The literature on conscientious objection in medicine presents two key problems that remain unresolved: (a) 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 (“the justification problem”)? (b) How does one respect both medical practitioners’ claims of conscience and patients’ interests, without leaving practitioners complicit in perceived or actual wrongdoing (“the complicity problem”)? 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: (a) an “Uber Conscientious Objection in Medicine Committee” (“UCOM 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; (b) medical practitioners should advertise their (UCOM Committee preapproved) 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.

关于医学中的良心拒服兵役的文献提出了两个尚未解决的关键问题：(a) 如果个体医生无法最终证明其反对的真实性或合理性（“正当性问题”），哪些医学上的良心拒服是合理的”）？(b) 如何既尊重医生的良心诉求又尊重患者的利益，同时又不让医生成为感知或实际不法行为的同谋（“同谋问题”）？我在本文中的目的是为医学中的良心拒服兵役提供一个新的框架，通过将医疗专业人员的良心拒服兵役带入公共领域，解决了正当性和共谋问题。特别是，我将论证：(a) 一个“医学界的 Uber 良心反对委员会”（“UCOM 委员会”）——其中包括来自医学界和其他行业的代表，以及来自不同宗教和患者群体的代表— 应根据公共原因评估各种众所周知的医学良心拒服兵役，并决定应允许哪些良心拒服兵役，而不听取个别出于良心拒服兵役者的意见；(b) 医疗从业者应提前在公众易于访问的在线数据库中宣传他们（UCOM 委员会预先批准的）依良心拒服兵役，而在大多数情况下，无需将患者转介给不反对的从业者。