School of Humanities and Social Science, Charles Sturt University, Wagga Wagga, New South Wales, Australia
Uehiro Centre for Practical Ethics, Wellcome Centre for Ethics and Humanities and Faculty of Philosophy, University of Oxford, Oxford, UK.
J Med Ethics. 2019 Oct;45(10):679-680. doi: 10.1136/medethics-2019-105748. Epub 2019 Aug 31.
Inspired by Smith, Ben-Moshe suggests that we should only accommodate conscientious objections (COs) in medicine based on moral beliefs that are true, or which closely approximate to the truth. He suggests that we can identify moral truths by consulting our consciences when our consciences adopt the standpoint of an impartial spectator. He also suggests some (surprisingly modest) changes to our current practices in regard to the management of CO in medicine that would be needed were his proposal to be adopted. Here, I argue that both Smith and Ben-Moshe underestimate the difficulties involved in adopting the standpoint of an impartial spectator. In particular, both authors fail to recognise the extent to which cognitive bias and ideological commitments prevent many of us from identifying the standpoint of an impartial spectator and also prevent us from realising that we are failing to be impartial. I also consider some different changes to current practices that would be needed if we were to take on Ben-Moshe's approach to CO in medicine while also recognising the difficulties involved in adopting the standpoint of an impartial spectator.
受史密斯的启发，本-摩西建议，我们应该只根据真实的或接近真实的道德信念来包容医学中的出于良心的拒绝（CO）。他建议，当我们的良心采取公正旁观者的立场时，我们可以通过咨询自己的良心来确定道德真理。他还对我们目前在管理医学中的 CO 方面的做法提出了一些（出人意料的适度）改变，如果他的建议被采纳的话。在这里，我认为史密斯和本-摩西都低估了采取公正旁观者立场所涉及的困难。特别是，两位作者都没有认识到认知偏见和意识形态承诺在多大程度上阻止我们中的许多人确定公正旁观者的立场，也没有认识到我们未能保持公正。我还考虑了如果我们接受本-摩西在医学中的 CO 的方法，同时也认识到采取公正旁观者立场所涉及的困难，那么我们目前的做法需要进行哪些不同的改变。
