Brock Dan W
Department of Social Medicine, Harvard Medical School, 651 Huntington Avenue, FXB Building, Rm 643, Boston, MA, 02115, USA.
Theor Med Bioeth. 2008;29(3):187-200. doi: 10.1007/s11017-008-9076-y.
Some medical services have long generated deep moral controversy within the medical profession as well as in broader society and have led to conscientious refusals by some physicians to provide those services to their patients. More recently, pharmacists in a number of states have refused on grounds of conscience to fill legal prescriptions for their customers. This paper assesses these controversies. First, I offer a brief account of the basis and limits of the claim to be free to act on one's conscience. Second, I sketch an account of the basis of the medical and pharmacy professions' responsibilities and the process by which they are specified and change over time. Third, I then set out and defend what I call the "conventional compromise" as a reasonable accommodation to conflicts between these professions' responsibilities and the moral integrity of their individual members. Finally, I take up and reject the complicity objection to the conventional compromise. Put together, this provides my answer to the question posed in the title of my paper: "Conscientious refusal by physicians and pharmacists: who is obligated to do what, and why?".
一些医疗服务长期以来在医学界以及更广泛的社会中引发了深刻的道德争议，并导致一些医生出于良心拒绝为患者提供这些服务。最近，一些州的药剂师基于良心拒绝为顾客填写合法处方。本文对这些争议进行评估。首先，我简要阐述依据良心行事的自由主张的基础和局限。其次，我概述医疗和药学专业责任的基础以及这些责任被明确和随时间变化的过程。第三，我提出并捍卫我所谓的“传统妥协”，将其作为对这些专业责任与其个体成员道德完整性之间冲突的合理调和。最后，我探讨并驳斥对传统妥协的同谋指责。综合起来，这就是我对本文标题所提出问题的回答：“医生和药剂师的良心拒绝：谁有义务做什么，以及为什么？”
