Ebook Ethical issues in anesthesiology and surgery: Part 2
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Ebook Ethical issues in anesthesiology and surgery: Part 2
Chapter 8Conscientious ObjectionRan Cheng and Kenneth R. AbbeyAbstract The phrase “conscientious objection" appears to have originated from the milita Ebook Ethical issues in anesthesiology and surgery: Part 2ary service, but today it can be applied in other Helds including education, child immunization, and healthcare. In medicine, conscientious objection refers to the right of providers to refuse to participate in certain types of medical care that they object to on religious or moral grounds. Most com Ebook Ethical issues in anesthesiology and surgery: Part 2monly, conscientious objection in medicine occurs when providers refuse to participate in abortion. However, conscientious objection is a much broaderEbook Ethical issues in anesthesiology and surgery: Part 2
issue and may also apply to a number of medical and quasi-medical interventions including lethal injection, work with prisoners, futile care, and medChapter 8Conscientious ObjectionRan Cheng and Kenneth R. AbbeyAbstract The phrase “conscientious objection" appears to have originated from the milita Ebook Ethical issues in anesthesiology and surgery: Part 2ional responsibilities as well as social, professional, and legal risks. In general, a physician will be better positioned to fulfill their professional responsibilities and minimize their professional risks if they prepare in advance.Keywords Conscientious Objection • Abortion • Right to Privacy • Ebook Ethical issues in anesthesiology and surgery: Part 2Lethal Injection • Physician-Assisted Suicide • Prisoners • Roe V. WadeR. Cheng. MD O)Department of Anesthesiology and Perioperative Medicine. OperatiEbook Ethical issues in anesthesiology and surgery: Part 2
ve Care Division. Oregon Health and Sciences University, 3181 sw Sam Jackson Park Road, Portland. OR 97239, USA e-mail: Chenra@ohsu.eduK.R. Abbey. MD.Chapter 8Conscientious ObjectionRan Cheng and Kenneth R. AbbeyAbstract The phrase “conscientious objection" appears to have originated from the milita Ebook Ethical issues in anesthesiology and surgery: Part 2thesiology and Perioperative Medicine. Operative Care Division. Oregon Health and Sciences University, Portland. OR. USAe-mail: Kenneth.Abbey@va.gov: abbeyk@ohsu.edu© Springer International Publishing Switzerland 201593B.G. Jericho (ed.). Ethical Issues ill Anesthesiology and Surgery.rv'M in inn?/07 Ebook Ethical issues in anesthesiology and surgery: Part 2 V 7 -Ỉ1O KO.1O 7 c94R. Cheng and K.R. AbbeyCase PresentationYou are a young anesthesiologist practicing at a community hospital in Oregon and you areEbook Ethical issues in anesthesiology and surgery: Part 2
consulted to provide better pain management to a terminally ill patient. The patient is a 67-year-old retired nurse with metastatic lung cancer to hiChapter 8Conscientious ObjectionRan Cheng and Kenneth R. AbbeyAbstract The phrase “conscientious objection" appears to have originated from the milita Ebook Ethical issues in anesthesiology and surgery: Part 2not bear it anymore. He knows that physician-assisted suicide is legal in Oregon and he asks you to help him end his life. What will you do? if you do not believe in suicide, is it appropriate to decline his request? Do you have an ethical obligation to decline his request ? If you decide you cannot Ebook Ethical issues in anesthesiology and surgery: Part 2 in good conscience assist in his suicide, what are your professional obligations to him?IntroductionConscientious objection in medicine refers to theEbook Ethical issues in anesthesiology and surgery: Part 2
right of providers to refuse to participate in certain types of medical care that they object to on religious or moral grounds [ I J. Most commonly, Chapter 8Conscientious ObjectionRan Cheng and Kenneth R. AbbeyAbstract The phrase “conscientious objection" appears to have originated from the milita Ebook Ethical issues in anesthesiology and surgery: Part 2ous objection for legal abortion is controversial and a discussion of conscientious objection is often colored by one’s views on abortion [2]. However, conscientious objection is a much broader issue that may apply to a number of medical and quasi-medical interventions including lethal injection, ca Ebook Ethical issues in anesthesiology and surgery: Part 2re of prisoners. futile care, and medical research. Moreover, conscientious objection has long held a place in history and applies far beyond medicineEbook Ethical issues in anesthesiology and surgery: Part 2
to many aspects of society and human interaction. Accordingly, thoughtful discourse about conscientious objection requires consideration of not only Chapter 8Conscientious ObjectionRan Cheng and Kenneth R. AbbeyAbstract The phrase “conscientious objection" appears to have originated from the milita Ebook Ethical issues in anesthesiology and surgery: Part 2se "conscientious objection" appears to have originated from the military service and in the modern military refers to a ’’firm, fixed, and sincere objection to participation in a war in any form or to the bearing of arms, by reason of religious training and or belief’ [3],The oldest known conscient Ebook Ethical issues in anesthesiology and surgery: Part 2ious objector to military service was Saint Maximilian of Tebessa who earned his sainthood for his refusal to serve in the Roman Legions on the basisEbook Ethical issues in anesthesiology and surgery: Part 2
of his Christian beliefs. He was executed on March 12th. 295 AD. and became a martyr for Christianity [4]. In America, the earliest known conscientiouChapter 8Conscientious ObjectionRan Cheng and Kenneth R. AbbeyAbstract The phrase “conscientious objection" appears to have originated from the milita Ebook Ethical issues in anesthesiology and surgery: Part 2ntious objectors8 Conscientious Objection95were allowed to take non-combatant military roles, but those w ho refused to serve in any position in the military were subjected to imprisonment and even physical abuse 11.5]. The honorable service received by conscientious objectors, especially during the Ebook Ethical issues in anesthesiology and surgery: Part 2 world wars, has helped to ensure the commitment of the military to the concept of conscientious objection. In fact, the first non-combat conscientiouEbook Ethical issues in anesthesiology and surgery: Part 2
s objector to be awarded the Congressional Medal of Honor was Desmond T. Doss, a Seventh Day Adventist who distinguished himself by heroic service as Chapter 8Conscientious ObjectionRan Cheng and Kenneth R. AbbeyAbstract The phrase “conscientious objection" appears to have originated from the milita Ebook Ethical issues in anesthesiology and surgery: Part 2bjection is based must be the primary controlling force in the applicant’s life” [3].Outside of the military, conscientious objection can be w itnessed in education, child immunization, and healthcare. In the United States, compulsory education varies slightly from state to state, but typically begi Ebook Ethical issues in anesthesiology and surgery: Part 2ns around the ages of 5-7 and ends between the ages of 16-18 [ 7 J. Home schooling serves as a form of conscientious objection for many parents w ho wEbook Ethical issues in anesthesiology and surgery: Part 2
ould like their children's education to have a certain religious or moral background or who object to some of the classes (e.g. sex education) or topiChapter 8Conscientious ObjectionRan Cheng and Kenneth R. AbbeyAbstract The phrase “conscientious objection" appears to have originated from the milita Ebook Ethical issues in anesthesiology and surgery: Part 2ous and fatal diseases prior to starting school. However, there are 48 states that allow for religious exemptions and 18 states that allow personal belief exemptions to these immunizations for daycare and school 18]. Many parents elect not to vaccinate their children because of a believed link to au Ebook Ethical issues in anesthesiology and surgery: Part 2tism, although scientific evidence does not support this belief [9]. However, in 2014. an outbreak of measles occurred in the western United States leEbook Ethical issues in anesthesiology and surgery: Part 2
ading to calls for the elimination of conscientious objection exemptions to immunization [10. 11].The History of Conscientious Objection in MedicineThChapter 8Conscientious ObjectionRan Cheng and Kenneth R. AbbeyAbstract The phrase “conscientious objection" appears to have originated from the milita Ebook Ethical issues in anesthesiology and surgery: Part 2entious objection to abortion, the original Hippocratic Oath (written in Ionic Greek around the fifth century BC) contained the promise that "1 will give no sort of medicine to any pregnant woman, w ith a view to destroy the child” [12]. Since the Oath was not and is not legally binding, the promise Ebook Ethical issues in anesthesiology and surgery: Part 2 amounted to an assurance that the practitioner would exercise conscientious objection against participation in abortion. But the Oath also called upoEbook Ethical issues in anesthesiology and surgery: Part 2
n physicians to refrain from a number of other interventions: poison, surgery (reserved for surgeons), and broadly to "refrain from injury or wrong frChapter 8Conscientious ObjectionRan Cheng and Kenneth R. AbbeyAbstract The phrase “conscientious objection" appears to have originated from the milita Ebook Ethical issues in anesthesiology and surgery: Part 2ch the Supreme Court found that laws banning abortion were unconstitutional [ 13]. Congress reacted to Roe by passing the Church Amendments that same year, w hich provide that "receipt of certain federal funds by any individual or entity does not authorize a public authority to96R. Cheng and K.R. Ab Ebook Ethical issues in anesthesiology and surgery: Part 2beyrequire the recipient lơ perform or assist in the performance of an abortion or sterilization. make its facilities available for an abortion, or prEbook Ethical issues in anesthesiology and surgery: Part 2
ovide personnel to perform or assist in the performance of an abortion or sterilization" [14-161- In 1996. the Public Health Service Act gave more speChapter 8Conscientious ObjectionRan Cheng and Kenneth R. AbbeyAbstract The phrase “conscientious objection" appears to have originated from the milita Ebook Ethical issues in anesthesiology and surgery: Part 2nancial assistance from discriminating against any health care entity on the basis that: the entity refuses to undergo training in the performance of induced abortions, to require or provide such training, to perform such abortions, or to provide referrals for such training or such abortions” [15. 1 Ebook Ethical issues in anesthesiology and surgery: Part 27J. More recently, the Affordable Care Act under Section 1303(b)(4) offers health care providers the right to conscientious objection by stating thatEbook Ethical issues in anesthesiology and surgery: Part 2
“No qualified health plan offered through an Exchange may discriminate against any individual health care provider or health care facility because ofGọi ngay
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