalised before being presented to the general assembly for approval. The International Code of Medical Ethics is a reference point for national medical associations throughout the world and is potentially of enormous influence.
The WMA also maintains its opposition to euthanasia and assisted suicide and to doctors being forced to refer patients for these procedures. This is in contrast to government policies in countries such as Canada where doctors are now required to refer people for “medical assistance in dying” even if the patients are not dying, and where some doctors are encouraging patients to consider euthanasia even when the patients have not raised the issue themselves. What is at first framed as a right to die can become a perceived duty to die. Where euthanasia or assisted suicide are legal the protection of patients may depend on the courage of conscientious healthcare professionals to resist such insidious pressures.
The WMA International Code of Medical Ethics is not perfect. For example, it requires doctors to tell patients whenever they have a conscientious objection. However, in the United Kingdom, the General Medical Council has rightly observed that it is not “always necessary or helpful for a patient to be aware of the professional’s personal beliefs”. What is important is that the patient is informed in a timely manner if a doctor will not provide what the patient is asking for, and that the patient is informed that they have the right to seek alternative medical care.
Commenting on the revised International Code of Medical Ethics, Professor David Albert Jones, Director of the Anscombe Bioethics Centre, said:
“It is heartening to see conscience upheld by a medical body representing so many doctors in so many countries. At the same time, in the United Kingdom, there is certainly a need to strengthen legal and professional protection of conscience rights. With so many pressures on health and social care, what we need is not the imposition of uncritical adherence to state or institutional control but more support for conscientious professionals. They are the last line of defence for ethical patient care”.
The Anscombe Bioethics Centre was founded in 1977, and is the oldest national bioethics research centre in the UK, and one of the oldest in the world. For many years the Centre was based in London and was known as the Linacre Centre for Healthcare Ethics, in honour of Thomas Linacre, the 16th Century scholar and physician to King Henry VII. In 2010, the Centre moved to Oxford, in order to be in close contact with the most advanced research in the world and to develop more strategic academic partnerships. The Centre’s change of name coincided with this move, and honours Elizabeth Anscombe, the great Catholic philosopher who taught in Oxford and Cambridge, debated with C.S. Lewis, studied with Wittgenstein, and who was well-known for her defence of human life. She died in 2001. The current Director (January-July 2001; 2010-) is Dr David Albert Jones, who is also Professor of Bioethics at St Mary’s University in Twickenham, and Research Fellow at Blackfriars Oxford.
