Conscience and Medical Practice John L. Rice, M.D. November 7, 2015

Conscience A judgment of the rightness or wrongness of an action An act of the intellect, not a feeling

Conscience Conscience is not free on its own to determine good and evil. Only God can do this.

Conscience There is an objective moral order. Truth exists apart from my perception of it. Ultimately Truth is a person. “I am the Way and the Truth and the Life” (John 14:6)

Conscience Conscience is not a passive judgment. It is an imperative, applying to a particular situation the fundamental principle to “do good and avoid evil.” When one’s conscience is certain of the good, one is obliged to choose it.

Conscience Guilt, the recognition of having done wrong, opens the door to seeking forgiveness and making amends. Without recognizing our guilt, there is no conversion.

Conscience Conscience must be properly formed. An improperly formed conscience can make erroneous judgments.

Conscience Erroneous conscience Vincible vs. invincible ignorance Act is still objectively wrong although the person may not bear full burden of guilt

Formation of Conscience Natural law Scripture Church teaching (Magisterium) Prayer Sacraments Virtues

Interior Life The more open we are to the life of grace, the more we will see as God sees. The more our work participates in the healing ministry of Christ, the more we will come to resemble Christ Himself.

The Dictatorship of Relativism The right to act freely and in accord with conscience is threatened. We live in a world which has taken for itself the power to determine right and wrong. Those who act differently are punished.

Cooperation Formal cooperation shares in the intent never permitted Material cooperation provides assistance for an immoral act without sharing in the intent May be permitted for proportionate reasons

Threats Freedom of conscience is threatened by: Legal requirements Economic coercion Patient requests

Contraception The contraceptive mandate of the Affordable Care Act is one example of a law which abridges freedom of conscience. Contraception was chosen because it was seen as the “Achilles heel” of the Catholic Church. Sexual union mirrors the creative and self-giving action of the Trinity. Contraception changes the meaning of sexual union in a fundamental way and has been consistently condemned by the teaching Church.

Contraception Economic coercion Reimbursement is increasingly based on meeting certain “quality measures.” Contraceptive utilization is among the quality measures proposed for some government health systems While the measures may initially trigger incentives, eventually there will be penalties for failure to meet a standard.

Contraception Patient requests Perhaps more difficult because the request is personal and in the context of an established relationship. Focus not on what you can’t do, but on what you are able to do for the patient. Recognize the unstated request. Always be charitable.

Conscience Patient requests (cont.) Many have not heard the Church teaching on contraception expressed in a positive, life-affirming way. The moral evil of contraception applies to all, even of other religions. Church teaching can be explained in terms of natural law. We owe our patients the truth. We place our own souls in jeopardy by cooperating with evil.

Summary As Catholic healthcare professionals: We must form our consciences correctly, making use of all the means God has provided through His Church. We must have integrity in our personal and professional lives. We are called to bring truth to our patients and to society, always with charity.