Doctors want to refuse legal health services ‘if it goes against their conscience’

A group of 14 Maltese medical associations says it wants the right to conscientious objection even if an intervention is deemed legal by the state

Fourteen medical associations are demanding the right to conscientious objection in an upcoming law that will regulate equality of provision of goods and services, and make it discriminatory for faith schools to refuse qualified teachers owing to their faith or other protected characteristics.

Now Malta’s doctors are demanding they be granted a veto on clinical situations, in which they say could force them to act against their ethical convictions, or be deemed liable if they exert their freedom of conscience.

“Medical practice requires a holistic understanding of the medical sciences, but also a sound knowledge of how to apply these in everyday life. As with all sciences, medical practice involves a degree of ethical judgement, such as making end-of-life decisions, deciding on the urgency of treatment provision or the optimal utilisation of limited resources for patient care. These circumstances require sound clinical and ethical judgement, based on the values of the medical profession, which include the value of life, justice, respect for others and equality,” the specialist associations said.

Malta’s main union of doctors, the MAM, was not part of the statement.

The doctors said they should be allowed to refuse to prescribe treatment or perform procedures that violate their ethical convictions, even if such interventions are deemed legal by the state, in “ethically-contentious scenarios.”

In a proposed clause they want included in the Equality Bill, the doctors propose that the Health Department be obliged to disseminate all relevant information on objector service providers to ensure the patient’s rapid and discrete access to a service “without putting them through the unnecessary time and expense of being transferred from one professional to another”.

They also want guidelines that ensure conscientious objection is restricted to specific circumstances and applied judiciously.

“Unfortunately, in the past few months, efforts at introducing conscientious objection in the Equality Bill have been rejected. The significant support by the medical profession for this clause, is also motivated by the implications of the supremacy clauses included in the Bill. These allow the bill to override other criminal and civil laws if a matter of legal contention arises. In practice, if conscientious objection is introduced in future laws, a healthcare worker could still be liable, since the Equality Bill would take legal precedence. It should be emphasised that this bill will impact not only doctors but all healthcare workers,” the doctors said.

“This is the first time that so many professional medical bodies have rallied together to push forward a common goal: it sends a clear message to the parliamentary committee that the Constitutional right of doctors to freedom of conscience should be safeguarded by being explicitly stated in this bill. The reluctance to introduce a conscientious objection clause so far runs the risk of introducing discrimination in a bill that specifically sought to eradicate it in the first place.”

The list of associations include the Association of Anaesthesiologists of Malta, the Association of Emergency Physicians of Malta, Association of Orthopaedic and Trauma Surgeons of Malta, Association of Physicians of Malta, Association of Private Family Doctors, Association of Surgeons of Malta, Geriatric Medicine Society of Malta, Malta Association of Ophthalmologists, Malta Association of Otorhinolaryngologists and Head and Neck Surgeons, Malta College of Obstetricians and Gynaecologists, Malta College of Pathologists, Maltese Association of Dermatology and Venereology, Maltese Association of Radiologists, and Nuclear Medicine Physicians Maltese Paediatric Association.