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How to Allow Conscientious Objection in Medicine While Protecting Patient Rights

Abstract:
Abstract:

Paradigmatic cases of conscientious objection in medicine are those in which a physician refuses to provide a medical service or good because doing so would conflict with that physician’s personal moral or religious beliefs. Should such refusals be allowed in medicine? We argue that (1) many conscientious objections to providing certain services must be allowed because they fall within the range of freedom that physicians have to determine which services to offer in their practices; (2) at least some conscientious objections to serving particular groups of patients should be allowed because they are not invidiously discriminatory; and (3) even in cases of invidiously discriminatory conscientious objections, legally prohibiting individual physicians from refusing to serve patients on the basis of such objections is not always the best solution.

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Notes

1. Gonzalez DK, Trueblood KV. Physician’s duty to treat despite religious objection. The Journal of the American Academy of Psychiatry and Law 2010;38(1):132–5.

2. Wicclair MR. Conscientious Objection in Health Care: An Ethical Analysis. Cambridge: Cambridge University Press; 2011.

3. Savulescu J. Conscientious objection in medicine. British Medical Journal 2006;332, at 294.

4. See note 3, Savulescu 2006, at 295.

5. See note 3, Savulescu 2006, at 294.

6. See note 3, Savulescu 2006, at 294.

7. Horvath-Cosper DJ. Being a doctor who performs abortions means you always fear your life is in danger. The Washington Post, October 29, 2015; available at https://www.washingtonpost.com/posteverything/wp/2015/10/29/being-a-doctor-who-performs-abortions-means-you-always-fear-your-life-is-in-danger/ (last accessed 20 Apr 2016).

8. See note 2, Wicclair 2011, at 6.

9. American Medical Association. Code of Medical Ethics of the American Medical Association, 2014–2015 ed., 2014; available at http://www.ama-assn.org/ama/pub/physician-resources/medical-ethics/code-medical-ethics.page (last accessed 20 Apr 2016).

10. Strickland S. Conscientious objection in medical students: A questionnaire survey. Journal of Medical Ethics 2012;38(1):22–5.

11. Douglas T. Refusing to treat sexual dysfunction in sex offenders. Cambridge Quarterly of Health Care Ethics 2017;26(1).

12. See note 3, Savulescu 2006, at 296.

13. Magelssen M. When should conscientious objection be accepted? Journal of Medical Ethics 2012;38(1):1821.

We thank the organizers and participants of the Conscience and Conscientious Objection in Healthcare conference at Oxford Martin School for their many helpful questions and comments on an earlier version of this article. This article also benefited greatly from detailed written comments provided by Katrien Devolder and Angela Ballantyne. Walter Sinnott-Armstrong is grateful to the Oxford Martin School for support.

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Cambridge Quarterly of Healthcare Ethics
  • ISSN: 0963-1801
  • EISSN: 1469-2147
  • URL: /core/journals/cambridge-quarterly-of-healthcare-ethics
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