Icomem position on conscientious objection

The Ethics Commission of the Madrid Official College of Physicians (Icomem) has published a position paper on conscientious objection in the medical profession. In this report, and according to Icomem himself, the aim is to “review and update, from deontology, the understanding of conscientious objection in the medical profession, taking into account the new contexts it faces”. You can consult the full document by clicking on this link.

The conclusions The professionals in charge of drafting the document have reached the following:

The Medical Ethics is not an exercise in the creativity of professionals but a reflection on the experience of attending to the needs of patients. One of his typical conclusions is that there are things that doctors should not do. The recognition of conscientious objection is considered as a necessary condition for the correct action of the doctor. Deontology does not treat it primarily as an exercise of the free opinion of professionals, but rather as a premise that guarantees the adequate framework for the fulfillment of their duty.

Any form of regulation that imposes forms of action contrary to the ethical and deontological duties that characterize their performance are contrary to the necessary collaboration between the Administration and professionals. It is not possible to object without first contributing adequately to the construction of a health environment in which rights of all people are adequately promoted and, at the same time, it is not possible to claim to regulate healthcare action without first listening, acknowledging and supporting the commitment of those who are responsible for making it possible.

Any form of restriction, limitation or regulation of the exercise of conscientious objection is contrary to its correct assessment

The recognition of the right to conscientious objection guarantees that the primacy of the duties that characterize the profession is respected. Thus, the doctor also finds legal support for the imperative of a conscience that orders him to omit certain types of acts contrary to his obligations. Conscientious objection must be appreciated as an authentic contribution to social life and, in any case, as an expression of the fundamental rights on which democracy itself is based, constitutive elements of the Rule of Law.

Any form of restriction, limitation or regulation of the exercise of conscientious objection is contrary to its correct assessment. Therefore, “Of conscientious objection no type of prejudice or advantage can be derived for the doctor who invokes it” (CD VI, Art 35.1).

The tendency towards excessive role of the Administration in regulating the exercise of conscientious objection is worrisome, particularly verifiable in the creation of registers of objectors, also taking into account its limited utility in order to organize health care. Although different qualification criteria can be described by their degree of participation, the primacy of the doctor’s conscience must always be recognized when evaluating their rejection of the acts that are going to be carried out.

Conscientious objection is an appropriate response, loaded with ethical and social value, but not without difficulties

The exceptionality of the exercise of conscientious objection introduces the objector into specific duties, among which the one of not abandoning the patient in his care process stands out, especially in cases of particular need. The acts that the doctor performs are not automatisms or impersonal processes. The scientific literature reflects the particular contribution to “wear” of professionals who can produce potentially harmful moral experiences such as those that violate moral values ​​or deeply rooted beliefs.

The Conscientious objection is an appropriate response, loaded with ethical and social value, but not without difficulties. Intense collaboration is necessary between the different agents involved in health protection so that the duties that characterize the medical profession and that best guarantee adequate care for patients are properly valued and in fact possible.

The members of the Icomem Ethics Commission, chaired by the Dr. Rafael Del Rio Villegasare the following: Dr. Julio Albisúa Sánchez, Dr. José Manuel Álvarez Avello, Dr. Juan Antonio Andueza Lillo, Dr. Raquel Barrero Alba, Dr. Juan José Bestard Perelló, Dr. Regina Cárdenas Santos, Dr. Álvaro Gándara del Castillo , Dr. Joaquín María Ojeda Ruiz de Luna, Dr. Pedro Antonio Pacheco Martínez, Dr. José Manuel Moreno Villares, Dr. María Jesús del Yerro Álvarez and Dr. Iciar Vegas Jáudenes.

Because health we all need…

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