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Reply to: Beyond Money: Conscientious Objection in Medicine as a Conflict of Interests

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Giubilini and Savulescu in their recent Journal of Bioethical Inquiry symposium article presented an account of conscientious objection that argues for its recognition as a non-financial conflict of interest. In this short commentary, I highlight some problems with their account. First, I discuss their solicitor analogy. Second, I discuss some problems surrounding their objectivity claim about standards of medical care. Next, I discuss some issues arising from consistently applying their approach. Finally, I highlight that conscientious objection should be viewed not as a conflict of interest but as something that society has an interest in preserving. I conclude by arguing that clinicians who have a conscientious objection can be treated in the same way as those who decide to subspecialize and do not need to give up work in their specialty. While Giubilini and Savulescu present an interesting argument about conscientious objection, theirs is not a compelling view. Indeed, the way we approach conscientious objection has more to teach us about conflicts of interest than the other way around.

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  1. That most cases of abortion do not involve medical interests was even highlighted in a publication of the British Pregnancy Advisory Service—an abortion provider (Furedi 2008).

  2. Similarly, the authors seem to mischaracterize the situation in Poland. When referencing Minerva (2017), they state “[i]n Poland, women have died due to their doctors refusing to perform an abortion that would have been life-saving,” but Minerva cites three court cases, in none of which the mother died as a consequence of an abortion refusal. In the only case in which the mother subsequently died (after a miscarriage), the mother was denied a colonoscopy for ulcerative colitis rather than being denied an abortion.


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The author thanks Mary Neal and Daniel Rodger for their comments on drafts of this manuscript.

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Correspondence to Michal Pruski.

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Pruski, M. Reply to: Beyond Money: Conscientious Objection in Medicine as a Conflict of Interests. Bioethical Inquiry 18, 177–180 (2021).

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