March 3, 2024

Do ‘conscientious providers’ matter more than ‘conscientious objectors’?

Dov Fox, an expert on health law and bioethics, has written a blistering attack on conscientious objection and a defence of “conscientious provision” in the Harvard Law Review. His basic contention is that “the conviction to take people in can be as noble as the reasons to turn them away”. He cites numerous doctors who feel that their conscience compels them to break the law to do abortions or to provide opioids for pain relief.

“Also, conscientious providers honor their patients’ wishes that conscientious refusers override,” he writes. “Shielding denials of care, while punishing its delivery without exception, isn’t just unprincipled. This radical asymmetry is pernicious too: it selectively burdens providers and drives patients underground.”

The American system, Fox argues, is loaded in favour of healthcare workers who have religious objections to providing services to which they object, like abortion, euthanasia, transgender medicine.

“America’s medical conscience regime is broken,” he writes. “Doctors or nurses who conscientiously deny care get shielded from being sued, fired, or prosecuted — even if they don’t tell patients what their options are. Yet there’s no solicitude for clinicians who have equally moral reasons to deliver services their hospital or state restricts.”