Jones-Nosacek Cynthia
Independent Researcher.
Linacre Q. 2022 Feb;89(1):36-46. doi: 10.1177/00243639211055970. Epub 2021 Dec 6.
Conscientious objection (CO) in medicine is where a healthcare professional (HCP) firmly opposes, with an expression of reasoned disapproval, a legally available procedure or treatment that is proscribed by one's conscience. While there remains controversy regarding whether conscientious objection should be a part of medicine, even among those who support CO state that if the HCP does not provide the requested service such as abortion, physician assisted suicide, etc., there is an obligation on the part of the objecting HCP to refer to someone who will provide it. However, referral makes the referring HCP complicit in the act the referrer believes to be immoral since the referrer has a duty to know that the HCP who will accept the patient is not only able to do the procedure but is competent in its performance as well. The referrer thus facilitates the process. Since one has a moral obligation to limit complicity with immoral actions when it cannot be avoided, the alternative is to allow the patient to transfer care to another when the patient has made the autonomous decision to reject the advice of the HCP.
医学中的良心拒斥（CO）是指医疗保健专业人员（HCP）以合理的反对意见坚决反对其良心所禁止的合法可用程序或治疗方法。尽管对于良心拒斥是否应成为医学的一部分仍存在争议，即使在支持良心拒斥的人当中也表示，如果医疗保健专业人员不提供诸如堕胎、医生协助自杀等所要求的服务，提出反对的医疗保健专业人员有义务将患者转介给愿意提供此类服务的人。然而，转介会使转介的医疗保健专业人员在其认为不道德的行为中成为同谋，因为转介者有责任了解接受患者的医疗保健专业人员不仅能够进行该程序，而且在操作上也具备能力。因此，转介者促进了这一过程。由于当无法避免与不道德行为的同谋关系时，人们有道义责任限制这种同谋关系，另一种选择是当患者自主决定拒绝医疗保健专业人员的建议时，允许患者将护理转至他人处。
