Conscientious Objection in Medicine: Making it Public

HEC Forum. 2021 Sep;33(3):269-289. doi: 10.1007/s10730-020-09401-z.

Abstract

The literature on conscientious objection in medicine presents two key problems that remain unresolved: (a) Which conscientious objections in medicine are justified, if it is not feasible for individual medical practitioners to conclusively demonstrate the genuineness or reasonableness of their objections ("the justification problem")? (b) How does one respect both medical practitioners' claims of conscience and patients' interests, without leaving practitioners complicit in perceived or actual wrongdoing ("the complicity problem")? My aim in this paper is to offer a new framework for conscientious objections in medicine, which, by bringing medical professionals' conscientious objection into the public realm, solves the justification and complicity problems. In particular, I will argue that: (a) an "Uber Conscientious Objection in Medicine Committee" ("UCOM Committee")-which includes representatives from the medical community and from other professions, as well as from various religions and from the patient population-should assess various well-known conscientious objections in medicine in terms of public reason and decide which conscientious objections should be permitted, without hearing out individual conscientious objectors; (b) medical practitioners should advertise their (UCOM Committee preapproved) conscientious objections, ahead of time, in an online database that would be easily accessible to the public, without being required, in most cases, to refer patients to non-objecting practitioners.

Keywords: Complicity; Conscientious objection; Constructivism; Genuineness; Public reason; Reasonableness.

MeSH terms

  • Conscience*
  • Dissent and Disputes
  • Ethics, Medical*
  • Health Personnel / ethics
  • Health Personnel / psychology
  • Humans
  • Religion and Medicine