The goal of medicine: heal, never harm

On his radio show last week, Sean O’Rourke hosted two doctors with opposing views on abortion. The debate went right back to medical first principles; what is medicine for?

Dr. John Monaghan, a recently retired obstetrician who delivered more than 10,000 babies over his career, said that everyone in his position had to terminate pregnancies for strictly medical reasons, sometime in their work. This is permitted by the law. The 8th amendment is not an impediment to interventions aimed at saving the life of the mother, even if the inevitable and unintended consequence is the death of her child.

Dr Mark Murphy, a GP representing “Doctors for Choice”, supported the Government’s proposal to allow abortion with no restriction as to reason and claimed that there are hundreds of health care professionals who are willing to facilitate the new regime.

Dr Monaghan replied that “the first rule of medicine is primum non nocere”. (‘First, to do no harm’).

He said: “If a woman requests an abortion which is not medically indicated, then I don’t think the doctors are the people that should be undertaking that. It’s not health care.”

Dr Monaghan believes that doctors should do only what is medically indicated. Their role is not to satisfy a patient’s demands, particularly if there is another patient involved. Terminating a pregnancy, and therefore a life, for non-medical reasons is not medicine and doctors shouldn’t be involved at all.

The discussion moved to the issue of conscientious objection, and whether doctors who don’t agree with abortion should be obliged to refer the woman to a pro-choice practitioner, which is a form of indirect participation.

“What he [Dr Murphy] is talking about is not health care.” Dr Monaghan said, “this is a termination of pregnancy in a healthy woman and a healthy child. The difference between Dr Murphy and myself is that I am allowing rights to the unborn child, as we just found out the only thing that gives child rights is the constitutional amendment that we are talking about removing.  But I allow rights to the unborn child and Dr Murphy doesn’t.  …. To oblige a doctor to refer a perfectly healthy woman with a normal pregnancy, to another doctor, who would provide her with an abortion, to me is ethically repugnant.”

To this Dr Murphy replied, in effect, that these women are not healthy because they are “in crisis”.

This is a strange definition of health. Is stress really to be counted as an illness? Is performing an abortion an adequate and proportionate response to this? Is it necessary? Is it the only thing possible? It seems that at the core of the abortion debate different conceptions of medicine are opposing to each other.

What we see here is the definition of ‘health’ being stretched beyond breaking point in order to present abortion as a form of ‘healthcare’. But it is a form of ‘healthcare’ that cannot point to an actual diagnosable illness that can be cured in no way other than by abortion, and as such is not healthcare at all. Given that the ‘cure’ is the killing of another human being, it simply cannot be counted as medicine.