Testing conscientious objection by the norm of medicine

Toni C. Saad, Gregory Jackson


Clinical Ethics

Debate persists over the place of conscience in medicine. Some argue for the complete exclusion of conscientious objection, while others claim an absolute right of refusal. This paper proposes that claims of conscientious objection can and should be permitted if they concern kinds of actions which fall outside of the normative standard of medicine, which is the pursuit of health. Medical practice which meets this criterion we call medicine qua medicine. If conscientious refusal concerns something consonant with the health-restoring aims of medicine, it entails a desertion of professional duty. If, however, it relates to something other than medicine qua medicine, it can rightly be refused. It thus becomes possible to test instances of conscientious objection to determine their validity, and thereby conserve both the principle of conscientious objection and define its scope. This test of conscience prevents arbitrary discrimination, and preserves doctors’ agency. It is a theoretical razor rooted in the practical reasoning of medicine whose operation will prompt, if nothing else, reflection on the goals of medicine.

Saad TC, Jackson G. Testing conscientious objection by the norm of medicine. Clinical Ethics 2018 Mar; 13(1); 9-16.

Conscientious objection is an important medical principle

Doctors are expected to have integrity. Does this not entail that they should do what they think is right?

The Spectator

Toni Saad

Something interesting is happening in the House of Lords. Baroness O’Loan’s Conscientious Objection (Medical Activities) Bill, now at the committee stage, has put on the agenda an issue which well-deserves to be there. Its point is simple: all healthcare professionals should have a legal right to opt out of certain procedures which they find objectionable. It specifies three areas: abortion provision, withdrawal of life-saving treatment, and actions relating to certain reproductive technologies.

This is not particularly radical; the 1967 Abortion Act already explicitly protects conscientious objection. Indeed, it could even be asked why this should, in a country with a tradition of liberty like ours, even be up for debate. Do we really need law to protect the right to conscience?

Sadly, it has become clear that we do. Armchair philosophers have been discussing the merits of forcing doctors and nurses to act against their conscience (or lose their jobs) over the last few years. Many papers against conscience have been published. . . [Full Text]