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A consequentialist case for permitting conscientious objection in healthcare

Steve Clarke

2025Journal of Medical Ethics9 citationsDOIOpen Access PDF

Abstract

Prominent consequentialists who write about conscientious objection (CO) in healthcare, Julian Savulescu and Udo Schüklenk, both argue for the ‘incompatibility thesis’—the view that healthcare professionals ought never to be entitled to exercise a CO to absolve themselves of the responsibility to perform professional duties. I argue, contra Savulescu and Schüklenk, that consequentialists should advocate for a compromise position under which healthcare professionals are entitled to conscientiously object to providing some services under some circumstances. The compromise advocated differs dramatically from the most prominent compromise position in the academic literature on CO in healthcare, Brock’s ‘conventional compromise’. The conventional compromise relies on referral, and I show that this is a problematic tool for consequentialists to rely on. I argue that the best approach to managing CO, from a consequentialist point of view, is to set up a system of region-based registers of available healthcare professionals who lack COs to procedures for which COs are permitted. Patients and healthcare professionals in the given region would be able to access—and be encouraged to consult—the register for their region before receiving any form of healthcare for which COs are permitted, thereby eliminating the need for referral in most circumstances.

Topics & Concepts

CompromiseHealth careHealth professionalsSet (abstract data type)SociologyLawConscientious objectorPosition (finance)Healthcare systemPublic relationsReferralPolitical scienceBioethicsPoint (geometry)LegislatureMedicineLaw and economicsHealth care rationingPsychologyHealth servicesHealth policyComputer sciencePsychology of Moral and Emotional JudgmentEthics in medical practicePatient Dignity and Privacy
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