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Protecting reasonable conscientious refusals in health care

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Abstract

Recently, debate over whether health care providers should have a protected right to conscientiously refuse to offer legal health care services—such as abortion, elective sterilization, aid in dying, or treatments for transgender patients—has grown exponentially. I advance a modified compromise view that bases respect for claims of conscientious refusal to provide specific health care services on a publicly defensible rationale. This view requires health care providers who refuse such services to disclose their availability by other providers, as well as to arrange for referrals or facilitate transfers of care. This requirement raises the question of whether providers are being forced to be complicit in the provision of services they deem to be morally objectionable. I conclude by showing how this modified compromise view answers the most significant objections mounted by critics of the right to conscientious refusal and safeguards providers from having to offer services that most directly threaten their moral integrity.

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Notes

  1. Professional bioethics journals that have published special issues or special sections devoted to this debate include the American Journal of Bioethics [4,5,6], Theoretical Medicine and Bioethics [7], Bioethics [8], the Journal of Clinical Ethics [9], the Cambridge Quarterly of Healthcare Ethics [10], and the Journal of Medical Ethics [11].

  2. Describing this practice as either physician-assisted suicide or physician aid in dying—medical aid in dying is another term—automatically betrays one’s stance on its ethical legitimacy (the former term signaling opposition, the latter support). Since this paper does not engage the question of whether such practice should be morally or legally endorsed, I will utilize both acronyms together as PAS/PAD.

  3. Gender transforming and gender confirming represent another pair of terms that demonstrate contrasting stances on the ethical permissibility of a practice, in this case, hormonal or surgical interventions to treat gender dysphoria (the former term signaling opposition, the latter support). This issue is not directly treated in the current paper.

  4. Two recent cases that have received attention from mainstream media and bioethicists alike involve pharmacists who would not fulfill a prescription for mifepristone—a pharmaceutical abortifacient—for patients whose fetuses had already died in utero and needed to be expelled to reduce the risk of further medical complications [12, 13]. These cases involve a misapplication of the pharmacists’ legal right to conscientiously refuse to fulfill such a prescription, since the drug was not functioning as an abortifacient insofar as the fetuses had already died.

  5. I prefer the term conscientious refusal to conscientious objection, since the latter has historically been utilized in reference to conscripts into military service, which does not present an apt analogue to health care professionals who have freely chosen to enter the profession as well as espouse a specific specialty or subspecialty [15].

  6. My argument is intended to bear on both health care institutions and individual health care providers. For a defense of the former’s possessing the right to conscientiously refuse to provide specific health care services, see [16].

  7. For further elucidation of Aquinas’s account, see [21, 1a.79.11–13; 22, 16.1–3, 17.1–5; 23].

  8. Savulescu was a signatory to a “consensus statement” issued at the conclusion of a three-day workshop sponsored by the Brocher Foundation in Geneva, Switzerland [34]. Although the consensus statement does not promote the incompatibility thesis, it does call for greater restrictions on and stronger justifying criteria for granting claims of conscientious refusal than what is required under the current AMA and ACOG opinions.

  9. Julian Savulescu and Udo Schuklenk are open to a compromise view that ensures “no impediment” to patients’ ability to access contested services [35]; however, they assess current compromise policies and conclude that they do not adequately guarantee the exclusion of such impediments.

  10. Udo Schuklenk and Ricardo Smalling similarly note that, while non–religiously based morals may also inform a health care provider’s conscientious refusal, the majority of litigated cases in Western societies involve refusals that are religiously based [37, p. 234].

  11. The term “magisterium” refers to the formal teaching authority of the Roman Catholic hierarchy concerning matters of faith and morals. As noted below, there is not necessarily a monolithic Catholic view on all bioethical issues, and some Catholic bioethicists disagree about how to interpret and apply certain magisterial teachings, or outright disagree with some teachings.

  12. The relevant assertion, articulated by Pope John Paul II, is as follows: “Even if the presence of a spiritual soul cannot be ascertained by empirical data, the results themselves of scientific research on the human embryo provide ‘a valuable indication for discerning by the use of reason a personal presence at the moment of the first appearance of a human life: how could a human individual not be a human person?’ Furthermore, what is at stake is so important that, from the standpoint of moral obligation, the mere probability that a human person is involved would suffice to justify an absolutely clear prohibition of any intervention aimed at killing a human embryo” [40, no. 60]. For non–theologically based, scientifically informed arguments that human personhood begins at conception, such that the moral duties of nonmaleficence and justice are applicable to human embryos and fetuses, see, inter alia, [41,42,43,44,45]. Rawls himself cites an argument against the moral permissibility of abortion by a Catholic leader, Cardinal Joseph Bernardin, as one that “is clearly cast in some form of public reason” [39, p. 480, n. 82].

  13. Rawls notes that certain Catholic social justice principles—namely, the common good and solidarity—fall within the scope of defensible conceptions of justice within the sphere of public reason [39, pp. 451–452]. That these Catholic principles of social justice encompass unborn, dying, and disabled human beings has been affirmed consistently by the Catholic magisterium, most recently by Pope Francis [54, no. 117; 55, no. 101].

  14. Although, on the Thomistic conception of conscience described above, individuals must adhere to even an erring conscience, they still bear a measure of responsibility for ensuring that their consciences are well-formed—in this case, through an accurate understanding and application of relevant religious teachings and their supportive rationales. Furthermore, an individual’s moral requirement to adhere to the dictates of an erring conscience does not entail that her appeal to conscience must be respected by the wider society.

  15. For elucidation of the principle of double effect, see [58, 59].

  16. For example, Lawrence Mayer and Paul McHugh report, based on a study conducted in Sweden: “Compared to the general population, adults who have undergone sex-reassignment surgery continue to have a higher risk of experiencing poor mental health outcomes. One study found that, compared to controls, sex-reassigned individuals were about 5 times more likely to attempt suicide and about 19 times more likely to die by suicide” [73, p. 9] (in reference to [74]).

  17. In refusing to perform a requested service, a health care provider inveitably makes a judgment about the morality of the patient’s request and seemingly, by extension, calls into question the patient’s moral character [75, pp. 2576–2578]. Yet judging a patient’s request to be immoral does not necessarily entail (a) failing to understand the patient’s reasons for requesting the service at issue, which may themselves be morally justifiable in isolation; (b) treating the patient in a disrespectful, discriminatory fashion; or (c) refusing to provide the patient other forms of unobjectionable care.

  18. The concept of moral complicity and its ramifications for the issue at hand are explored in greater depth in [23].

  19. The locus classicus for the distinction between formal and material cooperation with moral evil is [76, 2.3.2 dub. 5, art. 3, no. 63]. For a more contemporary formulation, see [77]. While this distinction originated with Roman Catholic moral theology, it has since become part of secular ethical discourse as well.

References

  1. Roe v. Wade, 410 U.S. 113 (1973).

  2. Doe v. Bolton, 410 U.S. 179 (1973).

  3. Health Programs Extension Act of 1973 (Church Amendment), Pub. L. No. 93-45, § 401, 87 Stat. 91, 95–96 (codified as amended at 42 U.S.C. § 300a-7 (2018)).

  4. Card, Robert F. 2007. Conscientious objection and emergency contraception. Target article, American Journal of Bioethics 7(6): 8–14.

    Google Scholar 

  5. Lawrence, Ryan E., and Farr A. Curlin. 2007. Clash of definitions: Controversies about conscience in medicine. Target article, American Journal of Bioethics 7(12): 10–14.

    Google Scholar 

  6. Nelson, Lawrence. 2018. Provider conscientious refusal of abortion, obstetrical emergencies, and criminal homicide law. Target article, American Journal of Bioethics 18(7): 43–50.

    Google Scholar 

  7. Curlin, Farr A. (ed.). 2008. Conscience and clinical practice: Medical ethics in the face of moral controversy. Special issue, Theoretical Medicine and Bioethics 29(3): 129–212.

    Google Scholar 

  8. McLeod, Carolyn, and Jocelyn Downie (eds.). 2014. Let conscience be their guide? Conscientious refusals in health care. Special issue, Bioethics 28(1): 1–48.

    Google Scholar 

  9. Howe, Edmund G. (ed.). 2016. Physicians’ exercise of conscience: Commentaries on the AMA’s Code of Medical Ethics. Special section, Journal of Clinical Ethics 27(3): 219–253.

    Google Scholar 

  10. Giubilini, Alberto, and Julian Savulescu (eds.). 2017. Conscientious objection in healthcare: Problems and perspectives. Special section, Cambridge Quarterly of Healthcare Ethics 26(1): 3–158.

    Google Scholar 

  11. Clarke, Steve (ed.). 2017. Conscientious objection in healthcare: New directions. Special issue, Journal of Medical Ethics 43(4): 191–278.

    Google Scholar 

  12. Miles, Steven H., and Arthur Caplan. 2018. Confusion and conscientious objection in Arizona. Bioethics.net (blog). July 1, 2018. http://www.bioethics.net/2018/07/confusion-and-conscientious-objection-in-arizona.

  13. Redinger, Michael. 2018. Catholic pharmacist didn’t get Catholic medical ethics right. Detroit Free Press, October 19. https://www.freep.com/story/opinion/contributors/2018/10/19/catholic-pharmacist-medical-ethics/1697138002.

  14. Brummett, Abram. 2018. Conscience claims, metaphysics, and avoiding an LGBT eugenic. Bioethics 32: 272–280.

    Google Scholar 

  15. Stahl, Ronit Y., and Ezekiel J. Emanuel. 2017. Physicians, not conscripts—conscientious objection in health care. New England Journal of Medicine 376: 1380–1385.

    Google Scholar 

  16. Bedford, Elliott L. 2016. The reality of institutional conscience. National Catholic Bioethics Quarterly 16: 255–272.

    Google Scholar 

  17. Savulescu, Julian, and Udo Schuklenk. 2017. Doctors have no right to refuse medical assistance in dying, abortion or contraception. Bioethics 31: 162–170.

    Google Scholar 

  18. Savulescu, Julian. 2006. Conscientious objection in medicine. BMJ 332: 294–297.

    Google Scholar 

  19. Hardt, John J. 2008. The conscience debate: Resources for rapprochement from the problem’s perceived source. Theoretical Medicine and Bioethics 29: 151–160.

    Google Scholar 

  20. MacIntyre, Alasdair. 2016. Ethics in the conflicts of modernity: An essay on desire, practical reasoning, and narrative. New York: Cambridge University Press.

    Google Scholar 

  21. Aquinas, Thomas. 1947. Summa theologica. Trans. Fathers of the English Dominican Province. New York: Benziger.

  22. Aquinas, Thomas. 1953. Quaestiones disputatae de veritate, vol. 2. Trans. James V. McGlynn. Chicago: Henry Regnery.

  23. Eberl, Jason T., and Christopher Ostertag. Forthcoming. Conscience, compromise, and complicity. In Proceedings of the American Catholic Philosophical Association 92.

  24. Pellegrino, Edmund D. 1987. Toward an expanded medical ethics: The Hippocratic ethic revisited. In In search of the modern Hippocrates, ed. Roger J. Bulger, 45–64. Iowa City: University of Iowa Press.

    Google Scholar 

  25. Pellegrino, Edmund D., and David C. Thomasma. 1993. The virtues in medical practice. New York: Oxford University Press.

    Google Scholar 

  26. Lombardo, Paul A. 2008. Three generations, no imbeciles: Eugenics, the Supreme Court, and Buck v. Bell. Baltimore: Johns Hopkins University Press.

    Google Scholar 

  27. Wicclair, Mark R. 2011. Conscientious objection in health care: An ethical analysis. New York: Cambridge University Press.

    Google Scholar 

  28. Lantos, John D., and Farr A. Curlin. 2008. Religion, conscience and clinical decisions. Acta Paediatrica 97: 265–266.

    Google Scholar 

  29. Beauchamp, Tom L., and James F. Childress. 2013. Principles of biomedical ethics, 7th ed. New York: Oxford University Press.

    Google Scholar 

  30. Wicclair, Mark R. 2008. Is conscientious objection incompatible with a physician’s professional obligations? Theoretical Medicine and Bioethics 29: 171–185.

    Google Scholar 

  31. Robertson, John A. 1994. Children of choice: Freedom and the new reproductive technologies. Princeton: Princeton University Press.

    Google Scholar 

  32. Crigger, B.J., Patrick W. McCormick, Stephen L. Brotherton, and Valarie Blake. 2016. Report by the American Medical Association’s Council on Ethical and Judicial Affairs on physicians’ exercise of conscience. Journal of Clinical Ethics 27: 219–226.

    Google Scholar 

  33. American College of Obstetrics and Gynecologists. 2007. ACOG Committee Opinion No. 385 November 2007: The limits of conscientious refusal in reproductive medicine. Obstetrics and Gynecology 110: 1203–1208.

    Google Scholar 

  34. Ballantyne, Angela, Robert Card, Steve Clarke, Katrien Devolder, Thomas Douglas, Alberto Giubilini, Jeanette Kennett, et al. 2016. Consensus statement on conscientious objection in healthcare. Practical Ethics (blog). August 29, 2016. http://blog.practicalethics.ox.ac.uk/2016/08/consensus-statement-on-conscientious-objection-in-healthcare.

  35. Savulescu, Julian, and Udo Schuklenk. 2018. Conscientious objection and compromising the patient: Response to Hughes. Bioethics 32: 473–476.

    Google Scholar 

  36. Schuklenk, Udo. 2015. Conscientious objection in medicine: Private ideological convictions must not supercede public service obligations. Bioethics 29(5): ii–iii.

    Google Scholar 

  37. Schuklenk, Udo, and Ricardo Smalling. 2017. Why medical professionals have no moral claim to conscientious objection accommodation in liberal democracies. Journal of Medical Ethics 43: 234–240.

    Google Scholar 

  38. Nussbaum, Martha. 2008. Liberty of conscience: In defense of America’s tradition of religious equality. New York: Basic Books.

    Google Scholar 

  39. Rawls, John. 2005. Political liberalism, exp. ed. New York: Columbia University Press.

    Google Scholar 

  40. John Paul II. 1995. Encyclical letter Evangelium vitae on the value and inviolability of human life (March 25, 1995). Acta Apostolicae Sedis 87: 401–522. http://w2.vatican.va/content/john-paul-ii/en/encyclicals/documents/hf_jp-ii_enc_25031995_evangelium-vitae.html.

  41. George, Robert P., and Christopher Tollefsen. 2008. Embryo: A defense of human life. New York: Doubleday.

    Google Scholar 

  42. Lee, Patrick. 2010. Abortion and unborn human life, 2nd ed. Washington, DC: Catholic University of America Press.

    Google Scholar 

  43. Finnis, John. 2015. Abortion and health care ethics. In Bioethics: An anthology, 3rd ed, ed. Helga Kuhse, Udo Schuklenk, and Peter Singer, 15–22. Oxford: Blackwell.

    Google Scholar 

  44. Kaczor, Christopher. 2015. The ethics of abortion: Women’s rights, human life, and the question of justice, 2nd ed. New York: Routledge.

    Google Scholar 

  45. Condic, Samuel B., and Maureen L. Condic. 2018. Human embryos, human beings: A scientific and philosophical approach. Washington, DC: Catholic University of America Press.

    Google Scholar 

  46. Kant, Immanuel. 1963. Duties towards the body in regard to life. In Lectures on ethics, trans. Louis Infield, 147–148. New York: Harper and Row.

  47. Aristotle. 1999. Nicomachean ethics, 2nd ed. Trans. Terence Irwin. Indianapolis: Hackett.

  48. Eberl, Jason T. 2003. Aquinas on euthanasia, suffering, and palliative care. National Catholic Bioethics Quarterly 3: 331–354.

    Google Scholar 

  49. Callahan, Daniel. 1992. When self-determination runs amok. Hastings Center Report 22(2): 52–55.

    Google Scholar 

  50. Sulmasy, Daniel P., John M. Travaline, Louise A. Mitchell, and E. Wesley Ely. 2016. Non-faith-based arguments against physician-assisted suicide and euthanasia. Linacre Quarterly 83: 246–257.

    Google Scholar 

  51. Anscombe, G.E.M. 1958. Modern moral philosophy. Philosophy 33: 1–19.

    Google Scholar 

  52. Smart, J.J.C., and Bernard Williams. 1973. Utilitarianism: For and against. Cambridge: Cambridge University Press.

    Google Scholar 

  53. Longmore, Paul K. 2005. Policy, prejudice, and reality: Two case studies of physician-assisted suicide. Journal of Disability Policy Studies 16: 38–45.

    Google Scholar 

  54. Francis. 2015. Encyclical letter Laudato Si’ on care for our common home (May 24, 2015). Acta Apostolicae Sedis 107: 847–945. http://w2.vatican.va/content/francesco/en/encyclicals/documents/papa-francesco_20150524_enciclica-laudato-si.html.

  55. Francis. 2018. Apostolic exhortation Gaudete et exsultate on the call to holiness in today’s world (March 9, 2018). http://w2.vatican.va/content/francesco/en/apost_exhortations/documents/papa-francesco_esortazione-ap_20180319_gaudete-et-exsultate.html.

  56. Paul VI. 1968. Encyclical letter Humanae vitae on the regulation of birth (July 25, 1968). Acta Apostolicae Sedis 60: 481–503. http://w2.vatican.va/content/paul-vi/en/encyclicals/documents/hf_p-vi_enc_25071968_humanae-vitae.html.

  57. United States Conference of Catholic Bishops. 2018. Ethical and religious directives for Catholic health care services, 6th ed. Washington, DC: United States Conference of Catholic Bishops. http://www.usccb.org/about/doctrine/ethical-and-religious-directives.

  58. Cavanaugh, Thomas A. 2006. Double-effect reasoning: Doing good and avoiding evil. New York: Oxford University Press.

    Google Scholar 

  59. Woodward, Paul A. (ed.). 2001. The doctrine of double effect: Philosophers debate a controversial moral principle. Notre Dame: University of Notre Dame Press.

    Google Scholar 

  60. Cataldo, Peter J. 2017. Moral certitude in the use of levonorgestrel for the treatment of sexual assault survivors. In Contemporary controversies in Catholic bioethics, ed. Jason T. Eberl, 197–222. Dordrecht: Springer.

    Google Scholar 

  61. Davis, Thomas J., Jr. 2017. Evaluation of the mechanism of action of anti-fertility treatment in cases of sexual assault: Moral certitude and human acts. In Contemporary controversies in Catholic bioethics, ed. Jason T. Eberl, 223–254. Dordrecht: Springer.

    Google Scholar 

  62. Kaczor, Christopher. 2017. Is it ethically permissible to separate conjoined twins? Murder, mutilation, and consent. In Contemporary controversies in Catholic bioethics, ed. Jason T. Eberl, 123–133. Dordrecht: Springer.

    Google Scholar 

  63. Watt, Helen. 2017. Vital conflicts, bodily respect, and conjoined twins: Are we asking the right questions? In Contemporary controversies in Catholic bioethics, ed. Jason T. Eberl, 135–145. Dordrecht: Springer.

    Google Scholar 

  64. Ozoliņš, Jānis T. 2017. On the provision of medical nutrition and hydration. In Contemporary controversies in Catholic bioethics, ed. Jason T. Eberl, 405–424. Dordrecht: Springer.

    Google Scholar 

  65. Boyle, Joseph. 2017. A Catholic approach to withholding medically provided food and water. In Contemporary controversies in Catholic bioethics, ed. Jason T. Eberl, 425–441. Dordrecht: Springer.

    Google Scholar 

  66. Eberl, Jason T. (ed.). 2017. Contemporary controversies in Catholic bioethics. Dordrecht: Springer.

    Google Scholar 

  67. Christopher, Meyers, and Robert D. Woods. 2007. Conscientious objection? Yes, but make sure it is genuine. American Journal of Bioethics 7(6): 19–20.

    Google Scholar 

  68. Clarke, Steve. 2017. Conscientious objection in healthcare, referral and the military analogy. Journal of Medical Ethics 43: 218–221.

    Google Scholar 

  69. Card, Robert F. 2016. In defence of medical tribunals and the reasonability standard for conscientious objection in medicine. Journal of Medical Ethics 42: 73–75.

    Google Scholar 

  70. Hughes, Jonathan A. 2017. Conscientious objection in healthcare: Why tribunals might be the answer. Journal of Medical Ethics 43: 213–217.

    Google Scholar 

  71. Cowley, Christopher. 2016. Conscientious objection and healthcare in the UK: Why tribunals are not the answer. Journal of Medical Ethics 42: 69–72.

    Google Scholar 

  72. Myskja, Bjørn K., and Morten Magelssen. 2018. Conscientious objection to intentional killing: An argument for toleration. BMC Medical Ethics 19: 82. https://doi.org/10.1186/s12910-018-0323-0.

    Article  Google Scholar 

  73. Mayer, Lawrence S., and Paul R. McHugh. 2016. Sexuality and gender: Findings from the biological, psychological, and social sciences. New Atlantis 50: 4–143.

    Google Scholar 

  74. Dhejne, Cecilia, Paul Lichtenstein, Marcus Boman, Anna L.V. Johansson, Niklas Långström, and Mikael Landén. 2011. Long-term follow-up of transsexual persons undergoing sex reassignment surgery: Cohort study in Sweden. PLOS ONE 6(2): e16885. https://doi.org/10.1371/journal.pone.0016885.

    Article  Google Scholar 

  75. NeJaime, Douglas, and Reva B. Siegel. 2015. Conscience wars: Complicity-based conscience claims in religion and politics. Yale Law Journal 124: 2516–2591.

    Google Scholar 

  76. Liguori, Alphonsus. 1905–1912. Theologia moralis, 4 vols. Ed. Leonardi Gaudé. Rome: Typographia Vaticana.

  77. Flannery, Kevin L. 2019. Cooperation with evil: Thomistic tools of analysis. Washington, DC: Catholic University of America Press.

    Google Scholar 

  78. Kaczor, Christopher. 2013. A defense of dignity: Creating life, destroying life, and protecting rights of conscience. Notre Dame: University of Notre Dame Press.

    Google Scholar 

  79. Medical Assistance in Dying Statute Law Amendment Act, S.O. 2017, c. 7, Bill 84. https://www.ontario.ca/laws/statute/s17007.

  80. McGowan, Carter Anne. 2018. Conscience rights and “effective referral” in Ontario. National Catholic Bioethics Quarterly 18: 255–268.

    Google Scholar 

  81. Cabal, Luisa, Monica Arango Olaya, and Valentino Montoya Robledo. 2014. Striking a balance: Conscientious objection and reproductive health care from the Colombian perspective. Health and Human Rights 16(2): 73–83.

    Google Scholar 

  82. Dickens, B.M., and R.J. Cook. 2000. The scope and limits of conscientious objection. International Journal of Gynecology and Obstetrics 71: 71–77.

    Google Scholar 

  83. Buetow, Stephen, and Natalie Gauld. 2018. Conscientious objection and person-centered care. Theoretical Medicine and Bioethics 39: 143–155.

    Google Scholar 

  84. Camosy, Charles C. 2018. Defending against formally innocent material mortal threats: A response to Joshua Evans. National Catholic Bioethics Quarterly 18: 217–225.

    Google Scholar 

  85. Camosy, Charles C. 2015. Beyond the abortion wars: A way forward for a new generation. Grand Rapids: Eerdmans.

    Google Scholar 

  86. Mumford, James. 2013. Ethics at the beginning of life: A phenomenological critique. New York: Oxford University Press.

    Google Scholar 

  87. Rhonheimer, Martin. 2009. Vital conflicts in medical ethics: A virtue approach to craniotomy and tubal pregnancies. Washington, DC: Catholic University of America Press.

    Google Scholar 

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Acknowledgements

I am most grateful to Abram Brummett, Christopher Ostertag, Udo Schuklenk, an anonymous reviewer, and participants at the 2018 meeting of the American Society for Bioethics and Humanities for helpful comments on earlier drafts of this paper.

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  1. Albert Gnaegi Center for Health Care Ethics, Saint Louis University, 3545 Lafayette Ave., Salus 527, Saint Louis, MO, 63104, USA

    Jason T. Eberl

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Eberl, J.T. Protecting reasonable conscientious refusals in health care. Theor Med Bioeth 40, 565–581 (2019). https://doi.org/10.1007/s11017-019-09512-w

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