Over the last few years there has been a vigorous and fascinating debate about the use of conscientious objection (CO) in healthcare. CO is when doctors (and other healthcare professionals) opt-out of providing a medical service because they have serious moral objections—abortion is a widely cited example.
If enough doctors object to abortions, there is a legitimate concern that some patients will have difficulty accessing them—for example in Italy 70% of obstetricians refuse to participate in abortions, even though this isn’t the intention of CO. Some ethicists have argued there is no place for CO at all in healthcare, in the strongest of terms.
Curiously, though—and this is what aroused our interest—these same ethicists usually recognise that there are still some instances when doctors should be permitted to object and withhold their services. But how can they allow some objections and not others? One way is by claiming these objections aren’t really cases of CO, which seems a bit arbitrary. A better approach is to propose sensible criteria for allowing certain objections and disallowing others, and this is where the CO debate is at the moment.
Part of this debate involves critiquing certain features of common COs such as abortion, and our recent paper in the Journal of Medical Ethics examines two major criticisms.