Wrongness, Responsibility, and Conscientious Refusals in Health Care.

Area of Science:

• Bioethics
• Medical Ethics
• Philosophy of Law

Background:

• Conscientious refusals in healthcare settings raise complex ethical and legal questions.
• Defining the scope and limits of moral claims that can ground such refusals is crucial for patient care and professional integrity.

Purpose of the Study:

• To determine the appropriate criteria for claims that justify conscientious refusals by healthcare professionals (HCPs).
• To investigate the permissible subjective assessments of moral responsibility and wrongness for HCPs.

Main Methods:

• Philosophical analysis of moral responsibility and normative ethics.
• Examination of legal precedents, specifically Zubik v. Burwell.
• Development of a framework for constraining subjective moral assessments.

Main Results:

• HCPs should be permitted to form subjective conclusions about moral wrongness and responsibility.
• These subjective assessments are constrained by the need to avoid empirical falsehoods, discriminatory attitudes, and unreasonable beliefs.
• Constraints stem from basic epistemic, relational, and normative competencies required of HCPs.

Conclusions:

• A framework is proposed for evaluating the validity of conscientious refusal claims.
• The framework suggests that the objection in Zubik v. Burwell was not of the appropriate kind to ground a conscientious refusal.