Conscientious objection and doctors’ personal beliefs
September 2008
In March 2008, the General Medical Council issued new guidance, “Personal Beliefs and Medical Practice”. This aims to balance doctors’ rights not to act contrary to their beliefs and patients’ rights to access lawful procedures. The BMA worked with the GMC on the guidance and supports it.
The BMA has long defended doctors’ rights not to participate in certain morally sensitive procedures as long as colleagues who do not have a conscientious objection are available to carry out the procedure. In 1993, for example, the BMA adopted its current policy that doctors should not to be forced to act contrary to their conscience if patients make an advance refusal of life-prolonging treatment (living will). This does not mean that treatment can be given if a patient refuses it but rather that the doctor with a conscientious objection to withdrawing treatment should arrange for a colleague to take over the patient's care.
Under the Abortion Act 1967 in England, Scotland and Wales, doctors have a right to opt out of participating in abortion but are obliged to provide necessary treatment in emergencies. If a woman’s life or long-term health are at stake, even doctors who hold a conscientious objection to terminating a pregnancy are obliged to provide necessary care. In 1999 and 2003 the BMA’s policy-making body – the Annual Representative Meeting – discussed conscientious objection to abortion. It strongly endorsed the established legal right for doctors to object to participating in abortions. At its 2008 meeting, the BMA reiterated doctors’ moral and legal rights to opt out of abortions, embryo research, fertility treatment and the withdrawal of life-prolonging treatment.
In its book Medical Ethics Today, the BMA stresses that doctors who have a conscientious objection to abortion must not be marginalised professionally and that medical students also have recognized rights to opt out of witnessing abortions.
In line with the law, the BMA recognises that in emergencies, doctors’ personal beliefs may have to take second place to ensuring patient safety.