ACOG and the Intolerance of Tolerance

The last three posts, all on the American College of Gynecologists and Obstetricians’ redefinition of conscience, have (I hope) been carefully reasoned arguments. The final post on ACOG’s ethics statement will be a little whinier. I’ll try to keep it short.

The problem I am addressing is not unique to ACOG. It is inherent in the modernist philosophy that ACOG espouses. Hypocrisy becomes natural when you don’t believe in objective truth. What’s true for you doesn’t have to be true for me. The ACOG statement on conscience has a number of points of contradiction.

1. ACOG states that a physician’s conscience must be grounded in science. This is a statement with which any Catholic can readily agree if science is not the only source of truth to which conscience can appeal. However, ACOG clearly shows a preference to artificial means of contraception. OBGYN doctors are notoriously scornful (and/or ignorant) of natural family planning despite the science that shows that modern methods of NPF are highly effective. Health care professionals in fact reveal their ignorance by stating that NFP is not highly effective because female cycles vary in length. They lump all NFP methods together under the oldest and least effective method. Where’s the appeal to science?

2. ACOG respects the conscience of the patient but fails to respect the conscience of the professional health care worker (who is in a better position to be knowledgeable). I covered the problem of poor medical practice in the previous blog entry. However, it is also hypocritical. ACOG goes through great lengths to define a “legitimate judgment of conscience” but then gives the greatest freedom of conscience to those less likely to be able to meet these requirements.

3. This hypocrisy extends even to a doctor’s ability to choose his own medical field! ACOG states that a doctor not willing to perform sterilization and abortion should not be allowed to practice in areas where such “services” are not readily available. To ACOG this is a matter of justice – you cannot deprive people in a certain geographical area access to these health care services. Following such a statement to its logical conclusion, every hospital or clinic should be offering every reproductive service – a conclusion that is just not realistic for many institutions.

4. ACOG calls the “moral value” of a fetus a contested issue then, without missing a beat, proclaims that the life of the mother has greater moral value than the life of a fetus. Moreover, they seem to indicate that the debate about the fetus’ moral value gives the fetus less moral value, since we can be sure of the moral value of the woman but not of her unborn child. I wonder if ACOG would have said the same thing about women when their equality to men was debated, or about African Americans when their equality to the white man was debated. One must assume they would not apply their principle to those cases. One must wonder at their applying such a flimsy principle at all.

5. ACOG claims that an undebatable principle is that a physician’s private beliefs must not unduly burden the most vulnerable of society. Interesting phrasing, that. I can’t imagine anyone more vulnerable in society than the unborn baby.

6. Wait a minute! Didn’t ACOG just base their entire argument (perhaps unawares) on the belief that there are really no objective principles, only subjective judgments of conscience (based on scientific evidence but not on any claim to objective moral law). They then proceed to lay down a set of moral “values” that every physician must accept – not the most logical ones like “do no harm,” but the modernist ideals of nondiscrimination. It is interesting to see them pick and choose their concepts of justice to fit their own philosophy. Isn’t the imposition of hand-picked moral principles the very definition of the kid of oppression they are trying to avoid?

We shouldn’t be too hard on ACOG. After all, when your underlying philosophy contradicts common sense and your starting point is so shaky, such contradictions are inevitable. Then again, who chose the underlying philosophy and the starting point? Maybe ACOG does deserve censure after all. Give it to them!