People need to be free to act on their conscience

Legislators should be free to vote on abortion in line with their conscience lest they risk breaking the moral compass that guides them, writes Dónal O’Mathúna.

CONSCIENTIOUS objection is a hugely important concept. On fundamental ethical issues, like life and death, people should have the freedom to act on their conscience.

This applies to those legislating on abortion and providing access to abortion. The Protection of Life During Pregnancy Bill 2013 allows conscientious objection, but in the most limited way. Its provisions are more restrictive than in many other jurisdictions, which carries a chilling message.

Discussion of conscience can be traced to ancient Greek philosophy and the development of moral character. Conscience was central in developing citizens who not only did the right thing, but who desired to do what was right. Limiting conscience means people are told to do what they have been told is right. You don’t have to think or decide for yourself.

The proposed legislation allows medical practitioners, nurses and midwives to conscientiously object to carrying out or assisting in legal terminations.

However, providing abortions will involve other professionals and non-professionals, and they also should be able to conscientiously object. Forcing people to violate their conscience risks bending or breaking the moral compass that guides them. Therefore, legislators should be free to vote on this legislation according to their conscience. And anyone working in hospitals providing abortions should be able to consciously object to being involved.

The proposed legislation should acknowledge the importance of moral complicity. Those who morally object to doing something, especially when it involves an innocent third party, should be able to conscientiously object to being involved in any way. The legislation should make it clear that this includes providing information or supporting those conducting terminations.

This would raise practical challenges for healthcare organisations that could be addressed through institutional conscientious objection. Based on its identity and mission, whether for religious reasons or others, a hospital could conscientiously object to providing abortions. Its staff and patients would then be clear about what would or would not happen there.

Health Minister James Reilly has stated that there is “absolutely no indication or room for an institution to have a conscientious objection”. Other jurisdictions allow conscientious objection for hospitals, medical schools, pharmacy corporations and other institutions.

Furthermore, the Parliamentary Assembly of the Council of Europe passed a resolution in 2010 declaring that: “No person, hospital or institution shall be coerced, held liable or discriminated against in any manner because of a refusal to perform, accommodate, assist or submit to an abortion, the performance of a human miscarriage, or euthanasia or any act which could cause the death of a human foetus or embryo, for any reason.”

In ethics, conscience is not just something individuals have, as if it was a little voice in our heads telling us what we should or should not do. One definition is that conscience is “the most fundamental of all moral duties — the duty to unite one’s powers of reason, emotion, and will into an integrated moral whole based upon one’s most fundamental moral principles and identity”.

Institutions and organisations can have a moral identity and be moral agents. Common sense shows we believe some (not all) institutions have moral duties. We blame our government for doing bad things. We praise our schools for doing good things. We question the integrity of the banks. We hold corporations morally accountable. Certain institutions, especially in healthcare, have a moral identity and should uphold moral principles. This is not just a religious thing.

Imagine an NGO providing medical care in war zones. Its moral vision includes neutrality and impartiality: they care for all sides. If the governing authorities required organisations to treat only “their” people, we would admire the NGO for conscientiously objecting to going along with this policy.

Conscientious objection is a way to protect the moral vision and identity of institutions and individuals. Conversely, when institutions fail morally, as the church has done, we find it particularly offensive and call them to account morally. We expect some institutions to act according to an institutional conscience. Therefore, we must also permit them to conscientiously object on certain occasions.

We need doctors and nurses who hold strongly to their moral principles, whether about abortion or just allocation of resources or compassionate care for patients. They should never be forced to violate their consciences either through direct involvement or indirect complicity. We also need healthcare institutions dedicated to moral visions. We need them committed to social justice and care of the weak and vulnerable. Such institutional visions need to be promoted and protected. One way to do this is by permitting institutions and organisations to conscientiously object to practices that violate their moral vision and core identity.

Martin Luther King Jr said: “Conscience asks the question — is it right?” When an individual or organisation conscientiously objects, it challenges the rest of us to reflect on our morals. When people conscientiously objected to accepted racist practices, it challenged others’ consciences and contributed to change.

King went on to say: “And there comes a time when one must take a position that is neither safe, nor politic, nor popular; but one must take it because it is right.” For the politicians voting on this legislation, this time has come.

Dónal O’Mathúna is a senior lecturer in ethics, decision-making, and evidence at Dublin City University’s school of nursing and human sciences. The views expressed here are those of the author and are not presented as those of Dublin City University.