Conscience, Mind Manipulation, and the 4th “R”

Response to the Globe and Mail’s Dec. 11 editorial: "Ontario MDs should not refuse contraception out of religious belief"

By Jean Maloney

I found something quite outstanding about this editorial.

While it is clear the editorialist does not support physicians’ freedom to practice medicine according to conscience, what especially stands out for me is the lack of any cogent argument in defense of that position.

Let me say right off, I will not attempt in this article to defend freedom of conscience (although I do support it.) Rather, I will explain how the G&M’s attempt to justify its position against freedom of conscience is flawed. It behooves all of us to assess with a critical mind arguments put forward to justify a particular position on any controversial issue and not be misled by what might sound reasonable, but in fact, is either untrue or unsubstantiated.

To start with, there is an underlying false premise in the opening line: “A physician who is predisposed by faith or belief to make negative moral judgments about a patient is a bad doctor.” However, one needs to read the second paragraph before being able to put that opening line into context and thereby recognize the false premise. In the second paragraph we read: “The need for a new policy became clear when an Ottawa woman was turned away from a walk-in clinic last February after she attempted to get a refill on her birth-control medication – a rejection letter from one of the clinic’s doctors cited his ethical and religious objections.”

The G&M editorialist is in essence saying that the Ottawa doctor’s refusal to prescribe the birth-control pill to the woman amounts to that doctor making a “negative moral judgment about a patient.”

And that is false.

Although it is possible the woman may have felt that a negative moral judgment was being made about her, in fact, the physician was making a moral judgment not about her but about himself. He believed, for reasons having to do with medical judgment, professional ethics, and religious belief, that it would be wrong for him to prescribe the birth control pill, and thus to do so would make him culpable in an immoral act.

No one can get into the mind and heart of another person, and so no one is capable of judging the moral culpability of someone else, even if one might believe the action itself to be immoral. It would be up to the woman who wanted the pill to do her own conscientious reflection and morally judge herself. No one else can do it for her.

The G&M goes on to say “We turn to physicians to resolve our most intimate problems with wisdom and compassion and fairness, not to be rejected because we don't fit a sacred model.” But physicians who allow their moral/ethical code to inform their practice believe they are treating patients with “wisdom and compassion and fairness.” So it is clear that the G&M editorialist is using the words “wisdom” “compassion” and “fairness” to mean something entirely different than what conscientious physicians would mean by those terms. Yet without explaining what is meant by those three terms and showing how the physicians fall short of embodying the three qualities those terms express, the statement means nothing. And so it cannot advance the G&M’s argument (i.e. it carries no weight in defending the G&M’s position that physicians should simply give a patient the treatment they request, regardless of any objections the physician might have to that treatment).

Likewise with this statement: “But the College has refused to come down harshly on doctors who let their religious views get in the way of their duty to provide care.” The G&M has given no evidence that “religious views get in the way of [the Ottawa physicians’] duty to provide care.” The Ottawa physicians believe that prescribing the birth control pill is not a helpful form of care (why that is so is beyond the scope of this article). These physicians provide Natural Family Planning (NFP). That is the form of care they believe best comports with good medicine and respect for the dignity of their patients. And no doubt the Ottawa physician would have provided that care if the woman had requested it. Yet the G&M has given nothing to back up its claim that prescribing the birth control pill is good medical care, or why the alternative that the physicians do provide – NFP – is unacceptable medical care, or how the physician’s religious views got in the way.

Two more unsubstantiated claims that the editorialist makes are that conscientious physicians “confuse a religious judgment with a medical decision” and “substitute personal belief for science.” First of all, what does the editorialist mean by “religious judgment” and how is choosing not to prescribe the birth control pill an example of it? The editorialist doesn’t say. How is choosing not to prescribe the birth control pill not a medical decision? The editorialist doesn’t say. And how is prescribing the pill scientific but not prescribing it is not? Again, the editorialist doesn’t say.

Claim after claim made by the G&M editorialist is either untrue or unsubstantiated. If there is an argument to be made for forcing physicians to prescribe the birth control pill, the G&M hasn’t made it.

We arrive finally at what is so disturbing about this G&M editorial. It is not always easy to spot the lack of logically coherent arguments in opinion pieces. The reader may fail to recognize that a claim has not been backed up with evidence and may confuse opinion with fact. In the absence of sound reasoning, the reader may be swayed simply by emotionally evocative words and themes, for example, “wisdom and compassion and fairness,” “religious judgment,” “sinner,” “rejection,” “duty to provide care,” “dignity,” “personal belief vs science,” and so on.

This is disturbing. One would hope newspaper editorialists would feel duty bound, by their own professional code of ethics, to give a thoughtful reasoned argument in defence of their position, especially when something as fundamental as freedom of conscience is at stake, and when there is the potential for a whole class of citizens to be excluded from the medical profession if the draft policy of the College of Physicians and Surgeons of Ontario is adopted.

Instead, the G&M editorialist has chosen to make misleading and unsubstantiated claims using language that can manipulate readers into bypassing their own logical thought processes.

The important lesson here for anyone who wants to protect their minds from being manipulated into accepting potentially dangerous ideas, is this: learn to think critically. Learn to spot logical fallacies / errors in reasoning. There are courses and books and articles, in print and online, on Critical Thinking /Argument /Logical Reasoning. Why such courses aren’t compulsory in school, is a mystery to me.

Along with the existing 3 “R’s” – Reading, wRiting and aRithmetic – we ought to add a 4^th “R” to the core curriculum in our schools: Reasoning.

Equipped with the basic tools of logic, we will be better able to withstand the attempts by others, especially those in positions of power, to confuse and mislead us.