Charles Sturt University
Charles Sturt University

Conscience and Conscientious Objection in Health Care

An ARC Discovery Project, running from January 2015 to June 2018

Summary of project

Conscientious objection is a central topic in bioethics and is becoming more ever important. This is hardly surprising if we consider the liberal trend in developments of policies about abortion and other bio-ethical issues worldwide. In recent decades the right to abortion has been granted by many countries, and increasingly many conservative and/or religious doctors are being asked to perform an activity that clashes with their deepest moral and/or religious values. Debates about conscientious objection are set to become more intense given the increase in medical options which are becoming available or may well be available soon (e.g. embryonic stem cell therapies, genetic selection, human bio-enhancement, sex modification), and given the increasingly multicultural and multi-faith character of Australian society. Not only will doctors conscientiously object to abortion, and to practices commonly acknowledged as morally controversial, but some of them may also object to a wide range of new and even established practices that conflict with their personal values for example, Muslim doctors refusing to examine patients of the opposite sex.

Defining conscientious objection and identifying reliable markers for it, as well as setting the boundaries of legitimate conscientious objection through clear and justifiable principles, are difficult but pressing tasks.

This project advances bio-ethical debate by producing a philosophically and psychologically informed analysis of conscience, and by applying this to discussions about the legitimate limits to conscientious objection in health care.

Personnel

Chief Investigator Dr Steve Clarke, Charles Sturt University

Chief Investigator Prof. Jeanette Kennett, Macquarie University

Partner Investigator Prof. Julian Savulescu, University of Oxford

Project relevant publications

  • McConnell, D. and Card R. (forthcoming). Public reason in justifications of conscientious objection in health care. Bioethics.
  • McConnell, D. (forthcoming). Conscientious objection in healthcare: Pinning down the Reasonability View. Journal of Medicine and Philosophy.
  • Giubilini, A. (2019). The Ethics of Vaccination. London Palgrave.
  • Clarke, S (2019). ‘Extremism: Operation Rescue, the Army of God and the Nashville Declaration of Conscience’, in Ethics and the Contemporary World, edited by David Edmonds (London: Routledge).
  • McConnell, D. (2019). Conscientious Objection in Healthcare: How Much Discretionary Space Best Supports Good Medicine? Bioethics 33 (1), 154-161.
  • Savulescu, J. (2018). Should Pharmacists of Tomorrow be able to conscientiously object to medicines supply based on personal beliefs? Canadian Journal of Hospital Pharmacy 71 (2) 149-151.
  • Savulescu J, Schuklenk U. (2018). Conscientious Objection and Compromising the Patient: Response to Hughes. Bioethics, 32 (7) 473-476.
  • Bambery, B., Douglas, T., Selgelid, M. J., Maslen, H., Giubilini, A., Pollard, A. J. and Savulescu, J. (2018). Influenza Vaccination Strategies Should Target Children, Public Health Ethics, 11 (2) 221-233.
  • Giubilini A. Douglas, T. and Savulescu, J. (2017). Liberty, Fairness and the ‘Contribution Model’ for Non-medical Vaccine Exemption Policies: A Reply to Navin and Largent. Public Health Ethics 10 (3), 235-240.
  • Clarke, S., Giubilini, A. and Walker, M. (2017). Conscientious Objection to Vaccination. Bioethics. 31 (3) pp. 155.161.
  • Clarke, S. (2017). ‘Conscientious Objection in Healthcare: New Directions’. Editorial for Special Issue on Conscientious Objections, Journal of Medical Ethics, 43 (4), p. 191.
  • Clarke, S. (2017). Conscientious Objection in Healthcare, Referral and the Military Analogy. Journal of Medical Ethics, 43 (4), pp. 218-221.
  • Giubilini, A. (2017). Objection to conscience. An argument against conscience exemptions in healthcare, Bioethics, 31 (5), 400-408.
  • Kennett, J. (2017). The Cost of Conscience: Kant on Conscience and Conscientious Objection. Cambridge Quarterly of Healthcare Ethics, 26 (1), pp. 69-81.
  • Clarke, S. (2017). Two Concepts of Conscience and their Implications for Conscience-based Refusal in Healthcare. Cambridge Quarterly of Healthcare Ethics, 26 (1), pp. 97-108.
  • Giubilini, A. and Savulescu, J. (2017). Guest editorial: conscientious objection in healthcare; problems and perspectives, Cambridge Quarterly of Healthcare Ethics, 26, 1: pp. 3-5
  • Savulescu, J., and Schuklenk, U. (2016). Doctors Have No Right to Refuse Medical Assistance in Dying, Abortion or Contraception. Bioethics http://onlinelibrary.wiley.com/doi/10.1111/bioe.12288/full
  • Giubilini, A., Milnes, S., and Savulescu, J. (2016). The Medical Ethics Curriculum in Medical Schools: Present and Future, Journal of Clinical Ethics, 27 (2) 129-146.
  • Giubilini, A. (2016). Conscientious objection and medical tribunals, Journal of Medical Ethics, 42: 78-79
  • Giubilini, A. (2016). Conscience, Stanford Encyclopedia of Philosophy, (Spring 2016 Edition), Edward N. Zalta (ed.), http://plato.stanford.edu/archives/spr2016/entries/conscience/
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Edited Collection

  • Clarke, S (ed.) Journal of Medical Ethics: Special Issue on Conscientious Objections, 43, (4), 2017.
  • Giubilini, A. and J. Savulescu (eds.), Cambridge Quarterly of Healthcare Ethics: Special issue on conscientious objection in healthcare 26 (1) 2017.

Conferences and Workshops

  • Conference: "The Role of Conscience and Conscientious Objection in Health Care". Sydney, 11-12 September 2017.
  • Workshop on ‘Conscience and Conscientious Objection’. CAPPE, Charles Sturt University, 2 September 2016.
  • Workshop: The Conscience of Health Professionals in the Time of Biotechnologies: Present and Future of Conscientious Objection in Medicine, Brocher Foundation, Hermance, Switzerland, 7-9 June 2016.
  • "Conscience and Conscientious Objection in Health Care". Oxford, 23-24 November 2015. The proceedings of which were published in a special issue of the Cambridge Quarterly of Healthcare Ethics.

Media Output

  • Savulescu, J. (2019). 30 May. Moral Maze on Religion’s Role in Society/ Conscientious Objection. BBC Radio 4.
  • Giubilini, A. (2019). 5 March. The Ethics of Vaccination. Video Interview with Katrien Devolder: http://blog.practicalethics.ox.ac.uk/2019/03/video-interview-alberto-giubilini-on-the-ethics-of-vaccination/
  • McConnell, D (2017) Podcast and Article: 'Picking apart conscientious objection in healthcare'. Nursing Review, September 8.
  • Clarke, S (2017). Podcast and Article: 'No Jab? Make an Appropriate Contribution to Society Instead: Paper. Nursing Review, February 8.
  • Clarke, S (2017). Podcast: 'Exploring vaccination objectors' ethical obligations to the community', Campus Review. February 7.
  • Clarke, S (2017). Radio interview : 'No Jab, No Pay' 6PR Mornings (Perth, Western Australia). February 7.
  • Clarke, S (2017). 'Call to Penalise Jab Objectors', The Western Australian (Perth, Western Australia). February 7.
  • Clarke, S (2017). Radio interview on Conscientious Objection to Vaccination. 'Deek', B-Rock (Bathurst, New South Wales), Interview on conscientious objection to vaccination, February 6.
  • Savulescu, J. (2016). Families shouldn't be allowed to veto organ donation. The Conversation. With William Isdale. January 5. https://theconversation.com/families-shouldnt-be-allowed-to-veto-organ-donation-51183.
  • Savulescu J. (2016). Bioethicist calls for a ban on doctors' conscientious objection appeared in over 100 print media sources throughout Australia.
  • Savulescu, J. (2016). Should Doctors Have the Right to Conscientiously Object? Health Report. ABC Radio National and podcast on ABC Online, August 29 http://www.abc.net.au/radionational/programs/healthreport/doctors-have-no-right-to-conscientious-objection/7794080

Media Responses to the Project

  • September 2016. ‘When the Prescription is a Lynching. James Franklin in Quadrant: https://quadrant.org.au/opinion/qed/2016/09/prescription-lynching/
  • September 2016. The Ethics of Conscientious Objection in Healthcare. ABC Religion and Ethics responds to article by Julian Savulescu.
  • September 2016. Marni Soupcoff: Doctors needed. Leave your conscience at home. National Post.
  • September 2016. Leading bioethics editors attack conscientious objection. Bioedge.
  • September 2016. Bioethicists Say Doctors Should be Forced to Do Abortions and If They Quit, "So Be It". LifeNews.com
  • September 2016. Pro-life activists oppose ‘ridiculous’ proposal from bioethicists to force doctors to kill babies. Christian News
  • August 2016, 'Bioethicist calls for a ban on doctors' conscientious objection' appeared in over 100 print media sources throughout Australia.

Government Consultation

  • Conscientious Objection The Role of Professional Conscience in Controversial Practice: Designer Babies, Abortion, and Euthanasia. 4 May 2017. Presentation to Attorney General Department Talking Heads Series, Canberra, Australia.
  • Julian Savulescu's work on conscientious objection was cited in a July 2016 United Kingdom All-Party Parliamentary Group report on "Freedom of Conscience in Abortion Provision"
  • Simplifying medical treatment decision-making and advance care planning, Victoria, Australia. July 2016 (Conscientious Objection) Co-authored submission with Lindy Willmott, Ben White, Julian Savulescu.

Public Lectures

  • Savulescu, J. 26 November 2016. Public Lecture: Responsibility, Conscientious Objection and Healthcare. Jean-Jacques Rousseau Annual Conference. Keele University
  • Savulescu, J. 30 August 2016. Public Lecture: Conscientious Objection and Value Pluralism in Medicine. QUT, Brisbane.
  • Savulescu, J.  6 December 2016. Late Termination of Pregnancy. Royal Women's Hospital and Monash Women's Joint Termination Review Panel Meeting. Advice on Ethics., Melbourne, Australia
  • Savulescu, J. 4 December 2016. End of Life issues. Monash Bioethics Retreat, Melbourne
  • Savulescu, J. 2 September 2016. Doctors Have No Right to Refuse Medical Assistance in Dying, Abortion or Contraception. Conscience and Conscientious Objection Workshop, Canberra, Australia
  • Savulescu, J. 7 June 2016. Conscientious Objection, Brocher Foundation, Switzerland.
  • Savulescu, J. 23 November 2015. Conscience, Values, and a Reasonable Range of Options. Conscience and Conscientious Objection in Healthcare. Oxford

Blog Posts

11 October 2018: Giubilini, A and Savulescu, J. http://blog.practicalethics.ox.ac.uk/2018/10/against-conscientious-objection-in-health-care-a-counterdeclaration-and-reply-to-oderberg/

29 August 2016: Consensus Statement on Conscientious Objection . Practical Ethics in the News. http://blog.practicalethics.ox.ac.uk/2016/08/consensus-statement-on-conscientious-objection-in-healthcare/


Julian Savulescu's Conscientious Objection Talks and Media Visits

Public Lecture

30 August 2016. Public Lecture: Conscientious Objection and Value Pluralism in Medicine. QUT, Brisbane.

More information: https://www.qut.edu.au/law/about/news-events/news?news-id=107337

Radio

29 August 2016. Should Doctors Have the Right to Conscientiously Object? Health Report. ABC Radio National and podcast on ABC Online.

More information: http://www.abc.net.au/radionational/programs/healthreport/doctors-have-no-right-to-conscientious-objection/7794080

Print Media

Bioethicist calls for a ban on doctors' conscientious objection appeared in over 100 print media sources throughout Australia.

Blogs

29 August 2016. Consensus Statement on Conscientious Objection . Practical Ethics in the News.

More information: http://blog.practicalethics.ox.ac.uk/2016/08/consensus-statement-on-conscientious-objection-in-healthcare/