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

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Abstract

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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Notes

  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.

References

  • BBC News. 2014. Catholic midwives lose abortion case. December 17. http://www.bbc.co.uk/news/uk-scotland-glasgow-west-30514054. Accessed April 12, 2018.

  • ______. 2020. Anti-abortion nurses fail in European court case. March 13. https://www.bbc.com/news/world-europe-51874119. Accessed May 17, 2020.

  • Beauchamp, T.L., and J.F. Childress. 2013. Principles of biomedical ethics, 7th ed. New York: Oxford University Press.

    Google Scholar 

  • Furedi, A. 2008. Are there too many abortions? Abortion Review, Special Edition 2: 3–7.

  • Gamble, N.K., and M. Pruski. 2019 Medical acts and conscientious objection: What can a physician be compelled to do? The New Bioethics 25(3): 262–282.

    Article  Google Scholar 

  • Giubilini, A., and J. Savulescu. 2020. Beyond money: Conscientious objection in medicine as a conflict of interests. Journal of Bioethical Inquiry 17(2): 229–243.

    Article  Google Scholar 

  • Herring, J. 2014. Medical law and ethics, 5th ed. Oxford: Oxford University Press.

    Google Scholar 

  • MacIntyre, A. 2013. Whose justice? Which rationality? 2nd ed. London: Bloomsbury Academic.

    Google Scholar 

  • MacKenzie, D. 1976. Eugenics in Britain. Social Studies of Science 6(3-4): 499–532.

    Article  CAS  Google Scholar 

  • Minerva, F. 2017. Conscientious objection, complicity in wrongdoing, and a not-so-moderate approach. Cambridge Quarterly of Healthcare Ethics 26(1): 109–119.

    Article  Google Scholar 

  • Neal, M. 2019. Conscientious objection, “proper medical treatment”, and professionalism: The limits of accommodation for conscience in healthcare. In Religious beliefs and conscientious exemptions in a liberal state, edited by J. Adenitire, 135–156. Cambridge: Hart Publishing.

    Google Scholar 

  • Neal, M., and S. Fovargue. 2019. Is conscientious objection incompatible with healthcare professionalism? The New Bioethics 25(3): 221–235.

    Article  Google Scholar 

  • Neal, M., S. Fovargue, and S.W. Smith. 2019. Guest editorial. The New Bioethics 25(3): 203–206.

    Article  Google Scholar 

  • Oderberg, D.S. 2017. Should there be freedom of dissociation? Economic Affairs 37(2): 167–181.

    Article  Google Scholar 

  • Pruski, M. 2019a. Double effect and ectopic pregnancy—some problems. Catholic Medical Quarterly 69(2): 17–20.

    Google Scholar 

  • ______. 2019b. Professional objections and healthcare: More than a case of conscience. Ethics & Medicine 35(3): 149–160.

  • ______. 2020. Conscientious objection and systemic injustice. Clinical Ethics 15(3): 120–125.

  • Saad, T.C. 2019. Conscientious objection: Unmasking the impartial spectator. Journal of Medical Ethics 45(10): 677–678.

    Article  Google Scholar 

  • Tanner, J. 2012. Eugenics before 1945. Journal of Modern European History 10(4): 458–479.

    Article  Google Scholar 

  • Weinstock, D. 2014. Conscientious refusal and health professionals: Does religion make a difference? Bioethics 28(1): 8–15.

    Article  Google Scholar 

  • Wicclair, M.R. 2008. Is conscientious objection incompatible with a physician’s professional obligations? Theoretical Medicine and Bioethics 29(3): 171–185.

    Article  Google Scholar 

Download references

Acknowledgements

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). https://doi.org/10.1007/s11673-020-10082-z

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