Conscientious objection in healthcare, referral and the military analogy.

An analogy is sometimes drawn between the proper treatment of conscientious objectors in healthcare and in military contexts. In this paper, I consider an aspect of this analogy that has not, to my knowledge, been considered in debates about conscientious objection in healthcare. In the USA and elsewhere, tribunals have been tasked with the responsibility of recommending particular forms of alternative service for conscientious objectors. Military conscripts who have a conscientious objection to active military service, and whose objections are deemed acceptable, are required either to serve the military in a non-combat role, or assigned some form of community service that does not contribute to the effectiveness of the military. I argue that consideration of the role that military tribunals have played in determining the appropriate form of alternative service for conscripts who are conscientious objectors can help us to understand how conscientious objectors in healthcare ought to be treated. Additionally, I show that it helps us to address the vexed issue of whether or not conscientious objectors who refuse to provide a service requested by a patient should be required to refer that patient to another healthcare professional.

Clarke S 《-》

Conscientious objection in healthcare: why tribunals might be the answer.

A recent focus of the debate on conscientious objection in healthcare is the question of whether practitioners should have to justify their refusal to perform certain functions. A recent article by Cowley addresses a practical aspect of this controversy, namely the question of whether doctors claiming conscientious objector status in relation to abortion should be required, like their counterparts claiming exemption from military conscription, to defend their claim before a tribunal. Cowley argues against the use of tribunals in the medical case, on the grounds that there are likely to be fewer unjustified claims to conscientious objection in this context than in the military, and that in any case tribunals will not be an effective way of distinguishing genuine and false cases. I reject these arguments and propose a different conception of the role of a medical conscientious objection tribunal.

Hughes JA 《-》

Conscientious objection and healthcare in the UK: why tribunals are not the answer.

A recent issue of the journal Bioethics discussed whether conscientious objectors within the healthcare context should be required to give their reasons to a specially convened tribunal, who would have the power to reject the objection. This is modeled on the context of military conscription. Advocates for such a tribunal offer two different justifications, one based on determining the genuineness of the applicant's beliefs, the other based on determining their reasonableness. I limit my discussion to a doctor's objection to abortion in the UK, and argue against both justifications: I thereby defend the status quo, where such doctors are not formally required to defend their beliefs. My argument has to do with the particular nature of the abortion debate in the UK, and the more general nature of ethical disagreement.

Cowley C 《-》

Against the accommodation of subjective healthcare provider beliefs in medicine: counteracting supporters of conscientious objector accommodation arguments.

We respond in this paper to various counter arguments advanced against our stance on conscientious objection accommodation. Contra Maclure and Dumont, we show that it is impossible to develop reliable tests for conscientious objectors' claims with regard to the reasonableness of the ideological basis of their convictions, and, indeed, with regard to whether they actually hold they views they claim to hold. We demonstrate furthermore that, within the Canadian legal context, the refusal to accommodate conscientious objectors would not constitute undue hardship for such objectors. We reject concerns that refusing to accommodate conscientious objectors would limit the equality of opportunity for budding professionals holding particular ideological positions. We also clarify various misrepresentations of our views by respondents Symons, Glick and Jotkowitz, and Lyus.

Smalling R ，Schuklenk U 《-》

The paradox of conscientious objection and the anemic concept of 'conscience': downplaying the role of moral integrity in health care.

Giubilini A 《-》