School of Health and Medical Sciences, Seton Hall University, Nutley, NJ, 07110, USA.
Department of Medical Sciences, Hackensack Meridian School of Medicine at Seton Hall University, Interprofessional Health Sciences Campus, 340 Kingsland Street, Nutley, NJ, 07110, USA.
HEC Forum. 2021 Sep;33(3):233-245. doi: 10.1007/s10730-020-09395-8.
In this paper, I consider the role of conscience in medical practice. If the conscientious practice of individual practitioners cannot be defended or is incoherent or unreasonable on its own merits, then there is little reason to support conscience protection and to argue about its place in the current medical landscape. If this is the case, conscience protection should be abandoned. To the contrary, I argue that conscience protection should not be abandoned. My argument takes the form of an analysis of an essential feature of the conscience dissenter's argument, the role of disagreement within "the medical profession." Conscience dissenters make certain assumptions within their arguments about the profession, disagreements within the professions, and how such disagreement should be adjudicated. If it is the case that these assumptions are accurate reflections of the current medical landscape, then the advocate of conscience protection has one less leg to stand on. I aim to show that this is not the case and that the assumptions of the conscience dissenter are not only mistaken but are mistakes of significant magnitude, so significant as to raise serious questions about the merit of their position. If the argument in this paper is sound, then, at the very least, the conversation over conscience protection in medicine, in particular, and health care, in general, must continue.
在本文中,我探讨了良心在医学实践中的作用。如果个体从业者的良心实践不能得到辩护,或者其本身是不连贯的或不合理的,那么就没有什么理由支持保护良心,并对其在当前医疗环境中的地位进行争论。如果是这样的话,就应该放弃对良心的保护。相反,我认为不应该放弃对良心的保护。我的论点采用了对良心异议者论点的一个基本特征进行分析的形式,即“医学界”内的分歧所扮演的角色。良心异议者在他们关于专业、专业内的分歧以及如何裁决这种分歧的论点中做出了某些假设。如果这些假设准确地反映了当前的医疗环境,那么良心保护的倡导者就少了一个依据。我的目的是表明事实并非如此,良心异议者的假设不仅是错误的,而且是非常严重的错误,以至于对其立场的价值提出了严重的质疑。如果本文的论点是正确的,那么,至少在医学,尤其是在一般的医疗保健领域,关于良心保护的对话必须继续。