Australia Catholic University, Melbourne, Australia.
J Med Philos. 2022 Nov 5;47(4):549-557. doi: 10.1093/jmp/jhac013.
The past decade has seen a burgeoning of scholarly interest in conscientious objection in health care. Specifically, several commentators have discussed the implications that conscientious objection has for the delivery of timely, efficient, and nondiscriminatory medical care. In this paper, I discuss the main argument put forward by the most prominent critics of conscientious objection-what I call the Professional Duty Argument or PDA. According to proponents of PDA, doctors should place patients' well-being and rights at the center of their professional practice. Doctors should be prepared to set their personal moral or religious beliefs aside where these beliefs conflict with what is legal and considered good medical practice by relevant professional associations. Conscientious objection, on this account, should be heavily restricted, if even allowed at all. I discuss two powerful objections against PDA. The first objection, which I call the fallibility objection, notes that law and professional codes of conduct are fallible guides for ethical conduct and that conscientious objection has in the past and continues today to provide a check on aberrations in law and professional convention. The second, which I call the professional discretion objection, states that restrictions on conscientious objection undermine one of the cornerstones of good medical practice, namely, a practitioner's right to independent professional judgment. I argue that these two objections give us reason to retain conscience clauses in professional codes of conduct.
过去十年中，学术界对医疗保健中的良心拒绝对健康护理的兴趣日益浓厚。具体来说，有几位评论家讨论了良心拒绝对及时、高效和无歧视医疗服务的影响。在本文中，我将讨论最著名的良心拒绝对手提出的主要论点——我称之为专业职责论点或 PDA。根据 PDA 的支持者的说法，医生应该将患者的福祉和权利置于专业实践的中心。医生应该准备好将自己的个人道德或宗教信仰放在一边，只要这些信仰与相关专业协会所规定的法律和良好医疗实践相冲突。在这种情况下，应该严格限制或甚至不允许良心拒绝对抗。我将讨论反对 PDA 的两个强有力的反对意见。第一个反对意见，我称之为易错性反对意见，指出法律和专业行为准则是道德行为的易错指南，而且良心拒绝对过去和现在都提供了对法律和专业惯例的偏差的检查。第二个，我称之为专业裁量权反对意见，指出对良心拒绝对健康护理的限制破坏了良好医疗实践的基石之一，即从业者独立专业判断的权利。我认为，这两个反对意见使我们有理由在专业行为准则中保留良心条款。
