Objection to Conscience: An Argument Against Conscience Exemptions in Healthcare

Giubilini, Alberto

doi:10.1111/bioe.12333

Cited by 33 publications

(43 citation statements)

References 4 publications

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“…Our position is not peculiar or uncommon À many others argue persuasively against the practice of CO not only in reproductive health care, but health care in general [2,3,4,5].…”

Section: Introductionmentioning

confidence: 83%

There is no defence for ‘Conscientious objection’ in reproductive health care

Fiala¹,

Arthur²

2017

European Journal of Obstetrics & Gynecology and Reproductiv

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A widespread assumption has taken hold in the field of medicine that we must allow health care professionals the right to refuse treatment under the guise of 'conscientious objection' (CO), in particular for women seeking abortions. At the same time, it is widely recognized that the refusal to treat creates harm and barriers for patients receiving reproductive health care. In response, many recommendations have been put forward as solutions to limit those harms. Further, some researchers make a distinction between true CO and 'obstructionist CO', based on the motivations or actions of various objectors. This paper argues that 'CO' in reproductive health care should not be considered a right, but an unethical refusal to treat. Supporters of CO have no real defence of their stance, other than the mistaken assumption that CO in reproductive health care is the same as CO in the military, when the two have nothing in common (for example, objecting doctors are rarely disciplined, while the patient pays the price). Refusals to treat are based on non-verifiable personal beliefs, usually religious beliefs, but introducing religion into medicine undermines best practices that depend on scientific evidence and medical ethics. CO therefore represents an abandonment of professional obligations to patients. Countries should strive to reduce the number of objectors in reproductive health care as much as possible until CO can feasibly be prohibited. Several Scandinavian countries already have a successful ban on CO.

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“…Our position is not peculiar or uncommon À many others argue persuasively against the practice of CO not only in reproductive health care, but health care in general [2,3,4,5].…”

Section: Introductionmentioning

confidence: 83%

There is no defence for ‘Conscientious objection’ in reproductive health care

Fiala¹,

Arthur²

2017

European Journal of Obstetrics & Gynecology and Reproductiv

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“…Conscientious objection in healthcare is the refusal by healthcare personnel to perform or take part in certain professional activities because they conflict with their own personal moral or religious beliefs (see, e.g., Savulescu 2006 ; Card 2007 ; Sulmasy 2008 ; Brock 2008 ; Wicclair 2011 ; Savulescu and Schuklenk 2016; Giubilini 2017 ). Of course, sometimes it is difficult to disentangle clinical judgements from value judgements based on personal beliefs.…”

Section: Interests Conflicts and Conflicts Of Interestmentioning

confidence: 99%

Beyond Money: Conscientious Objection in Medicine as a Conflict of Interests

Giubilini

Savulescu

2020

Bioethical Inquiry

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Conflict of interests (COIs) in medicine are typically taken to be financial in nature: it is often assumed that a COI occurs when a healthcare practitioner’s financial interest conflicts with patients’ interests, public health interests, or professional obligations more generally. Even when non-financial COIs are acknowledged, ethical concerns are almost exclusively reserved for financial COIs. However, the notion of “interests” cannot be reduced to its financial component. Individuals in general, and medical professionals in particular, have different types of interests, many of which are non-financial in nature but can still conflict with professional obligations. The debate about healthcare delivery has largely overlooked this broader notion of interests. Here, we will focus on health practitioners’ moral or religious values as particular types of personal interests involved in healthcare delivery that can generate COIs and on conscientious objection in healthcare as the expression of a particular type of COI. We argue that, in the healthcare context, the COIs generated by interests of conscience can be as ethically problematic, and therefore should be treated in the same way, as financial COIs.

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“…Fiala and Arthur state that ‘if the treatment is legal, within the HCP’s qualifications, requested by a mentally healthy patient, and primarily beneficial (which abortion is), there is simply no excuse to refuse’ 2. Giubilini believes patients should receive ‘the legal and beneficial medical treatment they request or that is in their best interest’ 6. Savulescu similarly refers to ‘medical interventions that are legal, beneficial, desired by the patient’ 5…”

Section: Is Abortion Beneficial?mentioning

confidence: 99%

“…One concern is that personal beliefs can vary widely between individuals. Giubilini describes the character of conscience as formal , not substantive: an ‘empty box that can be filled with various substantial moral views’ 6. This, he believes, implies the content of conscience cannot be used to defend CO—because of moral diversity, this would entail treating all COs equally.…”

Section: Personal Beliefs and Valuesmentioning

confidence: 99%

“…As we have seen, one approach is to appeal to beneficence and non-maleficence as legitimate grounds for objecting rather than individual beliefs. Giubilini similarly believes doctors can object when they ‘are asked to perform activities which conflict with the values and principles of medicine’ 6. The difficulty here is that these values and principles are so broad as to be of little value in demarcating whether a certain treatment should be objected to.…”

Section: Values and Principles Of Medicinementioning

confidence: 99%

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Questionable benefits and unavoidable personal beliefs: defending conscientious objection for abortion

Blackshaw

Cooper

2019

J Med Ethics

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Conscientious objection in healthcare has come under heavy criticism on two grounds recently, particularly regarding abortion provision. First, critics claim conscientious objection involves a refusal to provide a legal and beneficial procedure requested by a patient, denying them access to healthcare. Second, they argue the exercise of conscientious objection is based on unverifiable personal beliefs. These characteristics, it is claimed, disqualify conscientious objection in healthcare. Here, we defend conscientious objection in the context of abortion provision. We show that abortion has a dubitable claim to be medically beneficial, is rarely clinically indicated, and that conscientious objections should be accepted in these circumstances. We also show that reliance on personal beliefs is difficult to avoid if any form of objection is to be permitted, even if it is based on criteria such as the principles and values of the profession or the scope of professional practice.

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Objection to Conscience: An Argument Against Conscience Exemptions in Healthcare

Cited by 33 publications

References 4 publications

There is no defence for ‘Conscientious objection’ in reproductive health care

There is no defence for ‘Conscientious objection’ in reproductive health care

Beyond Money: Conscientious Objection in Medicine as a Conflict of Interests

Questionable benefits and unavoidable personal beliefs: defending conscientious objection for abortion

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