Conscience, values, and justice in Savulescu

Alvan A. Ikoku

Virtual Mentor. 2013 Mar 1;15(3):208-12. doi: 10.1001/virtualmentor.2013.15.3.jdsc1-1303. PubMed PMID: 23472810

Introduction

Savulescu’s 2006 article in the British Medical Journal takes up perennially unfinished work on the nature and place of conscience, carried out against the background of contested laws shaped by states and their institutions as well as peoples and their professions. His writing on conscientious objection essentially returns to and intervenes in an extended conversation made possible by continued shifts in relations between individual citizens and loci of authority; shifts that characterized the mid-to-late decades of the twentieth century, when debates about war, civil rights, reproduction, and capital punishment made objection a vital mode of participation and engendered fields of practice and scholarship organized around the mission to decentralize decision making. [Full Text]

Ethicist supports “positive” eugenics: likens current practice to Nazi policies

Julian Savulescu, an ethicist at the University of Oxford, argues that the current practice of using prenatal screening and abortion to eliminate embryos suspected of having disabilities or diseases is akin to Nazi eugenic policies, which were also directed at eliminating the ‘unfit.’  He supports the use of prenatal testing to identify and destroy embryos with disease or disabilities as long as it is understood that this implies nothing about the moral status of disabled people, but argues that people should also be able to select for desirable characteristics, like intelligence or sex.  His position is that “freedom of reproduction” can be restricted “for social purposes,” but only if the purposes are “uncontroversially good,” the restrictions are necessary, and that no less restrictive policies would be workable. [News Limited]

Conscientious objection in medicine

BMJ. 2006 February 4; 332(7536): 294–297. doi:  10.1136/bmj.332.7536.294

Julian Savulescu

Shakespeare wrote that “Conscience is but a word cowards use, devised at first to keep the strong in awe” (Richard III V.iv.1.7). Conscience, indeed, can be an excuse for vice or invoked to avoid doing one’s duty. When the duty is a true duty, conscientious objection is wrong and immoral. When there is a grave duty, it should be illegal. A doctors’ conscience has little place in the delivery of modern medical care. What should be provided to patients is defined by the law and consideration of the just distribution of finite medical resources, which requires a reasonable conception of the patient’s good and the patient’s informed desires (box). If people are not prepared to offer legally permitted, efficient, and beneficial care to a patient because it conflicts with their values, they should not be doctors. Doctors should not offer partial medical services or partially discharge their obligations to care for their patients. . .[Full Text]