Conscience, compassion and calling: A personal reflection

In this piece, a Healthcare for Both Lives declaration signer reflects on twenty years of GP and SRH practice in Northern Ireland.

As I write, it is twenty years to the day since I graduated from a Scottish university after entering medicine as a postgraduate student from Northern Ireland. For me medicine is a vocation – one shaped by faith, conscience, and a commitment to serve every person who seeks care. I completed GP training thirteen years ago, and alongside this I have worked as a sexual reproductive health (SRH) doctor in my local healthcare trust for almost 10yrs.

Working as an SRH doctor, I do not participate directly with the provision of abortion services out of deeply held moral and religious convictions. But I do see women following an abortion for their ongoing contraceptive needs and follow up. As a GP, I regularly care for women who have miscarried, are considering an abortion, or need after-care following an abortion. I also provide advice on fertility, HRT, and other aspects of women’s health such as contraception, including provision of a long-acting contraceptive service to protect women against unplanned pregnancies. I do not offer copper IUDs as a form of emergency contraception, again due to personal beliefs. These aspects of practice are not contradictory; rather they have taught me that personal conviction and compassionate patient care can coexist when guided by professionalism, humility and respect. Conscientious objection is sometimes misunderstood as a refusal to care. But in my experience, it is not a rejection of patient centred care. Rather it is a recognition that healthcare professionals are moral agents as well as clinicians. We bring our knowledge, skills, and humanity into every consultation. We do not leave our deepest convictions at the door, just as our patients don’t leave theirs behind when they seek our help.

Medicine rightly demands that personal beliefs never become barriers to compassionate care. But respecting patient autonomy does not require abandoning personal integrity; it requires honesty, humility, and a commitment to the patient’s welfare. Every woman who comes to me deserves to be treated with dignity, kindness, and clinical excellence, regardless of the circumstances that brought her. Whether she is experiencing physical complications, emotional distress, uncertainty, or grief after an abortion, my responsibility is clear: to assess, treat, relieve suffering, and support her recovery. My duty is to respond without judgement and with compassion. A woman seeking help with physical complications after an abortion is not seeking a moral debate, she is seeking medical help. Another woman might be struggling with emotions she was not anticipating, and needs someone to listen without assumptions. In these moments, compassion is not diminished by conscientious objection. On the contrary, it is demonstrated through presence, careful listening, skilled treatment, and respect for her humanity.

Practising in Northern Ireland adds another dimension to these reflections. This is a place where Abortion has long been a subject of profound ethical, political, and religious debate. Indeed, abortion was only decriminalised in October 2019 with a legal framework for abortion services established in March 2020. This was passed by the UK parliament at Westminster and happened at a time when the Northern Ireland assembly was suspended. While many welcomed the change, many others opposed it and felt such a significant issue should have been decided upon by locally elected representatives. As an SRH clinician at that time, I decided to stay in my role, and navigate this new context according to my own moral compass. I have stayed there ever since, and remain both uncompromised personally and able to provide uncompromised care. Inevitably, healthcare professionals work alongside colleagues who hold differing ethical views and care for patients whose beliefs differ from their own. I believe this diversity should not be regarded as a weakness but as a strength. A mature healthcare system should be able to accommodate sincerely held moral convictions while ensuring that each patient receives equitable, high-quality care. Professional integrity is not only about following clinical guidelines. It is also about practising honestly, acknowledging the moral dimensions of medicine, and acting consistently with one’s conscience. Equally, professionalism requires that these personal convictions never become an excuse for disrespect, discrimination or neglect.

Ultimately, my identity as a doctor is defined neither solely by the procedures I perform, nor by those I conscientiously decline. It is defined by the care I provide, the trust I seek to earn, and the compassion I strive to show. I hope that every woman I meet, whatever her story, leaves feeling heard, respected and well cared for. If I can achieve that while remaining faithful to my moral and religious convictions, then I believe I am honouring both my patients and the vocation to which I have been called. Medicine asks much of those who practise it. It demands clinical competence, emotional resilience, ethical reflection, and profound compassion. It also requires faithfulness to conscience. These commitments are not competing loyalties but complementary ones, and together they shape a way of practising medicine that seeks both integrity and mercy. Remaining true to my moral and religious convictions while never losing sight of the person before me is not a contradiction, but a calling and one I will never take for granted and endeavour to do to the best of my ability for the remainder of my career.