This is one of the most important but underappreciated civil rights issues of our time.
Medical conscience is under sustained assault as doctors are being threatened with societal punishment or professional discipline for refusing to provide controversial but legal interventions such as abortion, euthanasia, and gender transition against their religious or moral beliefs. Now, a British Columbia doctor has been fined $28,100 for refusing to administer puberty blockers to a child based on his religious and moral objections. From the CBC story:
The decision describes Child Q, the 14-year-old at the centre at the decision, as a “brave, sensitive, kind transgender girl.”
It says in late 2020, she came out as transgender and struggled with her mental health as she entered puberty. Ajaero referred her to the B.C. Gender Clinic, where an endocrinologist prescribed Lupron, a medication that pauses puberty.
According to the decision, Child Q describes the day she started the medication as “one of the best days of my life.”
Lupron needs to be injected every three to four weeks. It can be injected at home, but according to the decision, Child Q and her family preferred to have it done by a doctor.
Her first appointment to get an injection at her family doctor’s was March 5.
The decision said when Ajaero learned that the shot was Lupron, he told Child Q’s mother he would not be administering it.
“He explained this was for religious and cultural reasons, and he hoped that was OK. Mother Q said it was not OK.”
Ajaero’s charting notes from the appointment said: “I noticed that the injection is for gender re-assignment as patient is already in the waiting room with [her] mother. I called mother into the room and explained to her that I would not be able to give the injection. Based on my religious belief and cultural background.”
So a doctor was financially punished for refusing to administer a drug “off-label,” i.e., for a purpose that has not been approved by Canadian health authorities. He was punished for refusing to administer substances that have the potential to cause material harm to the patient; substances now banned for use in gender transitions in some European countries.
In other words, ideology over medical science. Canada is becoming increasingly authoritarian. In Ontario, the highest provincial court ruled that doctors who refuse to participate in euthanasia, abortion, and other legal but controversial actions can be professionally disciplined, and that if they don’t like it, they should get out of medicine. This despite an explicit provision in the Canadian Charter of Rights and Freedoms protecting “freedom of conscience and religion.”
But before we look down our noses at our northern cousins, the same anti-conscience agenda is being pushed energetically in the U.S. via medical journals and state statutes. Writing in the New England Journal of Medicine some years ago, Ezekiel Emanuel decried medical conscience in a way so extreme that he stated that doctors should have to perform abortions because that procedure is not controversial among the medical establishment. Other journal articles have advocated requiring doctors and caregivers to enable patients to commit suicide by self-starvation and dehydration.
The recently enacted law in New York legalizing assisted suicide requires doctors to participate in some aspects of euthanasia. As a result, several orders of nuns involved with providing health care have sued for the right to opt out based on their religious beliefs. They are currently protected by an injunction, but the case is still pending. Meanwhile, the ACLU and others have sued Catholic hospitals for refusing to violate the church’s moral teachings about health care that forbid abortion, sterilization, and the removal of healthy organs.
The problem exists throughout the increasingly decadent West. A few years ago, Swedish midwives were denied employment for refusing to perform abortions, actions validated in the courts. A U.K. midwife was similarly reprimanded. Italian doctors are being criminally investigated for refusing to assist a suicide. An Australian doctor was professionally disciplined for refusing to perform a sex-selection abortion. Many more such cases could be listed.
Why are attacks on medical conscience proliferating? When doctors refuse to abort a fetus, participate in assisted suicide, excise healthy organs, inject young bodies with puberty blockers, perform hysterectomies on healthy uteruses, or otherwise follow their consciences about morally contentious matters, they send a powerful message: Just because a medical act is legal doesn’t make it right. Such a clarion witness is intolerable to those who want to weaponize medicine to impose secular individualistic and utilitarian values on all of society.
There will be a high social cost if medical conscience is obliterated. Think of the brain drain. Doctors will retire early or otherwise leave the profession. Nurses too. Religious nursing homes may close, and hospices that refuse to kill could be denied funding — as has already happened in Canada. And think of the highly qualified young people who could make great medical professionals but who will not attend medical school because they do not want to be forced to violate their consciences.
Medical conscience is one of the most important but underappreciated civil rights issues of our time. At stake is not only the free exercise of religion but also medical professionalism, “do no harm” ethics, and the very integrity of our health-care systems.