School of Medicine, Australian National University, Canberra, Australian Capital Territory, Australia
Institute of Ethics, Dublin City University, Dublin, Ireland.
J Med Ethics. 2023 Mar;49(3):189-195. doi: 10.1136/medethics-2021-107740. Epub 2022 Mar 8.
Some contributions to the current literature on conscience objection in healthcare posit the notion that the requirement to refer patients to a non-objecting provider is a morally questionable undertaking in need of explanation. The issue is that providing a referral renders those who conscientiously object to being involved in a particular intervention complicit in its provision. This essay seeks to engage with such claims and argues that referrals can be construed in terms of what Harman calls morally permissible moral mistakes. I go on to suggest that one might frame the (in)actions of those who exercise the right of non-participation generated by the claim to conscientiously object in similar terms; they can also be considered morally permissible moral mistakes. Finally, and given that the arguments already advanced involve simultaneously looking at the same issue from competing ethical perspectives, I offer some brief remarks that support viewing conscientious objection as an ethicopolitical device.
一些关于医疗保健中良心反对的当前文献认为,将患者转介给无反对意见的提供者的要求是需要解释的有道德问题的行为。问题在于,提供转介会使那些出于良心反对参与特定干预措施的人在提供该干预措施方面成为同谋。本文试图探讨这些主张,并认为可以根据哈曼所谓的道德上可允许的道德错误来解释转介。我接着建议,可以用同样的术语来构建那些行使因声称出于良心反对而产生的不参与权的人的(不)行为;它们也可以被视为道德上可允许的道德错误。最后,鉴于已经提出的论点同时从相互竞争的伦理角度来看待同一个问题,我提供了一些简短的评论,支持将出于良心的反对视为一种伦理政治手段。