President Obama, in his commencement speach at the University if Notre Dame yesterday, said he supported a “sensible conscience clause” for medical professionals to refuse to perform abortions, and presumably other procedures, which they found to contradict their ethical and moral beliefs.  The exact terms of such a clause weren’t stated, but despite my normal belief that the convictions of the individual should guide their own actions rather than external considerations, I have to oppose this.

That is not to say that a doctor shouldn’t be able to hang up his shingle and define his practice in any way that suits him. If a surgeon opposes abortion and decides to open a practice specializing in ophthalmology, of course he shouldn’t be expected to perform abortions. But if that surgeon went to work in a clinic that provided abortions, and then refused to perform them while drawing his salary, then that doctor should suddenly, and without ceremony or honor, find himself unemployed.

In previous invocations of this concept it has been suggested that pharmacists should be able to refuse to fill prescriptions for drugs of which they disapprove, notably the “morning after pill” abortifacients. But what if a pharmacist was of the opinion, apparently held by many otherwise-sensible persons, that ADD is not really a disorder and that treating it with drugs is wrong? Should that pharmacist be able to refuse to fill prescriptions for Ritalin or Concerta or any of the other drugs that make life with ADD manageable? The answer is no.  Federal law requires most drugs to be dispensed by pharmacists, and as such they are, in effect, a public utility and must not be able to impose their own standards on who can or can’t make use of their services.

I can certainly see a case for professional standards being maintained by physicians.  To say “I do not believe in abortion after the first trimester and therefore decline to seek the training to perform procedures to handle later cases” seems completely reasonable.  But, If I Were King, it would most certainly not be acceptable for someone to take a position that required certain work and then to refuse to perform it.