September 25, 2022

Academics continue to spar over conscientious objection

Some argue it’s about conscience; others say it’s about real issues.

Conscientious objection has been a subject of vigorous debate in medical ethics in recent years. Two major journals have published themed issues on the topic, and in 2016 a group of influential bioethicists published a consensus statement arguing for greater restrictions on conscientious objection in the UK and other Western liberal democracies.

Opponents of conscientious objection argue that doctors’ primary duties are to their patients and not to their own personal conscience, and that, where a conflict should occur between a clinicians values and that of their patients, the wishes of the patient should normally take priority.

There have even been calls for a military-style tribunal in which conscientious objectors would be required to explain, to the satisfaction of their peers, why they should be exempted from performing procedures that are otherwise deemed “safe, legal and effective medical treatment”.

Yet the academic clamour against conscience protections has not gone without dissent. Earlier this year philosopher David S. Oderberg of the University of Reading published a Declaration in Support of Conscientious Objection in Health Care, in which he argued that liberal democracies should allow health care professionals with sincere, deeply held conscientious objections “to exercise their professional judgment and to allow their consciences to inform that judgment”.

The declaration states:

[In] a liberal, democratic society the state may not play favourites by choosing one system of morality to trump all others no matter what objections of conscience are made against it. Conscientious objectors must not be silenced or marginalised merely because of their unwillingness to participate in activities to which they object.

Oderberg’s declaration has already received several hundred signatures from professionals working in healthcare and related disciplines.

This week, Oxford bioethicists Alberto Giubilini and Julian Savulescu published a lengthy response to professor Oderberg’s declaration, arguing that liberal appeals to tolerance are predicated on “moral relativism”, and that we should instead be engaging with substantive questions about the morality of particular medical procedures.

“We should stop focussing on the value of conscience and of freedom of conscience and shift our attention to substantial moral issues to determine what exactly should and should not fall within the proper scope of medicine (or indeed of any other profession)”.

Academics continue to spar over conscience objection
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