Medical Practice and Freedom of Conscience in “Hacksaw Ridge”

Brody-Hacksaw-Ridge
This post was originally published on my Facebook page on February 3rd, 2017. I’ve made a few edits, here and there, but the content is exactly the same.
Among the many struggles in bioethics, today, is the question of how to respond to medical professionals who will not carry out an action for reasons anchored in personal conviction, specifically in the context of controversial topics like assisted dying and abortion. Should doctors everywhere be required to carry out an abortion if the patient demands it, even if they have a religious or moral disagreement with the procedure? What if the doctor refuses? Should physicians everywhere be required to conduct or provide means of assisted death if the patient demands it? What if the physician refuses on a moral basis? Both are legal services, but how do we coordinate professionalism and religious liberty or freedom of conscience?

This is a complicated problem which leaves room for very few practical and appealing solutions. This problem understandably exists wherever euthanasia and abortion are legal. It also exists where they are banned–nurses and physicians performed abortions and assisted deaths while they were illegal here in Canada and abroad. The question stands regardless.
On this note, we saw the release of two extremely popular and highly successful films last year [2016]: Arrival and Hacksaw Ridge. The former is a sci-fi first-encounter-with-aliens story, oft-praised as being among the very best of its genre. The latter is a second world war biopic about the true story of Desmond Doss, a combat medic and conscientious objector to violence and killing during the second world war. These two films have been given massive amounts of praise and confident award predictions. The fact that Hollywood, and most of secular America, have embraced and enjoyed these movies near-unanimously might suggest not just acceptance of the directorial tact of Denis Villeneuve (Arrival) and Mel Gibson (Hacksaw Ridge), but also a curiosity towards some of the ideas conveyed by the stories.
Perhaps to the surprise of those reading, Arrival and Hacksaw Ridge both happen to possess pro-life themes. (If you haven’t seen Arrival, skip the next paragraph.)
Arrival was not so much explicitly political as it was a tranquil philosophical piece on language, determinism and human responsibility. The conclusions of the film, arguably, were that life, in and of itself, is good, including the parts which involve suffering. From this perspective, while we might have foresight on historical events to come, we might be compelled not to alter the future. Even a life destined for death and pain has value and deep meaning.
Hacksaw Ridge is a different story reaching into a different question. It’s about a man, Doss, who wants to serve his country at war but insists on never using a rifle. It is curious and honest, bloody and visceral, but the story is also fairly reserved and not excessively pushy in its ethics. Gibson’s project has for its primary conflict a debate which extends much more applicably to that tricky balance between professionalism and freedom of religion. As much as it upholds the sanctity of life and the preciousness of the human person, it also presents an inquiry into how severely the government should dictate professional practice when worldviews clash. This is the issue. What is the professional to do when their worldview disagrees fundamentally with the mandates of the law? How should the person respond when individual morality disagrees with a specific point of their job description or assignment? Should that person be removed from office?
The movie was challenging to me. I’m not a pacifist and I have certain disagreements with Doss’s worldview (as it is presented). But I do believe the film is right to some degree. The funny thing is that while Hollywood may buy into the heroism of Desmond Doss, in the real world, the Desmond Doss refusing to conduct abortions and assisted killings as a medical professional isn’t at all a hero. Not everyone who is “pro-choice” would agree, here, but the Desmond Doss at the clinic, conscientiously disagreeing on the basis of his fundamental worldview beliefs, is often a bigot, a coward and an arrogant religious fanatic who hasn’t earned his position. Desmond Doss doesn’t deserve his station. Pro-life nurses and physicians are refusing to carry out abortions and killings because their religion prohibits it and yet many people would suggest that if they are unwilling to execute the act, they should not hold their office.
This is entirely the plot of Hacksaw Ridge. Desmond Doss doesn’t agree with killing and war (as a pro-life nurse doesn’t agree with abortion or assisted death), yet he wishes to serve the US Military as a medic. He wants to heal people and preserve life. He gives scores of fallen warriors, lacking limbs, shots of Morphine, wraps them up in gauze, and carries them on his back to safety. This sounds like heroism but he had to face the antagonizing of his superiors for his unwillingness to carry a rifle. Doss perseveres, in the face of violent aggression and imprisonment, and persuades the world that he has earned a right to serve, though not along the same description of his peers. Hollywood calls this heroism (and a Mel Gibson comeback). Others might call this arrogance.
The ultimate suggestion of Hacksaw Ridge is that whenever the individual’s religious worldview disagrees with a facet of their job description, the first step at a solution should be to re-examine the post and in what capacity the person may fill that post. Doss could be said to have fought the war but in a different and entirely justified way. And so while the tension between the job and the worldview exists, he was able to fill an alternative role (or the same role but in a different direction). Similarly, if the same principle is applied to medical practice, if the nurse’s or physician’s religious worldview fundamentally contradicts a certain facet of their position, the solution should be, not to remove them from office entirely, but to provide an alternative direction. Let someone else carry the task of “shooting the rifle”. Let the one who agrees with it perform the abortion (for the sake of protecting an individual’s conscience). This doesn’t mean the objecting nurse or physician isn’t still committed to giving adequate healthcare per the Hippocratic Oath–Doss was still committed to serving his nation–it just means they disagree on what means are appropriate.
If we are to say that a nurse or physician, to hold their office, must be willing to conduct abortions and assisted deaths, in spite of a potential violation of their conscience, then the ultimate fear is that we will see something similar to the unification of church and state, except replacing ‘church’ with whatever constitutes the liberal, progressive, pro-choice worldview. While the potential objection, here, might be that we had the same thing going the other way when abortion and assisted dying were banned, the reality is that forcing medical practitioners to carry out abortions and euthanasia would contradict the very precepts of liberalism and the so-called tolerance of ideas. At least when abortion was illegal and assisted dying was banned, the law was consistent with a moral principle, devoted to moral absolutes, and protecting the rights of all. Since abortion is killing human life and killing is immoral, therefore, abortion should be illegal. But if we’re going to say that people should have the choice to do with themselves as they please so long as it doesn’t harm others, then what good does it do to restrict the professional rights of conscientious objectors when they fundamentally believe they are harming–no, killing–an individual (and society) by aborting or euthanizing another person?

Further reading–

Canada:

United States:

Photo retrieved from https://www.newyorker.com/culture/richard-brody/mel-gibsons-hacksaw-ridge-religious-pomp-laced-with-pornographic-violence

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