Abstract
Discussions of conscientious objection (CO) in healthcare often concentrate on objections to interventions that relate to reproduction, such as termination of pregnancy or contraception. Nevertheless, questions of conscience can arise in other areas of medicine. For example, the intensive care unit is a locus of ethically complex and contested decisions. Ethical debate about CO usually concentrates on the issue of whether physicians should be permitted to object to particular courses of treatment; whether CO should be accommodated. In this article, I focus on the question of how clinicians ought to act: should they provide or support a course of action that is contrary to their deeply held moral beliefs? I discuss two secular examples of potential CO in intensive care, and propose that clinicians should adopt a norm of conscientious non-objection (CNO). In the face of divergent values and practice, physicians should set aside their personal moral beliefs and not object to treatment that is legally and professionally accepted and provided by their peers. Although there may be reason to permit conscientious objections in healthcare, conscientious non-objection should be encouraged, taught, and supported.
Highlights
Discussions of conscientious objection (CO) in healthcare often concentrate on objections to interventions that relate to reproduction, such as termination of pregnancy or contraception
When we make a moral judgment that a particular course of action would be right, we should take into account the possibility of error.[36]
I noted at the start of this article that one consequence of the difficult decisions encountered in intensive care is the high rate of moral distress
Summary
Controversial Nonprovision of Treatment: CO to Premature Limitation of Treatment/Palliative Care. There are a number of reasons why institutions should potentially be prepared to accommodate objections to perceived futile treatment or to premature limitation of treatment.[28] The ATS statement suggests that this would protect clinicians’ autonomy and moral integrity, and could improve quality of care.[29] I accept that accommodation may be necessary. In cases such as the ones described, I argue that the individual clinician should in conscience support the family’s and patient’s request, notwithstanding their qualms. Why should clinicians act contrary to their moral beliefs? Here () are three potential reasons
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