Abstract
Robert Card’s “Reasonability View” is a significant contribution to the debate over the place of conscientious objection in health care. In his view, conscientious objections can only be accommodated if the grounds for the objection meet a reasonability standard. I identify inconsistencies in Card’s description of the reasonability standard and argue that each version he specifies is unsatisfactory. The criteria for reasonability that Card sets out most frequently have no clear underpinning principle and are too permissive of immoral objections. Card has also claimed that petitioners must justify their positions with Rawlsian public reason. I argue that, although the resulting reasonability standard is principled, it is overly restrictive. I also show that a reasonability standard built on Rawls’ more lenient conception of reasonableness would be overly permissive of objections at odds with professional healthcare standards. Finally, I argue for my favored solution, which bases the reasonability standard on minimal professional standards.
Highlights
Robert Card’s recently developed “Reasonability View” (2014, 2017a, 2017b) is a significant contribution to the debate over the place of conscientious objection in health care
Doug McConnell grant conscientious objector status if they judge that the grounds of the objection meet a reasonability standard (Card, 2014, 321; 2017a, 224)
The Reasonability View represents a moderate position that promises to uphold the standards of public health care by preventing unreasonable objections and protect the consciences of healthcare professionals (HCPs) by accommodating objections based on sufficiently good reasons
Summary
Robert Card’s recently developed “Reasonability View” (2014, 2017a, 2017b) is a significant contribution to the debate over the place of conscientious objection in health care. The Reasonability View represents a moderate position that promises to uphold the standards of public health care by preventing unreasonable objections and protect the consciences of HCPs by accommodating objections based on sufficiently good reasons. In a first attempt to rescue Card’s view, I develop a more attainable reasonability standard built on Rawls’ principle of reasonableness This reasonability standard places such a high value on pluralism that it is overly permissive of objections grounded in beliefs that are at odds with healthcare values. My second attempt to rescue Card’s view responds to this problem by basing the reasonability standard on Alida Liberman’s (2017) concept of minimally decent health care On this version of the Reasonability View, conscientious objections grounded in beliefs that are inconsistent with being a minimally decent HCP are unreasonable and should not be accommodated
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