This paper follows on from a brief debate about the role of conscientious objection in healthcare, where the issue arose as to whether conscientious objection is (or can) be a tool of resistance against systemic injustice. The paper contributes to this debate by highlighting that some authors generally opposed to conscientious objection in healthcare have shown some support to this idea. Perhaps if there is one area in which all can agree, it is that in healthcare conscientious objection should be allowed so as to prevent cases of systemic injustice.
RabinowitzJL.Go with the flow or fight the power? The interactive effects of social dominance orientation and perceived injustice on support for the status quo. Political Psychol1999;
20: 1–14.
6.
LevinsonM.Moral injury and the ethics of educational injustice. Harvard Educ Rev2015;
85: 203–228.
7.
Human Rights Watch. Systemic Injustice: Torture, ‘Disappearance,’ and Extrajudicial Execution in Mexico.
New York:
Human Rights Watch, 1999.
8.
BrandtAM.Racism and research: the case of the Tuskegee syphilis study. Hastings Cent Rep1978;
8: 21.
9.
ParentSShevellM. The ‘first to perish’: child euthanasia in the third Reich. Arch Pediatr Adolesc Med 1998; 152: 79–86.
Plato. The Republic. Amazon Classics Kindle.
Amazon, 2017.
19.
ZinnH.The Zinn Reader: Writings on Disobedience and Democracy. 2nd ed.
New York:
Seven Stories Press, 2009.
20.
GambleNKPruskiM.Medical acts and conscientious objection: what can a physician be compelled to do?New Bioeth2019;
25: 262–282.
21.
PruskiM.Professional objections and healthcare: more than a case of conscience. Ethics Med2019;
35: 149–160.
22.
BlackshawBPRodgerD. Questionable benefits and unavoidable personal beliefs: defending conscientious objection for abortion. J Med Ethics. Epub ahead of print 31 August 2019. DOI: 10.1136/medethics-2019-105566.
23.
LongS.The Teleological Grammar of the Moral Act. 2nd ed.Ave Maria, FL:
Sapientia Press, 2015.
MaguireA.Towards a holistic definition of death: the biological, philosophical and social deficiencies of brain stem death criteria. New Bioeth2019;
25: 172–184.
33.
EberlJT.Thomistic Principles and Bioethics. 1st ed (Kindle).
New York:
Routledge, 2006.
34.
SingerP.The challenge of brain death for the sanctity of life ethic. Ethics Bioethics2018;
8: 153–165.
35.
GillettG.Consciousness, the brain and what matters. Bioethics1990;
4: 181–198.
36.
McMahanJ.The Ethics of Killing: Problems at the Margins of Life.
New York:
OUP, 2003.
37.
This is not far from Socrates’ suggestion in Plato’s18Republic that only those capable of swift and full recovery be treated, for of what use they be otherwise to themselves or the state? Here their organs would at least be of such use.
38.
Interestingly, Scott highlights that organ retrieval from anencephalic infants in the early days of transplantation was made easy due to societal attitudes towards this group exemplified by phrases such as ‘anencephalic monsters’.49
39.
Despite the still fierce philosophical debate about the definition of death and the epistemic uncertainty surrounding its assessment.34 It is not the intention here to argue against any specific definition of death, but to highlight the judgements we make when we accept any definition of death.
40.
WeinstockD.Conscientious refusal and health professionals: does religion make a difference?Bioethics2014;
28: 8–15.
41.
FialaCArthurJH.There is no defence for ‘conscientious objection’ in reproductive health care. Eur J Obstet Gynecol Reprod Biol2017;
216: 254–258.
42.
SavulescuJSchuklenkU.Doctors have no right to refuse medical assistance in dying, abortion or contraception. Bioethics2017;
31: 162–170.
43.
BeauchampTLChildressJF.Principles of Biomedical Ethics. 7th ed.
New York:
OUP USA, 2013.
44.
This description would not be accurate if the woman was forced to have the abortion by e.g. her relatives. But the parallel of power and disenfranchisement would still hold.