By Carolina S. Ruiz Austria

The word "Heresy"

was used by Irenaeus in Contra Haereses to discredit his opponents in the early Christian Church. It has no purely objective meaning without an authoritative system of dogma.

Friday, March 06, 2009

Doctors and Lawyers

I spoke before a group of health practitioners today. While many of them were nurses and midwives, many more were doctors of obstetrics and gynecology. The topic I was assigned was the reproductive health bill but since the main sponsor of the bill was also an invited speaker, I decided to talk about only one thing in the bill: "conscientious objection." But before I could even begin my short talk, there were medical updates from doctors practicing in the field. Two doctors lectured on medical assistance during labor and new-born screening. Instead of reading my notes or reviewing the bill, I decided to listen. In fact it was not hard not to listen since the lectures were very accessible and quite interesting. The two doctors knew they would be addressing health practitioners with different roles in the health care system and varying levels of health education and training. So since I did not come prepared with a written speech or lecture save for some notes I made last night about the ethical guidelines on conscientious objection, I took a moment to reflect about the similarities and differences between doctors and lawyers.

Number #1 Similarity: If we were to go by the popularity of soap operas and TV shows, people have always been fascinated with the lives of doctors and lawyers. Like everyone else doctors and lawyers have failed marriages, dysfunctional families, steamy affairs and although perhaps to a lesser degree, money problems. But people seem to think the lives of ordinary doctors and lawyers make great prime time TV fare. This may be partly because doctors and lawyers are powerful professionals and gatekeepers. Both often wield power over their patients and clients.

Perhaps another reason why doctors and lawyers or at least their professions seem to be regarded in high esteem, is because their professions relate to a lot of the things we value - justice, liberty, autonomy, and well-being. Certainly not all doctors and perhaps even fewer lawyers, are "good guys," and working to promote and protect those ideals. But in their professional and technical capacities, and in the context of the highest ideals reflected in each profession's codes of ethics, they can actually be a great source of good.

Number #1 Difference (and this I observed from having attended the forum). Doctors are more used to working in tandem with a set of others on a collegial basis. Arguably lawyers do have law partnerships and justices in appellate courts are a collegial body. However, in huge part, recognition in legal practice is usually more individualist and focused on the lone legal practitioner. This is even more apparent in litigation, which is primarily adversarial.

I did note, however, that in terms of engaging the abstract principles of the professions and applying them to concrete cases, the current state of medical ethics (esp. obstetrics and gynecology) are far more advanced than our sadly archaic legal canons of professional and judicial responsibility. (I am referring to FIGO guidelines for the most part) On one hand, this could very well be a consequence of the advances in medical technology. New technology always raises new medical and ethical issues. On the other hand, some of the issues like conscientious objection are not exactly new but rather it is the way they have been invoked in the context of health practice that has led to new ethical questions in the context of health care.

In legal parlance, "conscientious objection" traces its roots in dissent against war. In moral philosophy, invoking conscience is at the core of the freedom of thought. But while conscience has usually been invoked in particular relation to the exercise of the freedom of religious practice and religious beliefs, invoking conscience is by no means an exclusively religiously based notion. The notion of having a conscience is embedded in the notion of human beings having the faculty (or capacity) of rational thought (reason). Yet rather than debate about the specifics of rational thought (the seat of reason, judgement), I’d rather talk about the more mundane question of what enables rational thought and thereby facilitates the exercise of conscience. As embodied humans in an imperfect society, the very things that enable rational thought and agency often come at a price. (And no, I’m not talking about a Kindle 2 or even a an imac pro)

In rather plain and simple terms, basic needs facilitate and enable rational thought. We are bodies after all and while we do not live by bread alone, the basic stuff including some education (language and communication), goes a long, long way. On the other hand, having more than enough (food and education) does not necessarily induce brilliance either. Many of the most prolific thinkers and authors were paupers in their day. (Some even produced their best work in prison). The point is, one's capacity to will, deliberate or exercise conscience is contingent on a myriad of things, not the least of which is a material basis. In order to think and decide freely, however, information must also be available or accessible. And whether censorship takes place by virtue of totalitarian state policies or by self censorship induced by narrow biases (religiously based or otherwise), the absence of information hinders the formation of understanding. Incomplete information makes deliberation an impossibility.


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