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Tuesday 3 October 2023 Dublin: 16°C
Haydn West/PA Archive/Press Association Images Mater Hospital, Dublin
Column Secular health policy must replace Catholic health policy
Society pays for its public health services through taxation, and the ethos of any public institution should reflect the secular, multi-denominational ethos of the citizenship it serves, writes Dr Mark Murphy.

THE NECESSITY TO separate church and state was seen with the interference of the Catholic Church during all phases of the Protection of Life During Pregnancy Bill.

The Catholic Church’s opinion on women’s reproductive health is a valid one, of course, and it is entitled to broadcast this stance publicly. However, its attempt to manipulate the political process, pressure TDs and subvert public opinion was highly anti-democratic.

No other democracy would accept the moral monopolisation by one religious order over the will of the people. The French term for secularism- laïcité – derived from ‘laity’, explicitly promotes the wishes of the non-clergy within a society, above that of the clergy. Only recently in Ireland, a member of the clergy attempted to undermine both Irish law the laity. Father Kevin Doran’s comments, pertaining to institutional objection (though the board of the Mater Misercordiae University Hospital have yet to formally comment), have highlighted the lack of secularisation within Irish society, and specifically healthcare.

Like the recent debate about patronage of our schools, we now need a debate on the patronage of our public voluntary healthcare facilities.

Individual conscientious objection

The ethical principles to which doctors adhere are governed by the Irish Medical Council’s (IMC) Guide to Professional Conduct and Ethics. As a GP, I may hold a personal, moral belief, but I can never allow this to influence a patient’s care. If a doctor’s religious belief prevents him/her from providing safe and accessible treatment for a patient, that doctor would be guilty of professional misconduct. The IMC is clear on the position of conscientious objection: “As a doctor, you must not allow your personal moral standards to influence your treatment of patients”.

For example, it is permissible for a GP not to prescribe the morning after pill to a woman on account of religious reasons, but the doctor must refer her expediently to an alternative GP in the locality, without compromising that patient’s care. The IMC state: “Conscientious objection does not absolve you from responsibility to a patient in emergency circumstances”. Conscientious objection can neither contravene the law of the land, nor be applied in an emergency situation when a woman’s life is in imminent threat.

Institutional objection

If we do not allow the moral position of an individual doctor to adversely affect a patient’s care, an institutional moral position, reflected by Catholic health policy, certainly cannot. A woman cannot be denied a life-saving, emergency treatment because of the religious belief held by a board-member of a publicly-funded hospital.

This was articulated by Dr Peter Boylan who asked anyone who might agree with Father Doran’s comments if they were “happy to stand by and watch a woman die and be denied life-saving treatment because it goes against their personal beliefs which are not shared by the doctors looking after the woman or by the woman herself or by her family?”

Society pays for its public health services through taxation and the ethos of any institution should reflect the secular, multi-denominational ethos of the society to which it serves. I am a pro-choice doctor. I believe all women should be able to choose to access safe and legal abortion services within the state. Like religious belief, I fully accept the opinion of anyone who disagrees with women being able to access abortion services. But that is not what this Bill is about. When a woman’s life is in danger, her life should be saved- institutional objection is simply medical malpractice.

Catholic health policy

There are examples of Catholic institutions providing good health and social care in the state. Yet there are many failures. Aside for the secular argument, it is these failures of Catholic health policy that render the Church unqualified to influence training, teaching, ethics, appointments and clinical governance.

Catholic health policy has not proved a model for compassionate or equitable care in Ireland, or indeed anywhere in the world. It has proved particularly caustic to the health of Irish women. This is symbolised most acutely by the 1983 ‘pro-life’ 8th Amendment, which has led to cases like Savita Halappanavar and X. It has caused umpteen crisis pregnancies as a result of their failure to promote hormonal contraception as a means of family planning, ironically increasing abortion rates.

Catholic social policy has been responsible for the Magdalene laundries and the promulgation of institutional childhood sexual abuse. Catholic social policy was responsible for abusive marriages staying together. It has promoted massive psychological trauma for LGBT adolescents, as they have been afraid to come out in hostile Catholic school environments. Worldwide, it has helped the spread of sexually transmitted diseases due to the stigma around barrier contraception.

Ireland does not need Catholicism influencing its health policies – we need secular, democratic processes based upon medical advice.

Religious influences is still present in our hospitals

Religious influence on healthcare is still present, only in 1997 a vasectomy clinic in Letterkenny General Hospital was picketed by pro-life campaigners. As Tom Inglis stated; “the ownership and control of hospitals and the representation of Catholic religious on the boards of public hospitals has meant the Church has been able to exert considerable influence on the way medicine is practised”.

Half of our public ‘voluntary hospitals’ are owned and governed by religious orders. I have worked in two of these, the Mater and St Vincent’s University Hospitals, which claim to have a ‘religious ethos’. I remember a cancer patient in one of these hospitals being refused a clinical-trial drug, as she would have to commence hormonal contraception. That is not an ethos I wish to be associated with.

Secular health policy must replace Catholic health policy. Minister Reilly should follow Minister Quinn’s admirable efforts in the education sphere, and address the patronage of Irish hospitals, so their ethos reflects the society to which they serve.

This article has been amended to remove an erroneous statement that the Pro-Life Campaign took part in a picket at LetterKenny Hospital in 1997. The Pro-Life Campaign is a non-denominational organisation .

Dr Mark Murphy is a GP living in Sligo. He is a member of Doctors for Choice.

Doctor’s right to object to abortions is “not absolute” – Department of Health>

Concern over whether hospital will comply with abortion legislation>

Column: My son was cremated alone, in a different country, because he had a fatal foetal abnormality>

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