This article argues that practitioners have a professional ethical obligation to dispense emergency contraception, even given conscientious objection to this treatment. This recent controversy affects all medical professionals, including physicians as well as pharmacists. This article begins by analyzing the option of referring the patient to another willing provider. Objecting professionals may conscientiously refuse because they consider emergency contraception to be equivalent to abortion or because they believe contraception itself is immoral. This article critically evaluates these reasons and concludes (...) that they do not successfully support conscientious objection in this context. Contrary to the views of other thinkers, it is not possible to easily strike a respectful balance between the interests of objecting providers and patients in this case. As medical professionals, providers have an ethical duty to inform women of this option and provide emergency contraception when this treatment is requested. (shrink)

In jurisdictions where voluntary assisted dying is legal, eligibility assessments, prescription and administration of a VAD substance are commonly performed by senior doctors. Junior doctors’ involvement is limited to a range of more peripheral aspects of patient care relating to VAD. In the Australian state of Victoria, where VAD has been legal since June 2019, all health professionals have a right under the legislation to conscientiously object to involvement in the VAD process, including provision of information about VAD. While this (...) protection appears categorical and straightforward, conscientious objection to VAD-related care is ethically complex for junior doctors for reasons that are specific to this group of clinicians. For junior doctors wishing to exercise a conscientious objection to VAD, their dependence on their senior colleagues for career progression creates unique risks and burdens. In a context where senior colleagues are supportive of VAD, the junior doctor’s subordinate position in the medical hierarchy exposes them to potential significant harms: compromising their moral integrity by participating, or compromising their career progression by objecting. In jurisdictions intending to provide all health professionals with meaningful conscientious objection protection in relation to VAD, strong specific support for junior doctors is needed through local institutional policies and culture. There are no data in this work. (shrink)

The purpose of this paper is to show that conscientious objection to military service is essentially not a dilemma of freedom of conscience versus the duty to obey the law, but above all a dilemma between two conflicting patriotic moral obligations. Furthermore, the paper demonstrates that CO is justifiable on the basis of what is known as moderate patriotism, that is, out of a patriotism which is committed simultaneously to universal and particular values. The paper begins with a critical (...) discussion of theoretical weaknesses in liberal thought of CO. Then, the concept of moderate patriotism is presented, followed by a discussion of the notion of patriotic CO. The next stage presents a step Towards A Theory of PCO to Military Service and shows how it differs from other liberal theories of disobedience. The conclusion is that if CO on patriotic grounds is morally justifiable, it follows that this is an act committed within the framework of legitimate political discourse. Therefore, PCO is politically legitimate even if it is not always legal. In other words, the discussion of PCO offers a theoretical distinction between politicallegitimacy and legality. (shrink)

The literature on conscientious objection in medicine presents two key problems that remain unresolved: Which conscientious objections in medicine are justified, if it is not feasible for individual medical practitioners to conclusively demonstrate the genuineness or reasonableness of their objections? How does one respect both medical practitioners’ claims of conscience and patients’ interests, without leaving practitioners complicit in perceived or actual wrongdoing? My aim in this paper is to offer a new framework for conscientious objections in medicine, which, by (...) bringing medical professionals’ conscientious objection into the public realm, solves the justification and complicity problems. In particular, I will argue that: an “Uber Conscientious Objection in Medicine Committee” —which includes representatives from the medical community and from other professions, as well as from various religions and from the patient population—should assess various well-known conscientious objections in medicine in terms of public reason and decide which conscientious objections should be permitted, without hearing out individual conscientious objectors; medical practitioners should advertise their conscientious objections, ahead of time, in an online database that would be easily accessible to the public, without being required, in most cases, to refer patients to non-objecting practitioners. (shrink)

This paper is a review of work on Newman's objection to epistemic structural realism (ESR). In Section 2, a brief statement of ESR is provided. In Section 3, Newman's objection and its recent variants are outlined. In Section 4, two responses that argue that the objection can be evaded by abandoning the Ramsey-sentence approach to ESR are considered. In Section 5, three responses that have been put forward specifically to rescue the Ramsey-sentence approach to ESR from the (...) modern versions of the objection are discussed. Finally, in Section 6, three responses are considered that are neutral with respect to one's approach to ESR and all argue (in different ways) that the objection can be evaded by introducing the notion that some relations/structures are privileged over others. It is concluded that none of these suggestions is an adequate response to Newman's objection, which therefore remains a serious problem for ESRists. Introduction Epistemic Structural Realism 2.1 Ramsey-sentences and ESR 2.2 WESR and SESR The Objection 3.1 Newman's version 3.2 Demopoulos and Friedman's and Ketland's versions Replies that Abandon the Ramsey-Sentence Approach to ESR 4.1 Redhead's reply 4.2 French and Ladyman's reply Replies Designed to Rescue the Ramsey-Sentence Approach 5.1 Zahar's reply 5.2 Cruse's reply 5.3 Melia and Saatsi's reply Replies that Argue that Some Structures/Relations are Privileged 6.1 A Carnapian reply 6.2 Votsis' reply 6.3 The Merrill/Lewis/Psillos reply Summary CiteULike Connotea Del.icio.us What's this? (shrink)

Although some healthcare professionals have the legal right to conscientiously object to authorise or perform certain lawful medical services, they have an associated duty to provide the patient with enough information to seek out another professional willing to authorise or provide the service (the ‘duty to refer’). Does the duty to refer morally undermine the professional's conscientious objection (CO)? I narrow my discussion to the National Health Service in Britain, and the case of a general practitioner (GP) being asked (...) by a pregnant woman to authorise an abortion. I will be careful not to enter the debate about whether abortion should be legalised, or the debate about whether CO should be permitted—I will take both as given. I defend the objecting GP's duty to refer against those I call the ‘conscience absolutists’, who would claim that if a state is serious enough in permitting the GP's objection in the first place (as is the UK), then it has to recognise the right to withhold any information about abortion. (shrink)

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. (shrink)

ABSTRACT In a recent (2015) Bioethics editorial, Udo Schuklenk argues against allowing Canadian doctors to conscientiously object to any new euthanasia procedures approved by Parliament. In this he follows Julian Savulescu's 2006 BMJ paper which argued for the removal of the conscientious objection clause in the 1967 UK Abortion Act. Both authors advance powerful arguments based on the need for uniformity of service and on analogies with reprehensible kinds of personal exemption. In this article I want to defend the (...) practice of conscientious objection in publicly‐funded healthcare systems (such as those of Canada and the UK), at least in the area of abortion and end‐of‐life care, without entering either of the substantive moral debates about the permissibility of either. My main claim is that Schuklenk and Savulescu have misunderstood the special nature of medicine, and have misunderstood the motivations of the conscientious objectors. However, I acknowledge Schuklenk's point about differential access to lawful services in remote rural areas, and I argue that the health service should expend more to protect conscientious objection while ensuring universal access. (shrink)

According to a common view, sentience is necessary and sufficient for moral status. In other words, whether a being has intrinsic moral relevance is determined by its capacity for conscious experience. The _epistemic objection_ derives from our profound uncertainty about sentience. According to this objection, we cannot use sentience as a _criterion_ to ascribe moral status in practice because we won’t know in the foreseeable future which animals and AI systems are sentient while ethical questions regarding the possession of (...) moral status are urgent. Therefore, we need to formulate an alternative criterion. I argue that the epistemic objection is dissolved once one clearly distinguishes between the question what determines moral status and what criterion should be employed in practice to ascribe moral status. Epistemic concerns are irrelevant to the former question and—I will argue—criteria of moral status have inescapably to be based on sentience, if one concedes that sentience determines moral status. It follows that doubts about our epistemic access to sentience cannot be used to motivate an alternative criterion of moral status. If sentience turns out to be unknowable, then moral status is unknowable. However, I briefly advocate against such strong pessimism. (shrink)

Assume that military professionals should have the right to exercise selective conscientious objection (SCO). Implementing policies and programs to facilitate the right to SCO would be tricky. This essay offers suggestions for how to proceed.

According to luck egalitarianism, inequalities are justified if and only if they arise from choices for which it is reasonable to hold agents responsible. This position has been criticised for its purported harshness in responding to the plight of individuals who, through their own choices, end up destitute. This paper aims to assess the Harshness Objection. I put forward a version of the objection that has been qualified to take into account some of the more subtle elements of (...) the luck egalitarian approach. Revising the objection in this way suggests that the Harshness Objection has been overstated by its proponents: because luck egalitarians are sensitive to the influence of unequal brute luck on individuals’ choices, it is unlikely that there will be any real world cases in which the luck egalitarian would not have to provide at least partial compensation. However, the Harshness Objection still poses problems for the luck egalitarian. First, it is not clear that partial compensation will be sufficient to avoid catastrophic outcomes. Second, the Harshness Objection raises a theoretical problem in that a consistent luck egalitarian will have to regard it as unjust if any assistance is provided to the victim of pure option luck, even if such assistance could be provided at no cost. I consider three strategies the luck egalitarian could pursue to accommodate these concerns and conclude that none of these strategies can be maintained without either violating basic luck egalitarian principles or infringing upon individual liberty. (shrink)

Freedom of conscience is a core element of human rights respected by most European countries. It allows abortion through the inclusion of a conscience clause, which permits opting out of providing such services. However, the grounds for invoking conscientious objection lack clarity. Our aim in this paper is to take a step in this direction by carrying out a systematic review of reasons by midwives and nurses for declining, on conscience grounds, to participate in abortion. We conducted a systematic (...) review of ethical arguments asking, “What reasons have been reported in the argument based literature for or against conscientious objection to abortion provision by nurses or midwives?” We particularly wanted to identify any discussion of the responsibilities of midwives and nurses in this area. Search terms were conscientious objection and abortion or termination and nurse or midwife or midwives or physicians or doctors or medics within the dates 2000–2016 on: HEIN legal, Medline, CINAHL, Psychinfo, Academic Search Complete, Web of Science including publications in English, German and Dutch. Final articles were subjected to a rigorous analysis, coding and classifying each line into reason mentions, narrow and broad reasons for or against conscientious objection. Of an initial 1085 articles, 10 were included. We identified 23 broad reasons, containing 116narrow reasons and 269 reason mentions. Eighty one narrow reasons argued in favour of and 35 against conscientious objection. Using predetermined categories of moral, practical, religious or legal reasons, “moral reasons” contained the largest number of narrow reasons. The reasons and their associated mentions in this category outnumber those in the sum of the other three categories. We identified no absolute argument either for or against conscientious objection by midwives or nurses. An invisibility of midwives and nurses exists in the whole debate concerning conscientious objection reflecting a gap between literature and practice, as it is they whom WHO recommend as providers of this service. While the arguments in the literature emphasize the need for provision of conscientious objection, a balanced debate is necessary in this field, which includes all relevant health professionals. (shrink)

With the advent of legalized medical assistance in dying [MAiD] in Canada in 2016, nursing is facing intriguing new ethical and theoretical challenges. Among them is the concept of conscientious objection, which was built into the legislation as a safeguard to protect the rights of healthcare workers who feel they cannot participate in something that feels morally or ethically wrong. In this paper, we consider the ethical complexity that characterizes nurses' participation in MAiD and propose strategies to support nurses' (...) moral reflection and imagination as they seek to make sense of their decision to participate or not. Deconstructing the multiple and sometimes conflicting ethical and professional obligations inherent in nursing in such a context, we consider ways in which nurses can sustain their role as critically reflective moral agents within a context of a relational practice, serving the diverse needs of patients, families, and communities, as Canadian society continues to evolve within this new way of engaging with matters of living and dying. (shrink)

Conscientious objection in health care is a form of compromise whereby health care practitioners can refuse to take part in safe, legal, and beneficial medical procedures to which they have a moral opposition (for instance abortion). Arguments in defense of conscientious objection in medicine are usually based on the value of respect for the moral integrity of practitioners. I will show that philosophical arguments in defense of conscientious objection based on respect for such moral integrity are extremely (...) weak and, if taken seriously, lead to consequences that we would not (and should not) accept. I then propose that the best philosophical argument that defenders of conscientious objection in medicine can consistently deploy is one that appeals to (some form of) either moral relativism or subjectivism. I suggest that, unless either moral relativism or subjectivism is a valid theory—which is exactly what many defenders of conscientious objection (as well as many others) do not think—the role of moral integrity and conscientious objection in health care should be significantly downplayed and left out of the range of ethically relevant considerations. (shrink)

This book argues that a conscientiously objecting medical professional should receive an exemption only if the grounds of an objector's refusal are reasonable. It defends a detailed, contextual account of public reasonability suited for healthcare, which builds from the overarching concept of Rawlsian public reason. The author analyzes the main competing positions and maintains that these other views fail precisely due to their systematic inattention to the grounding reasons behind a conscientious objection; he argues that any such view is (...) plausible to the extent that it mimics the 'reason-giving requirement' for conscience objections defended in this work. Only reasonable objections can defeat the prior professional obligation to assign primacy to patient well-being, therefore one who refuses a patient's request for a legally available, medically indicated, and safe service must be able to explain the grounds of their objection in terms understandable to other citizens within the public institutional structure of medicine. The book further offers a novel policy proposal to deploy the Reasonability View: establishing conscientious objector status in medicine. It concludes that the Reasonability View is a viable and attractive position in this debate. A New Theory of Conscientious Objection in Medicine: Justification and Reasonability will be of interest to researchers and advanced students working in bioethics, medical ethics, and philosophy of medicine, as well as thinkers interested in the intersections between law, medical humanities, and philosophy. (shrink)

Abstract:Discussions of conscientious objection (CO) in healthcare often concentrate on objections to interventions that relate to reproduction, such as termination of pregnancy or contraception. Nevertheless, questions of conscience can arise in other areas of medicine. For example, the intensive care unit is a locus of ethically complex and contested decisions. Ethical debate about CO usually concentrates on the issue of whether physicians should be permitted to object to particular courses of treatment; whether CO should be accommodated. In this article, (...) I focus on the question of how clinicians ought to act: should they provide or support a course of action that is contrary to their deeply held moral beliefs? I discuss two secular examples of potential CO in intensive care, and propose that clinicians should adopt a norm of conscientious non-objection (CNO). In the face of divergent values and practice, physicians should set aside their personal moral beliefs and not object to treatment that is legally and professionally accepted and provided by their peers. Although there may be reason to permit conscientious objections in healthcare, conscientious non-objection should be encouraged, taught, and supported. (shrink)

In this paper, I argue that van Fraassen's "bad lot objection" against Inference to the Best Explanation [IBE] severely misses its mark. First, I show that the objection holds no special relevance to IBE; if the bad lot objection poses a serious problem for IBE, then it poses a serious problem for any inference form whatever. Second, I argue that, thankfully, it does not pose a serious threat to any inference form. Rather, the objection misguidedly blames (...) a form of inference for not achieving what it never set out to achieve in the first place. (shrink)

I answer Alvin Plantinga's challenge to provide a ‘proper’ de jure objection to religious belief. What I call the ‘sophisticates’ evidential objection' concludes that sophisticated Christians lack epistemic justification for believing central Christian propositions. The SEO utilizes a theory of epistemic justification in the spirit of the evidentialism of Richard Feldman and Earl Conee. I defend philosophical interest in the SEO against objections from Reformed epistemology, by addressing Plantinga's criteria for a proper de jure objection, his anti-evidentialist (...) arguments, and the relevance of ‘impulsional evidence’. I argue that no result from Plantinga-style Reformed epistemology precludes the reasons I offer in favour of giving the SEO its due philosophical attention. (shrink)

Bioethicists criticize Jürgen Habermas’s argument against “liberal eugenics” for many reasons. This essay examines one particular critique, according to which Habermas misunderstands the implications of human evolution. In adopting Hannah Arendt’s concept of “natality,” Habermas seems to fear that genetically modified children will lose the contingency of their births, which would impair their capacity for political action; but according to evolutionary theory, bioethicists argue, this fear is unfounded. I explore this objection by entertaining the hypothesis that Habermas’s argument assumes (...) Arendt’s interpretation of Darwinian evolution in addition to her conception of natality, and then I answer it by contrasting the conceptions of evolution held by Habermas, by Arendt, and by Habermas’s critics. Les bioéthiciens critiquent l’argument de Jürgen Habermas contre « l’eugénisme libéral » pour de nombreuses raisons. Cet essai examine une critique en particulier, selon laquelle Habermas comprend mal les implications de l’évolution humaine : en adoptant le concept de la « natalité » de Hannah Arendt, Habermas semble craindre que les enfants soumis à une modification génétique ne perdent la contingence propre à leur naissance, une perte qui diminuerait leur capacité pour l’action politique, mais selon la théorie de l’évolution, les bioéthiciens soutiennent que cette peur est sans fondement. J’explore cette objection à Habermas en considérant l’hypothèse que, en plus du concept de la natalité, Habermas suppose aussi l’interprétation arendtienne de l’évolution biologique de Darwin, et j’y répond en confrontant cette conception de l’évolution avec la conception propre à Habermas et avec celle des bioéthiciens qui lui ont répondu. (shrink)

Ethically challenging or controversial medical procedures have prompted increasing requests for the exercise of conscientious objection, and caused concerns about how and when it should be practised. This paper clarifies definitions, especially with regard to discrimination, and explores the restrictions, duties, and practical limitations, in order to suggest criteria for its practice. It also argues that a conscientious refusal to treat, where there is therapeutic doubt, is a valid form of conscientious objection. An email survey sent to General (...) Practitioners (GPs), explored the adherence to the suggested criteria, and assessed the outcomes, in terms of acceptability, impact, and difficulties experienced by the GPs, their colleagues and their patients. The results demonstrate high acceptability of conscientious objection, and better outcomes when the suggested criteria are adhered to. The GPs would support education to improve the practice of conscientious objection to a professional level, which could further improve outcomes and acceptability. (shrink)

Presentism is usually understood as the thesis that only the present exists whereas the rival theory of eternalism is usually understood as the thesis that past, present, and future things are all equally real. The significance of this debate has been threatened by the so-called triviality objection, which allegedly shows that the presentist thesis is either trivially true or obviously false: Presentism is trivially true if it is read as saying that everything that exists now is present, and it (...) is obviously false if read as saying that everything that has existed, exits or will exist is present. If eternalism is taken as the negation of presentism, it is also either trivially false or obviously true. In this paper, I try to respond to the triviality objection on behalf of presentism. In second section, I will examine how the argument proceeds. In third section, I will reflect on three possible ways to respond but will argue that none of them succeeds in giving a satisfactory solution. I will then try to clarify the core idea of presentism and to suggest that if we characterise presentism accurately, the problem will disappear. In fourth section, I will offer a plausible definition of presentism and will show how it can avoid the triviality objection and demonstrate why it is advantageous to accept the version of presentism I offer. (shrink)

In this paper I defend the Reasonability View: the position that medical professionals seeking a conscientious exemption must state reasons in support of their objection and allow those reasons to be subject to evaluation. Recently, this view has been criticized by Jason Marsh as proposing a standard that is either too difficult to meet or too easy to satisfy. First, I defend the Reasonability View from this proposed dilemma. Then, I develop this view by presenting and explaining some of (...) the central criteria it uses to assess whether a conscientious objection is proper grounds for extending an exemption to a medical practitioner. (shrink)

Dogged resistance to demanding moral views frequently takes the form of The Demandingness Objection. Premise (1): Moral view V demands too much of us. Premise (2): If a moral view demands too much of us, then it is mistaken. Conclusion: Therefore, moral view V is mistaken. Objections of this form harass major theories in normative ethics as well as prominent moral views in applied ethics and political philosophy. The present paper does the following: (i) it clarifies and distinguishes between (...) various demandingness objections in the philosophical literature, (ii) identifies a formidable and interesting form of the demandingness objection that targets a wide scope of moral views, and (iii) defuses this objection by developing a local skeptical argument from unreliability the form of which may, interestingly, be effectively deployed in other areas of philosophy. (shrink)

ABSTRACTSince 2007, when Mexico City decriminalized abortion during the first trimester, a debate has been taking place regarding abortion and the right to conscientious objection. Many people argue that, since the provision of abortions is now a statutory duty of healthcare personnel there can be no place for “conscientious objection.” Others claim that, even if such an objection were to be allowed, it should not be seen as a right, since talk about a right to CO may (...) lead to a slippery slope where we may end up recognizing a right to disobey the law. In this paper, I argue that there is a right to CO and that this may be justified through the notions of autonomy and integrity, which a liberal democracy should respect. However, it cannot be an absolute right, and in the case of abortion, it conflicts with women’s reproductive rights. Therefore, CO should be carefully regulated so that it does not obstruct the exercise o... (shrink)

The Molinist doctrine that God has middle knowledge requires that God knows the truth-values of counterfactuals of freedom, propositions about what free agents would do in hypothetical circumstances. A well-known objection to middle knowledge, the grounding objection, contends that counterfactuals of freedom have no truth-value because there is no fact to the matter as to what an agent with libertarian freedom would do in counterfactual circumstances. Molinists, however, have offered responses to the grounding objection that they believe (...) are adequate for maintaining the coherence of middle knowledge. I argue that these responses to the grounding objection are not adequate, and that what I call the ‘generic grounding objection’ still poses a serious challenge to middle knowledge. (shrink)

I argue that james otten's attempt to revive the logical connection argument by maintaining that there is a weak logical connection between causes and effects is a failure. Claiming that the weak logical connection is only a relation between descriptions of events rather than between events themselves, I conclude that otten has repeated the same mistake of confusing properties of propositions with properties of events made by earlier advocates of the lca.

Background: Ethical nursing practice is increasingly challenging, and strategies for addressing ethical dilemmas are needed to support nurses’ ethical care provision. Conscientious objection is one such strategy for addressing nurses’ personal, ethical conflicts, at times associated with conscience. Exploring both conscience and conscientious objection provides understanding regarding their implications for ethical nursing practice, research, and education. Research aim: To analyze the concepts of conscience and conscientious objection in the context of nurses. Design: Concept analysis using the method (...) by Walker and Avant. Research context: Data were retrieved from Philosopher’s Index, PubMed, and CINAHL with no date restrictions. Ethical consideration: This analysis was carried out per established, scientific guidelines. Findings: Ethical concepts are integral to nursing ethics, yet little is known about conscientious objection in relation to conscience for nurses. Of note, both concepts are well established in ethics literature, addressed in various nursing codes of ethics and regulatory bodies, but the meaning they hold for nurses and the impact they have on nursing education and practice remain unclear. Discussion and conclusion: This article discusses the relevance of conscience and conscientious objection to ethical nursing practice and proposes a model case to show how they can be appreciated in the context of nurses. Conscientious objection is an option for ethical transparency for nurses but is situated in contentious discussions over its use and has yet to be fully understood for nursing practice. Conscience is an element in need of more exploration in the context of conscientious objection. Further research is warranted to understand how nurses respond to conscience concerns in morally, pluralistic nursing contexts. (shrink)

In his 'The Disorder of Things' John Dupré presents an objection to reductionism which I call the 'anti-essentialist objection': it is that reductionism requires essentialism, and essentialism is false. I unpack the objection and assess its cogency. Once the objection is clearly in view, it is likely to appeal to those who think conceptual analysis a bankrupt project. I offer on behalf of the reductionist two strategies for responding, one which seeks to rehabilitate conceptual analysis and (...) one (more concessive) which avoids commitment to any such analysis. (shrink)

In response to physicians who refuse to provide medical services that are contrary to their ethical and/or religious beliefs, it is sometimes asserted that anyone who is not willing to provide legally and professionally permitted medical services should choose another profession. This article critically examines the underlying assumption that conscientious objection is incompatible with a physician’s professional obligations (the “incompatibility thesis”). Several accounts of the professional obligations of physicians are explored: general ethical theories (consequentialism, contractarianism, and rights-based theories), internal (...) morality (essentialist and non-essentialist conceptions), reciprocal justice, social contract, and promising. It is argued that none of these accounts of a physician’s professional obligations unequivocally supports the incompatibility thesis. (shrink)

Theological stateist theories, the most well-known of which is Divine Command Theory (DCT), ground our moral obligations directly in some state of God. The prior obligations objection poses a challenge to theological stateism. Is there a moral obligation to obey God’s commands? If no, it is hard to see how God’s commands can generate any moral obligations for us. If yes, then what grounds this prior obligation? To avoid circularity, the moral obligation must be grounded independent of God’s commands; (...) and therefore DCT fails to ground all moral obligations in God’s commands. I argue that DCT proponents should embrace “metaethical DCT.” On this view, there is no moral obligation to obey God. God creates our moral obligations out of normative nothingness. I argue that this helps DCT proponents to escape the prior obligations objection. Other theological stateist theories can modify their theory similarly to meet this objection. (shrink)

Conflict of interests in medicine are typically taken to be financial in nature: it is often assumed that a COI occurs when a healthcare practitioner’s financial interest conflicts with patients’ interests, public health interests, or professional obligations more generally. Even when non-financial COIs are acknowledged, ethical concerns are almost exclusively reserved for financial COIs. However, the notion of “interests” cannot be reduced to its financial component. Individuals in general, and medical professionals in particular, have different types of interests, many of (...) which are non-financial in nature but can still conflict with professional obligations. The debate about healthcare delivery has largely overlooked this broader notion of interests. Here, we will focus on health practitioners’ moral or religious values as particular types of personal interests involved in healthcare delivery that can generate COIs and on conscientious objection in healthcare as the expression of a particular type of COI. We argue that, in the healthcare context, the COIs generated by interests of conscience can be as ethically problematic, and therefore should be treated in the same way, as financial COIs. (shrink)

In this response paper, we respond to the criticisms that Michal Pruski raised against our article “Beyond Money: Conscientious Objection in Medicine as a Conflict of Interests.” We defend our original position against conscientious objection in healthcare by suggesting that the analogies Pruski uses to criticize our paper miss the relevant point and that some of the analogies he uses and the implications he draws are misplaced.