According to the ethics report, physicians objecting to abortion or contraception must refer patients desiring such services to other providers (recommendation # 4); may not argue or advocate their views on these matters though they are required to provide prior notice to their patients of their moral commitments (recommendation #3); and, in emergency cases or in situations that might negatively affect patient physical or mental health, they must actually provide contraception and/or perform abortions (recommendation #5, emphasis added).
In order to justify these recommendations, the committee appeals to an idiosyncratic conception of ethics and conscience. The ACOG guidelines implicitly view ethics as a matter of private emotion and sentiment, rather than as common rationality and shared practical wisdom. Against Kant’s unconditional command, Newman’s magisterial dictate, and Butler’s famous dictum (”were its might equal to its right, it would rule the world”), the ACOG committee makes conscience a mere prima facie guide. “Although respect for conscience is a value, it is only a prima facie value, which means it can and should be overridden in the interest of other moral obligations that outweigh it in a given circumstance.”
This peculiar account of conscience stands in no small tension with the view expressed by Antigone in Sophocles’ tragedy, Socrates in the Crito, and Aquinas in the Summa Theologiae. Traditionally, conscience is the supreme proximate norm for human action precisely because it represents the agent’s best ethical judgment all things considered.
In addition to the issues of conscience, though, I think this issue raises questions that confront directly what I said yesterday. If a society actually forces citizens in certain professions to perform morally reprehensible acts, then the development of an alternative subculture seems almost inevitable.
However, I think the two can stand together. It is true that as a society forces people of faith to the margins in certain areas, a kind of alternative culture in those areas will develop. I would certainly hope that if pro-life doctors were forced out of the mainstream that they would continue to practice under a different umbrella. And I would give them my patronage. But that does not absolve us of our duty to seek out and embrace the good and the true in the wider culture, wherever and whatever it is.