University of Oxford, Oxford, United Kingdom.
J Med Philos. 2021 Jan 25;46(1):37-57. doi: 10.1093/jmp/jhaa029.
Robert Card's "Reasonability View" is a significant contribution to the debate over the place of conscientious objection in health care. In his view, conscientious objections can only be accommodated if the grounds for the objection meet a reasonability standard. I identify inconsistencies in Card's description of the reasonability standard and argue that each version he specifies is unsatisfactory. The criteria for reasonability that Card sets out most frequently have no clear underpinning principle and are too permissive of immoral objections. Card has also claimed that petitioners must justify their positions with Rawlsian public reason. I argue that, although the resulting reasonability standard is principled, it is overly restrictive. I also show that a reasonability standard built on Rawls' more lenient conception of reasonableness would be overly permissive of objections at odds with professional healthcare standards. Finally, I argue for my favored solution, which bases the reasonability standard on minimal professional standards.
罗伯特·卡德的“合理性观点”是对医疗保健中出于良心拒服兵役地位的辩论的重要贡献。在他看来，如果反对的理由符合合理性标准，出于良心的反对才可以得到容忍。我发现卡德对合理性标准的描述存在不一致之处，并认为他具体规定的每一个版本都令人不满意。卡德列出的最频繁的合理性标准没有明确的基础原则，并且对不道德的反对过于宽容。卡德还声称，请愿者必须用罗尔斯的公共理性为自己的立场辩护。我认为，尽管由此产生的合理性标准是有原则的，但它过于严格。我还表明，基于罗尔斯更宽松的合理性概念的合理性标准将过于宽容与专业医疗保健标准相悖的反对意见。最后，我主张采用我赞成的解决方案，该方案将合理性标准建立在最低专业标准之上。
