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An Expressivist Defence of Conscientious Objection in Physician-Assisted Dying
1Centre for Bioethics, The Chinese University of Hong Kong, 6/F, Wong Foo Yuan Building, Hong Kong, China. weianzhong@cuhk.edu.hk.
Abstract:
This paper examines the "expressivist objection" to physician-assisted dying (PAD) laws, which argues that limiting eligibility to terminal or incurable conditions expresses a discriminatory message devaluing such patients' lives. It critiques three common responses-abolishing PAD, removing medical criteria, and consequentialist justification-as inadequate. Instead, the author proposes that legally protecting healthcare professionals' conscientious objection can counterbalance this expressive harm. By accommodating conscientious objectors, the legal system actively affirms that the lives of incurably or terminally ill patients remain worthy of respect and preservation. This expressivist rationale grounds conscientious objection as a legal right rather than a mere permission, offering a key mechanism to address the moral residue generated by PAD legislation. Furthermore, this expressivist rationale addresses concerns about the reasonableness, genuineness, and professional ethics of conscientious objection. Finally, the paper provides a principled defence of conscience protections that preserves value pluralism without undermining access to PAD or abandoning the clinical foundations of PAD.
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