A Bioethical Exploration of Conscience Clauses

The world is full of controversies, and Emily Sayegh loves to talk about them. A pre-med junior at Fordham College Rose Hill majoring in biology and minoring in bioethics, this future neonatologist has used her bioethics research to sharpen her argumentation skills when it comes to discussing controversial topics such as abortion and euthanasia.

Last fall, Emily assisted Dr. Bryan Pilkington of the bioethics department with his research regarding conscience clauses. “Conscience clauses,” according to Emily,  “are legislations that allow physicians to determine procedures and treatments they are comfortable administering to patients.” They look to protect the physician’s autonomy and the patient’s interests. The aim of their research was to uncover and understand the controversy surrounding these clauses from a bioethical perspective. Specifically, they examined at what point it is no longer about protecting a physicians right to decide how to treat a patient and becomes more about patient discrimination.

Throughout the process, Emily was charged with compiling the research for the academic paper. She gathered publications from databases and peer reviewed journals that provided the substantive base of examples for the argument. For example, some of the research Emily found dealt with OB GYNs and their autonomy over deciding to perform an abortion or not. This example, among others, explores whether or not these clauses that are meant to help physicians could simultaneously be harmful to their patients’ wellbeing. She also collected information regarding alternative measures physicians could take to allow them to follow their personal ethics while also providing patients care. For example, in the case with an OB GYN refusing to perform an abortion, Emily examined research that questioned if it would be ethical for them to provide a referral to a physician who would be willing to perform the procedure.

This type of work allowed Emily to explore a different side of research than what she was used to. For example, she previously conducted clinical research with an organization in Mahopac, New York that examined the availability for preventative care for females in impoverished areas. During that time, the research included more patient interaction and statistical analysis. Researching with Dr. Pilkington was more theoretical- concerned with constructing arguments rather than finding the answer to a problem through numbers.

This initial research about conscience clauses with the bioethics department has provided Emily with the foundational skills to conduct a similar type of research project on her own. She hopes to begin researching the impacts of concierge medical practices in impoverished neighborhoods. She plans to explore the ethical implications for physicians who have full autonomy over their practices and charge high fees that the populations surrounding them are unable to afford. She wants to know the effects it has these populations as they are forced into larger, inefficient but affordable healthcare networks.

Emily hopes to present this research at the Undergraduate Research Symposium this April. But in the meantime, she is happy that she received the opportunity to conduct bioethics research as an undergrad. Asked if she would recommend doing undergraduate research, she responded emphatically, “Absolutely.”

Not only has this type of research allowed her to strengthen her academic skills, it has provided her with the opportunity to strengthen her desire to help patients. “Doing this and being involved in the bioethics department has given me more of a love for medicine and a desire to become a physician.” She notes that people have different experiences and emotions and these are equally as important as the science behind medicine when it comes to treating patients. “I see bioethics as taking the more intimate side of medicine, not just formulas, equations and biological pathways. It’s seeing patients as actual people with human rights and applying [that fact] to ethical issues.”

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