Professional and conscience-based refusals: the case of the psychiatrist’s harmful prescription

Morten Magelssen

Abstract

By way of a case story, two common presuppositions in the academic debate on conscientious objection in healthcare are challenged. First, the debate typically presupposes a sharp division between conscience-based refusals based on personal core moral beliefs and refusals based on professional (eg, medical) reasons. Only the former might involve the moral gravity to warrant accommodation. The case story challenges this division, and it is argued that just as much might sometimes be at stake morally in refusals based on professional reasons. The objector’s moral integrity might be equally threatened in objections based on professional reasons as in objections based on personal beliefs. Second, the literature on conscientious objection typically presupposes that conflicts of conscience pertain to well-circumscribed and typical situations which can be identified as controversial without attention to individualising features of the concrete situation. However, the case shows that conflicts of conscience can sometimes be more particular, born from concrete features of the actual situation, and difficult, if not impossible, to predict before they arise. Guidelines should be updated to address such ‘situation-based’ conscientious refusals explicitly.


Magelssen M. Professional and conscience-based refusals: the case of the psychiatrist’s harmful prescription.  Journal of Medical Ethics Published Online First: 24 April 2017. doi: 10.1136/medethics-2017-104162

Irish psychiatrists reject proposed part in assessment of women seeking abortion

About one third of Irish psychiatrists who treat adults have signed a statement rejecting a draft government proposal that psychiatrists should assess women seeking who are threatening suicide.  One of a group of psychiatrists involved in discussion with the Irish government told the Irish Independent that “there is no evidence that abortion is a treatment for suicidality in pregnancy and may in fact be harmful to women.”  113 of about 300 practitioners have signed a statement to that effect. [Irish Independent]