Rethinking Conscientious Objection in Health Care

Societies around the world are becoming increasingly multicultural, while the range of new or controversial medical procedures that are available to patients also grows. This has led to an increase in claims from health care professionals regarding their right to abide by their own moral or religious views and refuse a long list medical interventions or drugs. This list includes abortions, euthanasia, access to contraceptives, sterilizations, cosmetic surgery, and many others. Depending on circumstances, these interventions might or might not be consistent with professional standards; however, when deciding whether to provide them, many doctors would rely on their own conscientious views about the morality of each case instead of professional standards. As societies become more pluralistic and the range of medical options continues to grow, it is inevitable that the problem of conscientious objection in health care will as well.

Rethinking Conscientious Objection in Health Care presents the case against the right of health care professionals to refuse delivery of certain health care services based on their moral views. It provides philosophical analyses of conscience and freedom of conscience, as well as the arguments and principles typically utilized when arguing in favor of allowing health care professionals conscientious objection. The authors criticize those arguments and offer a philosophical and historical analysis of the concept of professionalism, as well as an appeal to the nature of professional obligations, to build their case against the right to conscientious objection in health care. They explain why arguments for pluralism, tolerance, and diversity which support a right to freedom of conscience in society at large do not necessarily support the same right within the health care profession, or indeed any profession that is governed by internal norms of professionalism which an individual freely decides to enter.

Alberto Giubilini is a Senior Research Fellow at the University of Oxford, based at the Uehiro Oxford Institute. He has published on different topics in bioethics, public health ethics, and philosophy and has worked extensively on the concept of conscience.

Udo Schuklenk is the Ontario Research Chair in Bioethics and Public Policy and Professor of Philosophy at Queen’s University at Kingston. He has worked extensively on end-of-life issues, conscientious objection in medicine, access to experimental drugs, as well as issues in public health ethics.

Francesca Minerva is Associate Professor in Moral Philosophy at the University of Milan. She previously worked at the University of Melbourne, University of Gent and University of Warwick. She wrote her PhD thesis on the topic of conscientious objection in medicine and published various articles on this topic.

Julian Savulescu is Chen Su Lan Centennial Professor in Medical Ethics and Director for the Centre for Biomedical Ethics at the Yong Loo Lin School of Medicine, National University of Singapore (NUS). He is an award-winning ethicist and moral philosopher trained in neuroscience, medicine, and philosophy. He has held the Uehiro Chair in Practical Ethics at the University of Oxford since 2002. He is Visiting Professorial Fellow in Biomedical Ethics at Murdoch Children’s Research institute and Distinguished International Visiting Professor in Law at the University of Melbourne where he leads the Biomedical Ethics Research Group.