Conscientious objection? “We’ll call it a draw”, says one academic.

Conscientious objection has come under fire recently, and several leading bioethics journals have published articles criticising healthcare professionals who object to participation in controversial procedures.

The latest addition to the literature, an article published online first in the Journal of Medical Ethics this week, criticises “conscience absolutists” who suggest that even the most remote forms of cooperation in pregnancy termination constitute licit grounds for conscientious objection.  

In his article “Conscientious objection in healthcare and the duty to refer”,  Christopher Cowley, a bioethicist at University College Dublin argues in favour of current UK abortion regulations, which permit conscientious objection, though only under certain conditions. NHS guidelines allow clinicians to abstain from participation in terminations, but nevertheless requires them to provide “reliable information” to patients about abortion services they could use.

Against “conscience absolutists”, Cowley argues that objecting doctors, as representatives of the NHS system, have a duty provide “reliable information” to patients about abortion services. Importantly, he argues that mere provision of information does not constitute formal cooperation in the procedure.

“the provision of information is not a necessary or indispensable link in the chain of actions leading to the abortion, since, after receiving the information, the patient leaves the NHS space and becomes a free agent, ready to make her…own decisions.”

Cowley argues that abortion is a “contestable” ethical issue, in the way that something like the Rawandan geocide was not.

In light of the reasonable disagreement that we have over abortion, conscientious objectors must acknowledge the rights of healthcare professionals and indeed patients, to act in accord with their ethical beliefs about pregnancy terminations.

“…the [objecting] GP also has to find a way to embrace (not just tolerate) this pluralism if she is to cooperate fully with her non-objecting colleagues and managers, and if she is to treat her patients with her full concern despite their deep moral disagreement”.

While Cowley offers a criticism of conscience absolutists in this article, he has in the past criticised those who argue that doctors must refer patients to abortionists.

A halfway house in the conscientious objection debate
Xavier Symons
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abortion
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Xavier Symons

Xavier Symons is a bioethicist and scholar in residence at the Kennedy Institute for Ethics at Georgetown University.

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