Friday, March 19, 2004

Conscience in Relation to “Health”

The folks who manage that superb website of the Protection of Conscience Project, www.consciencelaws.org, sent out a note earlier this week about a student at the medical school at the University of Manitoba. Apparently this medical student has been threatened with loss of graduation if, because of his stated religious reasons, he will not offer abortion as an option to a patient. In terms of the legal requirement, the issue is whether or not a physician is required to refer a patient for an abortion.

The answer is “no.”

A certain Dr. Brian Magwood, Associate Dean at the Faculty of Medicine states that “policy” requires that students tell patients about all treatment options which fall within “the medical standard of care.”

I don’t know who is advising the University of Manitoba medical school on the relevant law and medical ethics in this situation but they had better think again about the extremely thin ice upon which they are currently standing. The Canadian Medical Association, a body whose policies ought to have something to do with a determination of what is “the medical standard of care”, in its own Code of Conduct does not require, that qualified physicians refer patients for an abortion should that be something the patient seeks. They are right to make this distinction and the U of M is wrong to ignore it. Perhaps there is a misunderstanding on this point between the student and the University. If so, I hope that the few paragraphs that follow will provide some assistance to both parties.

Unless something is missing in the press reports to date, it appears as if, in this case, a student is in a conflict between his own conscience and religious beliefs (protected in the Charter of Rights by the way) and what might be the wishes of some future patient to have “a full-range of medical care” or, in this case, an abortion.

As with a fully-fledged physician, when such a conflict arises, and these will increasingly arise as technology raises more difficult moral questions, the answer to sorting out the conflict is not to apply a broad requirement that “all services” be provided or referred.

There are mid-points that introduce a necessary flexibility to professional duties. Nothing in medicine, its Codes of Conduct or medical ethics gives a “trump right” to a patient seeking a particular medical service that involves vexed ethical questions.

That is the way it ought to be in philosophy and in a free and democratic society.

Patients cannot demand all services from physicians (or for that matter pharmacists, nurses or anyone else in the health care sector). What is necessary is that both sides are clear about what they seek and what they refuse to provide. On the other hand, a physician must not hide his/her refusal to refer behind silence or euphemism or deceit. He or she must clearly state the grounds of the refusal so that the patient can “go elsewhere.”

There is a worrying movement afoot to try and make health care workers into the mere instruments of a patients’ will subordinating the physician’s conscience to the demands of the patient. This movement must be resisted. When there is a conflict of consciences - - or a conflict of dignities as it is ultimately best understood, we must have recourse to some other kind of principles than a “zero-sum” winner or loser scenario.

Without getting into the controversial question of how pregnancy could ever be a disease (and therefore a question of “health” at all) it is clear that no proper protection of conscience could force a person who believes abortion is murder to refer a person to another murderer. Sorry that this is put rather bluntly but that is how those who are opposed to abortion see things. That is the reality of why the Canadian Medical Association itself does not have a blanket “duty of referral” in the way that the University of Manitoba appears to be approaching the issue.

The conscientious objection, whatever ones’ view of abortion or whatever the controversial practice is, relates to the end point of the thing being sought and being part of the chain to the end point is the same, morally, as being the end point (i.e. the abortionist). This ought not to be too complicated for the administrators such as Dr. Magwood at the U of M to understand. If it is, they should call someone reliable in their philosophy department or, here’s a radical idea, the Canadian Medical Association or, perhaps, the World Medical Association, who also agree with the CMA that there is no blanket requirement to provide or refer for “all treatment options.”
The station that first carried this story has the following question on an on line poll (left sidebar) at http://www.cjob.com/: should a medical student be allowed to graduate, even though he won't offer abortion as an option?

The answer is that he or she, in a free and democratic society, can only be required to tell a patient the following: “I am conscientiously opposed to abortion and will neither perform one nor refer you to another physician who will. If that is what you seek you must go elsewhere.” End of story.

Time for the University of Manitoba to change its (politically motivated) position or start saving up the hefty damages that will likely (and should) follow if it persists in its current course of action. I hope someone lets the student know that he is on much thicker ice than the administration if the issue is properly focused….

CENTREBLOG Volume 21
Iain T. Benson©

Tuesday, March 09, 2004

Mel Gibson's "Passion"

Last week in London England (where the film has not yet been released), I attended a private screening of Mel Gibson's "The Passion of Christ". It was interesting to see the film having read so many reviews about it. The film is bloody, it is not anti-Semitic unless one uses a definition of that word that amounts to racism in reverse.

We all know by now that the film is about the last hours of Jesus' life leading from the Garden of Gethsemane to the Crucifixion and (briefly) the Resurrection. A large part of the action relates to the violent capture and scourging of Jesus, his carrying the cross up the Via Dolorosa and his Crucifixion on Golgotha outside the walls of Jerusalem. It could not be about this, be realistic and not be violent and bloody.

The film is also rather beautiful in places. Flashback scenes are exquisitely done. Most notable here are those with Mary and the boy Jesus and Mary Magdalene when she is forgiven as "the woman taken in adultery". Here Gibson gets high marks for artistic exploration and inspiration. But is the film "anti-Semitic"?

Those who say it is anti-Semitic have been watching the film with selective lenses on. Such lenses appear to suggest that nothing negative may be said about any particular Jewish person or group without that indicating a generalized anti-Semitism. No human being or group is beyond criticism and any viewpoint that suggests this is, in fact, just racism in reverse.

There are, and always will be individual Jews that are flawed as there are and always will be flawed Gentiles, Romans, Christians and people of every race and belief. Failure to acknowledge this frankly is inaccurate and dangerous. In this film the violence against Jesus is largely done by the Roman soldiers and not the Jews in any case but I do not hear Italians jumping up and down complaining about how their ancestors were portrayed.

Only if one finds the whole idea of the Gospel itself - - of a man becoming the scape-goat once and for all -- anti-Semitic is the film anti-Semitic. Clearly, if one has this view then any portrayal of the story of Jesus would be viewed as anti-Semitism. Such a definition of anti-Semitism would, as a matter of fact, hide a religious claim (Judaism is superior to Christianity) beneath a claim of race-hatred.

In relation to this portrayal, however, the charge is blatantly unfair. The film shows that there are Jews who do not go along with the trial, the sentence or the actual punishments as inflicted and who show sympathy to the tormented Christ along the way The portrayal of some Jewish religious leaders (others refuse to be involved) as involved in the crucifixion of Jesus cannot amount by itself to anti-Semitism unless Jewish leaders are not like all other leaders - - capable of corruption, lack of justice and cruelty.

It is also claimed that the portrayal of Jewish religious leaders in the film will lead to animosity against Jews themselves. This is also incorrect.

It is as if Germans were to begin complaining that they feared attacks on the basis of the numerous films about the acts of some Germans during World War II - - events much closer in time to us than the Crucifixion. Human beings have made scape-goats of each other from the beginning of time and there is no nationality under the sun that has avoided being the victims of oppression and then, at other times, the oppressors.

In fact, if one is concerned about attacks on Jewish people a much stronger case could be made, but it is not, that there could be more prospect of anti-Jewish violence from the nightly news with its often graphic scenes of Jewish military acts against Palestinians along the Gaza strip than from a film of this sort. Is it wise to show the damaged bodies of Palestinian youths in front of Israeli tanks? Isn't that likely to excite animosity against the Jews?

Do we hear Palestinians saying that showing the horrific results of terrorist attacks by Hamas against the Jews is anti-Palestinian and will lead to attacks on Palestinians? No we do not.

The story in this film is about much more than where and between what races (Jew, Roman and a few others) it took place.

This film, like the story on which it is based, claims that there is a purpose in the Jesus story. The violence is justified in the film only if it has a purpose. That is what is behind many of the criticisms: the critics do not believe in sin or its antidote or the story about this Divine and human scape-goat; for this reason the violence is seen as gratuitous and unnecessary. The biblical phrase "he was wounded for our transgressions..." becomes either "what transgressions" or "who, me?"

The central claim, around which the film revolves, is that human lives, and all human lives, can be changed. It is a claim that transcends time, place and the nationalities of those involved. That is why, ultimately, some will see it as meaningless violence without a purpose and others (as so many have done) as moving, life-changing and full of purpose and meaning.

Pointless or meaningful - - ultimately it is a question of whether one believes the story or not or whether one believes that such a "story" full of violence and love is important for human consideration. For on that belief so much else will depend. Did God make Himself into the final scape-goat to put an end to humans making other humans into scapegoats? One would think that it is a question worth considering and amidst the oceans of superficial nonsense on offer in movie theatres today Mel Gibson offers something profound for consideration - - whether or not we can ultimately accept it.

That is why this film, graphic for a graphic time, is so different from many others and why it and its themes will always be controversial. It is a film everyone should see and it is not anti-Semitic, it is anti-sin and considering that involves all of us, whether or not we are Jews.

CENTREBLOG Volume 20
Iain T. Benson©

Tuesday, March 02, 2004

Indoctrination or Education?

What is indoctrination? The Oxford English Dictionary (the really big one reduced to really small print) tells us that it means "to imbue with learning or to teach" and not one of the definitions given is negative. The more recent Oxford English Reference Dictionary (Second edition 2002) refers to the teaching element but adds "to teach systematically or for a long period to accept (especially partisan or tendentious) ideas uncritically". It is this second, more recent, negative sense that I wish to focus on for a minute.

No thinking person can be against education generally. For to be against education generally means that one has learned to be against it and that is self-contradictory. What we object to in education is when either the content or manner are inappropriate in some way. Inappropriate about what and inappropriate to whom? Ah, as Shakespeare had it in the mouth of Hamlet, "there's the rub".

Our common education in free societies has wrestled a kind of freedom by limiting itself. It has got the general confidence of the population by avoiding those areas that cannot command general respect or support. There are "hot button" issues from time to time but the school system manages, more or less, to deal with them and parents here and there who have lost confidence in the system use other options such as, home education or, if they can afford it, private schooling. Statistics show that increasing numbers of Canadians do both of these.

The most controversial things in education are those that matter most. So the personal beliefs of families about the meaning of life (which for most people are their "religious beliefs") we have decided to leave out of public education. Why did we do this?

Two reasons: because they matter very deeply to people and because there was no agreement about what should be taught or by whom. Thus at the very foundation of Canada in the 19th century, a major consideration in the provinces was how Catholics and Protestants would have their beliefs accommodated in public education. The Constitutional protection in some provinces reflects this to this day.

Now we have to rethink another set of beliefs that will tear public education apart and which are already doing so. Sexual practices and our views in relation to them. Make no mistake, the public school system has (rightly) left the religious beliefs and indoctrination (defined as teaching) to the families who are, as the Supreme Court of Canada has recognized, the primary educators of children, but it now needs to do so with respect to beliefs about appropriate and inappropriate sexual conduct. Why is this?

Well, simply because certain people believe sexual matters are sacred and personal and others believe they are public and political. The two views are completely irreconcilable (just as differing religious beliefs are irreconcilable).

The latter group, who have made "sexual orientation" an identity banner under which to march, wish to impose their conceptions of what is and is not appropriate sexual conduct publicly. Those who would prefer that public education stick with the three R's and that controversial sexual practices be left for the home are having their views trumped not accommodated. For some reason sexual indoctrination is seen as necessary (as education) in the schools but religious indoctrination is viewed as inappropriate. Why?

If the reason is "health" well, then, are we really giving children the full story about how healthy (psychologically, physically) certain sexual "lifestyles" are? No.

Those for whom the "new sexuality" (let us call it that) functions as a religion are zealous to be sure and they are, in their way, fundamentalist in their approach. They do not wish others to dissent. They wish to control. Increasingly they are doing so and the court decisions are helping them.

Canada, however, was founded upon the principles of accommodation and it will remain a free country only insofar as it develops a richer understanding of how the accommodation of differing beliefs is to operate in the public realm - - including public education.

The signs of the times are worrying indeed for they suggest that this lesson has been forgotten in Canada. When there are fundamentally differing beliefs that diversity allows to exist in Canada (and no one suggests that to hold for "traditional sexuality" is yet a banned category in Canada) then these must be allowed to share the public space.

The only way for that to happen is to drop certain matters out of public education entirely. It was once inconceivable that religion would not be taught in public education. It seems now equally inconceivable that "sex education" would be dropped from schools. Yet "sex -ed" is now about so much that is controversial and unaccepted by many that the programs themselves must be completely reconsidered in the light of the proper understanding of accommodation.

If the agenda of the "new sexual fundamentalists" is such that the win/loss nature of litigation is giving them a free rein (and reign) in the public schools, then we will have set the stage for a new round of wars about beliefs. That would be a very stupid thing to have done. The current phrase is correct; we "don't need to go there". Better to help the principals learn or relearn the principles and treat the "new sexuality" as what it really is -- a new sort of religion. It should be treated as such.

CENTREBLOG Volume 19
Iain T. Benson©