Huddle Thomas S
Division of General Internal Medicine, UAB School of Medicine and the Birmingham VA Medical Center, University of Alabama at Birmingham, FOT 744, 1530 3rd avenue South, Birmingham, AL, 35294, USA.
Theor Med Bioeth. 2017 Dec;38(6):429-445. doi: 10.1007/s11017-017-9426-8.
The dispute over professional conscientious objection presumes a picture of medicine as a practice governed by rules. This rule-based conception of medical practice is identifiable with John Rawls's conception of social practices. This conception does not capture the character of medical practice as experienced by practitioners, for whom it is a sensibility or "form of life" rather than rules. Moreover, the sensibility of medical practice as experienced by physicians is at best neutral, and at worst hostile, to the demands of those who would override physician conscientious objection to the provision of currently contested services. That being so, calls for overriding physician conscientious objection are much more demanding of the medical profession than they appear in light of Rawls's view. As such overriding may entail the forcible transformation of medicine's form of life, the author contends that it would be more prudent to provide contested services by circumventing the medical profession than by compelling it.
关于专业良心拒斥的争论假定医学是一种受规则支配的实践。这种基于规则的医学实践概念与约翰·罗尔斯的社会实践概念是一致的。这种概念并没有抓住从业者所体验到的医学实践的特征，对他们来说，医学是一种感知或“生活方式”，而非规则。此外，医生所体验到的医学实践的感知，对于那些想要推翻医生对提供当前有争议服务的良心拒斥的人的要求，充其量是中立的，最坏的情况下是敌对的。既然如此，要求推翻医生的良心拒斥对医学专业的要求比从罗尔斯的观点来看显得更为苛刻。由于这种推翻可能需要强行改变医学的生活方式，作者认为，通过绕过医学专业来提供有争议的服务，比强制医学专业这样做更为审慎。
