conscientious objection

The subtitle of the revised and updated version of my book criticizing utilitarian bioethics, Culture of Death, is, “The Age of ‘Do Harm’ Medicine.” Helping patients kill themselves by self-starvation and dehydration — known in euthanasia parlance as VSED (for voluntary stopping eating and drinking) — certainly fits that designation.

Two major medical associations now have endorsed doctors assisting in such suicides by palliating the painful symptoms to help patients go all the way to death. The first was the American Academy of Hospice and Palliative Medicine (AAHPM) in 2023. This is especially notable because the organization shamefully went “neutral” on the legalization of assisted suicide, despite that action being the antithesis of the hospice philosophy enunciated by the great medical humanitarian Dame Cecily Saunders. The AAHPM’s journal also published a piece recently endorsing intentionally undernourishing dementia patients under certain conditions (MCF, or “minimal comfort feeding”) — VSED in slow motion, if you will.

Now, another “do harm” shoe has dropped. The British Medical Association has issued an ethical guidance that requires practitioners to participate in VSED when asked to do so by a patient. While the AAHPM guidance assumes that the act will only be done by terminally ill or seriously ill or disabled patients, the BMA guidance notably acknowledges that even those not in ill health can kill themselves in this slow manner — and that doctors must further the suicide palliatively. From the guidance (my emphasis):

Legalizing euthanasia/assisted suicide, abortion, and transgender interventions for dysphoric children is only the beginning of the ongoing destruction of Hippocratic moral values in medicine. Once such interventions are legal, activists next insist that they become readily available. But many (and I hope most) doctors want nothing to do with causing death or interfering with the normal functioning of healthy bodies. Indeed, many assisted suicide, abortion, and gender ideologues complain that too few doctors willingly participate in these procedures, as is sometimes protected by the law. These “medical conscience” rights inhibit the increasing hegemony of utilitarian medical values in health care. As a result, once life-taking or mutilating procedures become legal, efforts soon begin to conscript unwilling medical professionals into performing Read More ›