Conscience rights aren't just there for pharmacists' sake, but for all of us

In an increasingly diverse society, conscience rights are more important than ever. But they constantly need to be defended. The most urgent example is the current proposals put forward by the General Pharmaceutical Council (GPhC).

If you are a pharmacist with ethical objections to abortion or contraception, the GPhC’s current professional standards allow you to inform the “relevant people or authorities” and refer patients to other providers. Naturally, such an expectation of referral poses its own, very real ethical problems. But under the proposed changes, pharmacists will not even be given these minimal conscience rights.

The GPhC now propose that pharmacists must “take responsibility for ensuring that person-centred care is not compromised because of personal values and beliefs”. The consultation makes it clear that this is a “significant change”, as it would entail that referral “might not be the right option” in certain cases. This means that a Catholic pharmacist may be expected to dispense a contraceptive pill they believe to be abortifacient, against their conscience.

We can stand up for conscience rights by writing to the GPhC, which is currently accepting submissions from the public regarding their proposal. This consultation ends on Tuesday 7 March. It is worth making a submission, and not just for the sake of pharmacists, but for the sake of the principle of conscience rights.

After all, this is certainly not an isolated development. In 2014, the Supreme Court set a legal precedent in a case concerning two Scottish midwives who objected to “delegating, supervising and/or supporting” staff participation in the abortion process on grounds of conscience. The Court chose to interpret the Abortion Act 1967 provision on conscientious objection narrowly, arguing that it only applied to direct, “hands-on” involvement in abortion, not to associated “ancillary administrative and managerial tasks”.

More recently, Julian Savulescu, an Oxford academic, co-authored a paper in the journal Bioethics calling for the right to conscientious objection to be removed and for candidates to be prevented from entering the medical profession if they admitted having a conscientious objection to any legal medical procedure.

All this exacerbates an increasing shift towards the perception of healthcare as passive service provision, where “the customer is always right”, rather than a field in which professional judgement and ethical practice are crucial, not least because healthcare professionals – like patients – are moral agents too.

The GPhC’s consultation document is no exception. It casts pharmacists’ religious beliefs and personal values as being in potential conflict with “person-centred care” and the patient’s “needs”, rather than as principled ways of thinking which can help a patient better identify their true needs. This seems at odds with current professional standards, which tell pharmacists to “be prepared to challenge the judgement of your colleagues and other professionals” on grounds of “safety or care”.

The point of conscientious objection rights in healthcare is not simply to safeguard each professional’s moral integrity, but also to ensure that the profession as a whole is able to serve a population with diverse ethical views. Many of these views, religious or not, are defensible in terms of natural reason alone.

Conscientious objection should thus not be taken as an obstacle to care, or as imposing one’s views on others, given that there remains much legitimate ethical debate – among patients and professionals alike – about some legal medical procedures. To remove conscientious objection rights is to attempt to win complex arguments by shutting them down.

If the GPhC’s proposals are accepted, they would lead society further towards a particular kind of legal positivism: that once something is legal, we should always provide it so long as we are materially able to. What, then, will we say of pharmacists’ conscience rights, if assisted suicide is one day legalised and all pharmacists are expected to dispense lethal drugs, perhaps even to minors, on grounds of “patient-centred care”?

Given that “patient-centred care” is a key pillar of this consultation, it is extremely important that all of us, as patients, respond to the consultation and make it known that pharmacists’ consciences are essential to true patient-centred care. For this reason, the Anscombe Bioethics Centre, where I work, has produced a briefing paper on the GPhC’s consultation, entitled “Supporting the Consciences of Pharmacists and the Inclusivity of the Profession”, to encourage others to make submissions. Let us make our voice heard and remind the GPhC that pharmacists’ conscience rights are, in fact, crucial to patient confidence in the health service.

Michael Wee is the Education Officer of the Anscombe Bioethics Centre, a Catholic academic institute based in Oxford. The Centre’s briefing paper includes details on how to access both the consultation itself as well as the Centre’s submission.