Recently, debate over whether health care providers should have a protected right to conscientiously refuse to offer legal health care services—such as abortion, elective sterilization, aid in dying, or treatments for transgender patients—has grown exponentially. I advance a modified compromise view that bases respect for claims of conscientious refusal to provide specific health care services on a publicly defensible rationale. This view requires health care providers who refuse such services to disclose their availability by other providers, as well as to (...) arrange for referrals or facilitate transfers of care. This requirement raises the question of whether providers are being forced to be complicit in the provision of services they deem to be morally objectionable. I conclude by showing how this modified compromise view answers the most significant objections mounted by critics of the right to conscientious refusal and safeguards providers from having to offer services that most directly threaten their moral integrity. (shrink)

In his ‘When conscientious objection runs amok: A physician refusing human immunodeficiency virus preventative to a bisexual patient’, Brummett has argued that Catholic physicians should not be able to raise conscientious objections to HIV pre-exposure prophylaxis for bisexual patients, as this constitutes discrimination. Brummett argues that such a conscientious objection represents an instance of conscience creep, which he argues is undesirable. Here I re-analyse the case presented by Brummett using a teleological framework and making reference to Catholic teaching on cooperation (...) with evil. While I agree with Brummett that in this case the physician should not have had the right to conscientiously object, I argue that the teleological framework offers advantages over the argument Brummett has presented. I also comment on why only considering empirically measurable harm as a publicly defensible reason for one to hold a conscientious objection is problematic, as well as on the difficulties associated with cases of discrimination in a pluralistic society. (shrink)

In this paper, I confront Engelhardt’s views—conceptualized as a cohesive moral perspective grounded in a combination of secular and Christian moral requirements—on two fronts. First, I critique his view of the moral demands of justice within a secular pluralistic society by showing how Thomistic natural law theory provides a content-full theory of human flourishing that is rationally articulable and defensible as a canonical vision of the good, even if it is not universally recognized as such. Second, I defend the principles (...) of Roman Catholic social teaching (RCST) against Engelhardt’s objection that it constitutes a watered-down version of the Christian moral vision which opens the door to intolerable moral compromises. While I acknowledge that Engelhardt’s criticism of RCST is well-grounded in certain abusive compromises that have been made by some Catholic healthcare institutions, I contend that such abuses are not endemic to RCST and avoidance of them is practically feasible in contemporary secular pluralistic societies. My primary aim is to show how continued dialogue between Engelhardtian libertarians and more communitarian-inclined RCST proponents may constructively yield a vision of healthcare allocation that ensures succor for the least advantaged within an authentically Christian social ethic. (shrink)

Commentary on re-opening dialogue between theological and secular voices in bioethics.

The target article by Kyle Fritz draws attention to the asymmetry debate, an under-analyzed issue within the broader debate over the proper role of physician conscience in healthcare. The as...