Patient and society’s demands have given rise both to changes in ideas about the goals of medicine and to changes in medical practice. Many of these changes are welcome improvements to medicine and to the relationship between healthcare professionals and patients.
However, problems in this relationship can arise when patients demand procedures and treatments which are not obviously oriented to the preservation or restoration of health. Some of these may have benefited from controversial research or involve contested techniques. Healthcare professionals may be morally conflicted about participating in certain service provision.
Recognizing this, democratic societies protect their right to avoid participation in activity which is incompatible with their conscience. “Conscience” in this sense is an individual’s inner reflection which produces a moral judgment. It may be informed and reinforced by religious faith, but this is not a prerequisite.
The point is often made that accommodating conscience rights risks restricting or even preventing patient access to lawful medical services. For this reason, the law strikes a balance between the legal entitlements of patients and the conscience rights of healthcare professionals.
The Irish government’s intended legislation following the constitutional referendum in May would permit “termination of pregnancy”. This is defined as a procedure “intended to end the life of the fetus”. Evidence is lacking which would demonstrate that a procedure specifically intended to end the life of the fetus over and above ending the pregnancy is necessary to avoid a risk to a pregnant woman’s life or to her health.
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