Freedom of conscience: how far should it go?In a controversy reminiscent of the Pharmacist's Conscience debate involving Hoosier pharmacist Karen Brauer, a Barrie, Ontario physician named Stephen Dawson has stirred up a significant controversy over his decision to refuse to prescribe birth control pills or Viagra to unmarried couples because he fears it would encourage extramarital sexual relations. Dawson and his supporters argue that he has a right to stand on his convictions under the Canadian Charter of Rights and Freedoms, while others argue that he is denying medical care and should be stripped of his license if he continues to refuse to prescribe contraception or Viagra.
Dawson argues that he would be contradicting Biblical teaching were he to prescribe contraceptives to unmarried couples, and would be promoting sex outside of marriage, which his Christian faith prohibits. He cites Ezekiel 3:18-21 as the passage that convicted him of this practice.
When considering this moral dilemma, it is important to consider what a doctor's most important obligations are. A doctor must intervene to save or prolong the patient's life or to relieve the patient's suffering while he or she is alive. A doctor must provide medically necessary services for the life or health of the patient. But does prescribing birth control or Viagra to unmarried couples meet the definition of "necessary medical services"?
A reasonable answer to that question is "no". Sex is not necessary to save one's life or protect one's health. The fact that Dawson's unmarried patients cannot get birth control from him will not endanger their life or physical health.
Other birth control methods are also available. Over-the-counter products, when used properly, can approach the effectiveness of the pill. In addition, an unmarried couple that Dawson refuses to serve can seek out another doctor to prescribe other forms of contraception. Furthermore, a couple can choose the one 100% effective method to prevent pregnancy, abstinence, until they are married at which point Dawson would prescribe these medications.
Dawson's religious liberty must also be considered. The Canadian Charter of Rights and Freedoms states that everyone has "freedom of conscience and religion", which Dawson is exercising in this case. Given the availability of other birth control methods, or of marriage itself, to couples Dawson refuses to serve, there is no reason to infringe on his freedoms under the Charter by punishing him for taking a stand on his faith.
Some of Dawson's critics have compared his situation to other scenarios to question whether his freedom of conscience gives him the right to refuse to prescribe birth control to unmarried couples. Dr. James Robert Brown, a professor in at the University of Toronto, asked in the Barrie Examiner if it would be appropriate if a doctor said "I'm uncomfortable with (treating) a minority." But refusing to enable a behavior (sexual intercourse outside of marriage) that one has a faith-based objection to hardly comparable to refusing to treat someone on the basis of his or her skin pigmentation.
In addition, refusing to treat someone due to racism may result in a life-threatening situation, or a situation where the patient's health might be adversely affected. Dawson has not refused to provide medically necessary care to anyone engaging in premarital sex, he has only refused to prescribe birth control. And while Brown may say that Dawson and others "have no right letting your private beliefs effect your public behaviour" (sic), the religious freedom clause of the Charter suggests otherwise.
But Brown goes a lot farther than simple saying that Dawson should be required to write a prescription for contraception. The Examiner also reports he believes doctors should be required to perform abortions. Beyond the shocking nature of Brown's pro-abortion extremism, his radical views also show why it is important to protect medical professionals' freedom of conscience lest a precedent be established that they be forced to engage in acts much more horrifying than enabling premarital sex.
Dr. Stephen Dawson has no right to force his views on unmarried sexual intercourse on his patients. Neither Canada nor the United States is a place where any specific code of personal morality can be enforced through the law. But Dawson's own religious freedom should also be respected.
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