Conscientious Objective in Medical Practice

Introduction

The article, “Why Medical Professionals have no Moral Claim to Conscientious Objection Accommodation in Liberal Democracies” by Udo Schuklenk and Ricardo Smalling presents critical arguments that different stakeholders in the field of medicine should examine from an informed perspective. The authors begin by explaining why clinicians should be aware of their obligations and responsibilities as providers of patient care.

The presented cases in this article reveal that majority of the issues revolving around conscientious objection are associated with specific professional services and support that patients are entitled to receive. Medical professionals and practitioners should not be allowed to have conscientious objections in their respective democracies when it comes to the delivery of evidence-based health services. The purpose of this paper is to describe the ideas the authors of this article present, the opposing views, and propose the best way forward towards ensuring that more patients receive high-quality services.

Presented Arguments and Analysis

In the current healthcare settings, typical conscientious objectors tend to object to the provision of medical services that patients are entitled to. What stands out is that the authors of the selected article do not focus on conscientious objectors of controversial procedures, including torture or suicide. The accommodation of this provision is capable of resulting in conflicts between clinicians and their patients.1

The background of this report is that many stakeholders have been focusing on the best ways to reintroduce the ethical debate regarding the concept of conscientious objection. Some professionals have been keen to have their personal, religious, and moral aspects of objections within the practice supported using legal frameworks. While this might be something appropriate or plausible, such doctors or physicians do so without considering the outcomes and experiences of patients and the services they are expected to receive.

The article is concerned with the issue of conscientious objectors who decided to join the field of medicine without coercion. Over the centuries, careers within the field of health have been identified as appropriate for individuals who have a calling. This is the case since they have to provide exemplary care to persons with diverse backgrounds, opinions, religious values, and expectations. Such individuals are also empowered by existing laws in liberal democracies that promise them autonomy, justice, and liberty throughout the care delivery process.2 With this kind of understanding, the article reveals that individuals who select this form of the profession should not be permitted to have a moral claim to conscientious objection.

Over the years, doctors have been observed to pursue their private ideologies and convictions whenever a conflict arises when supporting their patients. This has been the case since they enjoy more power and expertise than the targeted beneficiaries. This kind of precedence remains questionable since it fails to consider the rights and welfare of the targeted individual. To take the argument further, the authors present examples of medical professionals who might put their religious beliefs first when providing health services.

In liberal societies, people embrace diversity and encourage people to pursue their unique opinions. They are also empowered to promote their specific worldviews. When the idea of conscientious objection is permitted, more patients will be unable to get the intended rights or services. This outcome challenges the goals and expectations of utilitarianism.3 Some medical practitioners can consider this kind of authority to fail to deny a specific service that is critical to the patient.

The article goes further to present the opinions of the Supreme Court of Canada. According to this institution, there is a need to halt or stop the conscientious belief of a given professional or doctor when it is capable of interfering with the expectations and rights of the patient.4 With this kind of ruling, it is evident that some physicians might consider this kind of objection to deny or fail to offer critical services.

This means that some individuals might be forced to look for different alternatives or services elsewhere. Another argument that stands out is that the decision to empower physicians and encourage them to offer specific care that is by their beliefs can result in increased workload. Some professionals might take advantage of this provision to avoid providing specified services to their patients. Instead, they will refer them to other facilities and eventually affect the image or effectiveness of the entire healthcare sector.

The decision to allow professionals in the field of medicine to have conscientious objection rights means that the nature of available health services will become unpredictable. This happens to be the case since these physicians will have the final say regarding whether to offer specific medical care or not. The result is that more patients will be unable to record positive or desirable health outcomes. With this kind of opinion, the authors are convinced that the services different professionals provide should never be subjected to their convictions, views, or expectations.5 This is the case since patients in need of care and medical support are not driven or motivated by personal beliefs, but the demand for high-quality and timely medical services.

How nurses, physicians, and doctors join their respective careers is something that happened voluntarily. The Hippocratic oath supports this kind of process by ensuring that those who decide to offer services to different patients do so without bias or focusing on their assumptions, beliefs, and convictions. The concept of informed concept goes further to explain why issues to do with the medical profession should be examined from an informed perspective.6

It is agreeable that those who have decided to join this profession should be willing to abide by the established rules and stop pursuing their conscientious objections. If this practice is allowed, chances are quite high that more patients will be unable to record positive health outcomes.

With such observations, it is evident that the outlined issue will remain controversial in the coming years. However, the authors appear to focus on the best ways to maximize patients’ health outcomes and prevent medical practitioners from taking advantage of their competencies. They conclude the article by arguing that medical professionals should not have a moral claim in democratic societies to the accommodation of personal views and conscientious objections.7 Any effort to allow such views and claims might undermine the true purpose and nature of the healthcare sector. Some professionals might embrace such objections and eventually fail to meet the needs of different stakeholders. Such an approach will also infringe on the innate liberties and rights of all patients.

Opposing Views

Some scholars and researchers have presented opposing views and arguments to support the notion that medical professionals should have a moral claim to this form of objection in every liberal democracy. For example, Brian Earp indicates that the ideas of the authors of the above article are unfounded or erroneous.8 Issues focusing on sensitive matters should be decided by the greatest majority of stakeholders. The authors should not have taken such a stand without considering the expectations of both the consumers and providers of medical services. The outstanding message is that the views of the majority are the ones needed to inform policy change.

Such an approach is capable of encouraging people to identify what is reasonable and what should be abandoned. Although the article presents some powerful reasons to explain why there is a need for conscientious objection to be illegalized, it fails to offer convincing thoughts on a wide range of issues, such as the beliefs of Christians and those of atheists and their unique places in the field of medicine.

Liberal democracy has emerged as a powerful concept that continues to promote equality to civil and human rights. This means that clinicians have the right to decide when to perform a specific medical act. The ideals of democracy emerge as powerful arguments that are opposed to the issue of conscientious objection. This is the case since they focus on the most appropriate strategies and procedures for ensuring that the needs of more patients are met. When providers of medical services are disallowed to have moral claim over this issue, chances are high that they will be unwilling to provide superior support or care to the targeted patients. This idea is, therefore, opposed to the utilitarianism theory that seeks to maximize happiness for the greatest majority.9

Some of the existing policies and ethical guidelines in different regions make the applicability of conscientious objection meaningless. For instance, many liberal democracies promote human rights and equality. This can be translated to mean that clinicians and other health professionals are free to select the most appropriate medical procedures, care delivery processes, and therapeutic options that are informed by the health needs of the targeted patients.10 Doctors should, therefore, be ready to do what is right depending on the targeted condition or illness.

Another argument against the article’s thesis is that societal values, practices, and norms will change from time to time. Sometimes doctors will be required to practice in challenging environments or situations. If such professionals are not allowed to pursue their conscientious objections or expectations, chances are high that more patients will be unable to receive high-quality or personalized services. This means that different stakeholders will have ignored the concept of cultural relativism.11 The application of this principle will ensure that medical professionals are empowered to act by their beliefs and cultural values.

What is the Way Forward?

The above issues are pertinent in the fields of medicine and nursing since they focus on a topic that affects the experiences of caregivers as well as the health outcomes of patients. Over the years, new laws and guidelines have emerged to ensure that clinicians adhere to specific models of care delivery. Before joining a specific field in healthcare, such caregivers are encouraged to pursue their dreams and focus on what might be rewarding to them. The introduction of different policies and oaths within the profession is an imitative intended to protect the welfare and rights of all citizens.12 Similarly, the ultimate objective of this field is to maximize the health outcomes of the greatest number of patients without any form of discrimination or bias.

From this kind of argument, it is quite clear that the identified article appears to present more convincing ideas that the global society should consider following. If by any chance a specific professional is unable to provide a given service, it would be appropriate for him or her to look for another career. This strategy resonates with the concept of utilitarianism since the caregiver will be empowered to pursue a different activity or hobby that will never undermine the experiences or outcomes of the targeted patients. The provision of this moral claim will make it hard for clinicians to provide specific services to different individuals.13

For instance, a physician might fail to offer appropriate medical support to an atheist patient simply because his or her religion does not permit such a process. In terms of diet, a given doctor might fail to recommend specific food types since they are not allowed in their cultures. From these malpractices, it becomes quite clear that the targeted patient will be unable to record positive health outcomes.

The conflicting nature of this topic should become the foundation for evidence-based ideas that are aimed at protecting patients. Medical professionals’ unique beliefs should never be allowed to take precedent when the targeted person might need high-quality services. This is also the reason why patients do not fail to accept care from a given provider simply because he or she is from different culture or religion. The emergence of more complicated or moral dilemmas in this field also explains why doctors should never be permitted to become conscientious objectors.14 This is the case since they are expected to act by the established guidelines and promote superior actions that will maximize patients’ experiences.

It can be appropriate for stakeholders to reason together and pursue this subject from an informed perspective using the Utilitarian approach. Such a practice is essential since it can ensure that all involved parties consider the best procedures to strike a balance and ensure that the liberties of both the physician and the patient are taken into consideration. Some analysts have argued that medical facilities should hire professionals with diverse backgrounds to ensure that patients can receive the intended services.15

Medical institutions and healthcare sectors in different countries can go further to consider appropriate guidelines that will outline mandatory services that professionals should offer without focusing on their rights or personal convictions. This policy will ensure that physicians make informed decisions before applying for specific jobs or positions whenever searching for jobs. Such an approach will address the challenges associated with this dilemma and eventually meet the demands of both patients and caregivers. These approaches will eventually transform the healthcare sector and empower all stakeholders.

Another evidence-based approach to address this issue is the introduction of new laws that are informed by citizens’ opinions. Every country can engage its people to offer their views by the attributes of democracy. This kind of practice will create a scenario whereby citizens can propose the most appropriate strategies for addressing the issues they face in their respective societies. Such a move can result in a new policy whereby professionals are allowed to pursue procedures that are by their philosophies.16 This means that such individuals will be willing to allow their caregivers to dictate the way forward.

From these aspects, it is worth noting that countries should strive to have physicians who are competent and guarantee timely and high-quality services to their people. This is something critical if positive health results are to be recorded. Issues to do with patients’ rights, expectations, and autonomy should guide this kind of practice. The role of the government is to provide adequate resources to these professionals to ensure that they are empowered to continue delivering high-quality services.17 The possible outcome is that the superiority of the entire healthcare sector will improve significantly and make it easier for more people to lead better lives. Such an initiative is by the utilitarianism theory.

Presently, it would be appropriate for all stakeholders to acknowledge the fact that medical professionals are required to act by the Hippocratic oath and the outlined guidelines in their respective fields of specialization.

The moral claim in liberal democracies to the accommodation of their conscientious objectives should be disallowed. The reason why this is the case is that such physicians are encouraged to take the career as a calling from the very beginning. The empowerment of doctors to object-specific care delivery procedures and practices is unethical and capable of undermining the nature and quality of services available to different patients.18 Some individuals might go further to capitalize on this kind of permission to abuse their powers or monopoly and eventually affect the nature of medical services.

With this kind of observation, the authors of the studied article acknowledge that medical practitioners in the 21st century should be guided about the requirements of different patients and be willing to be part of the process. The definitions outlined in the scope of medical practice encourage or require all physicians and clinicians to put the demands of their respective patients first.

Permitting such practitioners to have this kind of moral claim will mean that more patients will be forced to abide by their values, whether right or wrong and eventually fail to record positive health outcomes. This kind of approach will also be an infringement on the fundamental rights and freedoms of such individuals. This means that it fails to support the applicability of Kantian ethics since the consequences are negative.19

The burden on some professionals might increase since they will be required to provide additional services. The result is that the image and effectiveness of the entire health sector will be affected significantly.

Conclusion

The above discussion has presented a contentious issue that continues to attract the attention of many stakeholders in the healthcare sector, such as patients, policymakers, nurses, physicians, and clinicians. The selected case study article has offered powerful arguments to explain why medical professionals should not be willing to claim to the accommodation of their conscientious objections. Although some scholars and researchers have managed to present their divergent views, the best action plan is for all stakeholders to collaborate and consider the existing guidelines by the professional code of practice.

Through the application of the above ethical theories, stakeholders can strike a balance and focus on the best actions that are capable of maximizing the health outcomes and experiences of the targeted patients. Such an initiative will transform the entire health sector and make all professionals competent providers of high-quality medical services.

Bibliography

Barrow, Robin. Utilitarianism: A Contemporary Statement. 2nd ed. New York: Routledge, 2015.

Cholbi, Michael. Understanding Kant’s Ethics. Cambridge: Cambridge University Press, 2016.

Earp, Brian D. “Conscientious Objection Accommodation in Healthcare – Clashing Perspectives. Journal of Medical Ethics (weblog) 2017. Web.

Odell, Jere, Rahul Abhyankar, Amber Malcolm, and Avril Rua. “Conscientious Objection in the Healing Professions – A Readers’ Guide to the Ethical and Social Issues.ScholarWorks, 2014. Web.

Savulescu, Julian. “Conscientious Objection in Medicine.” BMJ 332, no. 1 (2006): 294-297.

Schuklenk, Udo, and Ricardo Smalling. “Why Medical Professionals have no Moral Claim to Conscientious Objection Accommodation in Liberal Democracies.” Journal of Medical Ethics 43, no. 1 (2018): 234-240.

Footnotes

  1. Udo Schuklenk and Ricardo Smalling, “Why Medical Professionals have no Moral Claim to Conscientious Objection Accommodation in Liberal Democracies,” Journal of Medical Ethics 43, no. 1 (2018): 234.
  2. Schuklenk and Smalling, “Why Medical Professionals”, 234.
  3. Robin Barrow, Utilitarianism: A Contemporary Statement, 2nd ed. (New York: Routledge, 2015), 21.
  4. Schuklenk and Smalling, “Why Medical Professionals”, 238.
  5. Ibid., 238.
  6. Ibid., 239.
  7. Ibid., 240.
  8. Brian D. Earp, “Conscientious Objection Accommodation in Healthcare – Clashing Perspectives,” Journal of Medical Ethics (weblog), 2017. Web.
  9. Barrow, Utilitarianism, 28.
  10. Julian Savulescu, “Conscientious Objection in Medicine,” BMJ 332, no. 1 (2006): 295.
  11. Savulescu, “Conscientious Objection”, 296.
  12. Ibid., 296.
  13. Ibid., 296.
  14. Ibid., 297.
  15. Ibid., 297.
  16. Jere Odell, et al., “Conscientious Objection in the Healing Professions – A Readers’ Guide to the Ethical and Social Issues,” ScholarWorks, 2014. Web.
  17. Schuklenk and Smalling, “Why Medical Professionals”, 240.
  18. Ibid., 240.
  19. Michael Cholbi, Understanding Kant’s Ethics (Cambridge: Cambridge University Press, 2016), 14.