Conscience-based refusal of patient care in medicine: a consequentialist analysis

Area of Science:

• Bioethics
• Medical Professionalism
• Healthcare Policy

Background:

• Conscience-based refusals by healthcare professionals pose ethical challenges.
• Existing ethical arguments for accommodating refusals are critically examined.
• The monopoly of healthcare professionals on service provision exacerbates the issue.

Purpose of the Study:

• To review and critique ethical arguments supporting conscientious refuser accommodation.
• To evaluate proposed compromise solutions, including effective referral policies.
• To analyze the impact of conscientious refusal accommodation claims on reproductive health progress.

Main Methods:

• Ethical analysis of arguments for conscientious objection.
• Review of existing policies on conscientious refusal accommodation and effective referrals.
• Examination of consequentialist and professionalism-based ethical frameworks.

Main Results:

• Standard ethical arguments for accommodation are found wanting.
• Compromise solutions, such as mandatory referrals, are deemed unworkable.
• Accommodation policies create a 'healthcare lottery,' undermining medical professionalism.
• Transnational efforts to undermine reproductive health via these claims are highlighted.

Conclusions:

• Accommodation of conscientious refusers is ethically indefensible.
• Such accommodation conflicts with fundamental values of medical professionalism.
• Consequentialist ethical grounds also render accommodation indefensible.