Story Posted: 2017-12-04

Conscientious Objectors Bring Valuable Discussion to Healthcare Teams

November 2, 2017 – The role of conscientious objection in healthcare was explored at the 2017 W.F. Mitchell Bioethics Seminar. Approximately one hundred people attended in person alongside ten telehealth sites to hear guest speaker Dr. Jeff Blackmer, VP Medical Professionalism for the Canadian Medical Association, present on the topic, “When good people disagree: What happens when our morals don’t align.”

The presentation gave an overview of conscientious objection in healthcare, focused on current controversies such as medical assistance in dying, and provided a practical approach for resolving moral dilemmas as part of a team.

Dr. Blackmer first reviewed the history of conscientious objection, drawing attention to the Hippocratic Oath’s emphasis on the physician’s own moral judgment of what is beneficial or deleterious to his or her patient’s health. However, since there is not clear consensus on what treatments are good or bad, Dr. Blackmer pointed out that different schools of thought have developed to guide the actions of the physician. He distinguished between one point of view that emphasizes the physician’s responsibility to uphold his or her patient’s wishes with little regard to the physician’s own moral compass, and another point of view that healthcare professionals “themselves are moral beings and that their morality should not be infringed upon by dictates from the legislatures, medical community or patient interests.”

Dr. Blackmer said the change in the medical assistance in dying law has brought this discussion to light in a new way. It has “forced us to confront [conscientious objection] in a way that has tried to respect individual conscience while making sure that we don’t compromise patient care. It’s forced us to have some of these difficult team conversations where we may not agree with our colleagues, but we try to be respectful in the way that we have those disagreements.”

“I think [talking about conscientious objection] has been helpful for both sides,“ Dr. Blackmer said. “I think physicians who feel very, very strongly in opposition to assisted dying, have helped their members in some of these organizations to understand what their responsibilities are, even if they don’t participate. And I think that has been a positive dialogue.”

Dr. Blackmer stressed the importance of having open dialogue on challenging ethical issues. “One of the things that has made me the most proud with this controversial issue and the way we’ve dealt with it has been the respect that physicians and other care providers have shown each other because I think that no matter which side of this debate you are on, you recognize why other people feel otherwise,” he said.

“We struggle with what’s right and what’s wrong – how to reconcile the different views that we have – and we’re all doing the best that we can in a very complex situation. And I think we need to remember that. If you’re dealing with someone on your team who has a different view than you have and you’re really struggling, they’re probably really struggling as well. This idea of open and compassionate dialogue and communication is always very important.”

The W.F. Mitchell endowment was created in memory of W.F. Mitchell, a Saskatoon businessman who was committed to ethics. The full 2017 W.F. Bioethics Seminar was recorded by Telehealth and is available below.


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