Some bioethicists argue that conscientious objectors in health care should have to justify themselves, just as objectors in the military do. They should have to provide reasons that explain why they should be exempt from offering the services that they find offensive. There are two versions of this view in the literature, each giving different standards of justification. We show these views are each either too permissive (i.e. would result in problematic exemptions based on conscience) or too restrictive (i.e. (...) would produce problematic denials of exemption). We then develop a middle ground position that we believe better combines respect for the conscience of healthcare professionals with concern for the duties that they owe to patients. Our claim, in short, is that insofar as objectors should have to justify themselves, they should have to do it according to the standard that we defend rather than according to the standards that others have developed. (shrink)

Lawrence Nelson (2018) criticizes conscientious objection (CO) to abortion statutes as far as they permit health care providers to escape criminal liability for what would otherwise be the legally wrongful taking of a pregnant woman’s life by refusing treatment (i.e. abortion). His key argument refers to the U.S. Supreme Court judgment (Roe v. Wade 1973) that does not treat the unborn as constitutional persons under the Fourteenth Amendment. Therefore, Nelson claims that within the U.S. legal system any vital interests (...) of pregnant women must always take precedence over fetuses’ interests. While agreeing with the main thesis of the article, we believe that the author’s argument neither vindicates his claim, nor explains why those who believe that fetuses are equally protectable human beings do not have the right to refuse to perform an abortion in lifethreatening emergency circumstances (AE). Therefore, the main aim of our commentary is to outline, by referring to our earlier works on conscientious objection in health care (Z_ uradzki 2016) and cultural exemptions (Ciszewski 2016), a better and universalizable argumentative path that would lead to the same conclusion. (shrink)

Religion is often singled out for special legal treatment in Western societies - which raises an important question: what, if anything, is special about religious conscience beliefs that warrants such special legal treatment? In this paper, I will offer an answer to this specialness question by investigating the relationship between religious conscientious objections and their insulation from relevant evidence. I will begin my analysis by looking at Brian Leiter’s arguments that religious beliefs are insulated from evidence and not worthy (...) of special legal treatment as a result. I will argue that he fails to show that religious conscience beliefs are both in principle responsive to empirical evidence and in practice typically more insulated from this evidence than secular conscience beliefs. If I am right about this, then Leiter fails to answer the “central puzzle” of his recent book and fails to sufficiently distinguish the religious conscience from the secular conscience. Second, I will look at whether or not it is plausible to understand the religious conscience as insulated from other forms of evidence. Following the research of social-psychologist Jonathan Haidt, I will argue that, typically, both forms of conscience seem to be similarly insulated from moral argumentation. I will also show that, while it seems as though the religious conscience usually draws from a larger set of moral values when compared to the secular conscience, this should make no legal difference overall. To conclude, I will explain that the arguments in this paper can be understood as evidence in support of an egalitarian response to religion’s specialness. (shrink)

A number of health care professionals assert a right to be exempt from performing some actions currently designated as part of their standard professional responsibilities. Most advocates claim that they should be excused from these duties simply by averring that they are conscientiously opposed to performing them. They believe that they need not explain or justify their decisions to anyone; nor should they suffer any undesirable consequences of such refusal. Those who claim this right err by blurring or conflating three (...) issues about the nature and role of conscience, and its significance in determining what other people should permit them to do (or not do). Many who criticize those asserting an exemption conflate the same questions and blur the same distinctions, if not expressly, by failing to acknowledge that sometimes a morally serious agent should not do what she might otherwise be expected to do. Neither side seems to acknowledge that in some cases both claims are true: a conscientious professional should not do her professional duty AND others need not permit or excuse her refusal. I identify these conflations and specify conditions in which a professional might reasonably refuse to do what she is required to do. Then I identify conditions in which the public should exempt a professional from some of her responsibilities. I argue that professionals should refuse far less often than most advocates do . . . and that they should be even less frequently exempt for that failure. Finally, there are compelling reasons why we could not implement a consistent moral policy giving advocates what they want, likely not even in qualified form. (shrink)

To date, both the United States federal government and twenty-one individual states have passed Religious Freedom Restoration Acts that aim to protect religious persons from having their sincere beliefs substantially burdened by governmental interests. RFRAs accomplish this by offering a three-pronged exemption test for religious objectors that is satisfied only when (1) an objector has a sincere belief that is being substantially burdened; (2) the government has a very good reason (e.g., health or safety) to interfere; and (3) there (...) is a reasonable alternative to serve the compelling interest. Legal balancing tests like those found in RFRA are content neutral insofar as they sideline the belief-content of conscientious objections as irrelevant when determining the permissibility of granting legal accommodations. However, some theorists worry that this legal picture may be backward: perhaps balancing tests should be content non-neutral given the usual features of conscientious objections. For example, Yossi Nehushtan contends that, contrary to their typical codification, religious conscience beliefs seem undeserving of special legal accommodations because they possess uniquely strong empirical and theoretical ties to intolerance. Thus, the illiberally intolerant content of these conscientious objections might actually give the state a reason to refuse to grant legal exemptions. In this paper, I offer a cursory defense of content neutrality with respect to balancing tests like those found in RFRA. To begin, I outline Nehushtan’s argument for content non-neutrality. The cornerstone of his argument is that illiberal intolerance is intolerable such that conscientious objections that are based upon illiberally intolerant values provide the state with strong, normally prevailing reason not to grant an exemption. I argue that, even when the illiberally intolerant content of one’s conscience constitutes a weighty and relevant factor in determining the permissibility of granting a legal exemption, there remain significant problems. It is difficult, for example, to determine which views are illiberally intolerant and difficult to say whether illiberally intolerant views can effectively serve as the principled demarcating line in balancing tests. To conclude, I offer several cursory arguments in favor of adopting content-neutral approaches without necessarily making a comprehensive case. By drawing on the work of Amy Sepinwall, Nadia Sawicki, and Nathan Chapman, I show that content-neutral approaches can help to safeguard robust protections for conscience by permitting atypical exercises of conscience, protect minority thoughts and practices from being coercively supplanted by majoritarian understandings of morality, appropriately maintain the skepticism and humility that we owe each other as compatriots in a pluralistic society, and allow the kind of justifiable civil disobedience that has an important place in political history among other things. (shrink)

In 2019, several US states passed “heartbeat” bills. Should such bills go into effect, they would outlaw abortion once an embryonic heartbeat can be detected, thereby severely limiting an individual’s access to abortion. Many states allow health care professionals to refuse to provide an abortion for reasons of conscience. Yet heartbeat bills do not include a positive conscience clause that would allow health care professionals to provide an abortion for reasons of conscience. I argue that this asymmetry is unjustified. The (...) same criteria that justify protecting conscientious refusals to provide abortion also justify protecting positive conscientious appeals regarding abortion. Thus, if the law provides legal exemptions for health care professionals who, as a matter of conscience, refuse to provide abortions where it is legal, it should also provide exemptions for health care professionals who, as a matter of conscience, feel obligated to provide abortions where it is illegal. (shrink)

The double subjectivity of conscience and the need to test conscientious objections -/- Abstract In spite of the collapse of the traditional objective concept of conscience and the subsequent subjectivation of conscience, conscientious objections are still often considered as a valid ground for exemption from legal and professional obligations. Conscientious objections are seen as more serious than ordinary moral objections. It is not evident why this is so. I argue, with Niklas Luhmann, that the function of (...) conscience is to protect the moral core of a person’s identity. Overruling conscientious objections threatens this core. Claims of conscience are usually founded on the right of freedom of conscience. This right is not absolute. I discuss the view of Richard Arneson who rejects the right of freedom of conscience and defends the right against conscience. I agree with Arneson that, at the one hand, conscientious objectors may constitute a threat to the social and legal order when their objections are not recognised and, at the other hand, too easy giving in to conscientious objections may also threaten the viability of social and legal order. That is why it is needed to determine when conscientious objections cannot be taken at face value, but should be subjected to a series of tests. The aim of these tests is to contain the number of objectors. I discuss 6 criteria for determining whether conscientious objections ground an exemption to legal and professional obligations. At the end of the article I discuss the conscientious objections of medical doctors. (shrink)

This chapter reviews fundamental ethical controversy surrounding the ongoing effort to revise the Uniform Determination of Death Act in the United States. Instead of focusing on the process of the revision itself, the chapter explores the underlying ethical debate over brain death that has been ongoing for many decades and finally culminated in this revision. Three issues are focused: the requirement for consent and personal exemptions before applying brain death for the diagnosis of death; redefining the areas of the brain (...) that have ceased to function in the definition of brain death; and codifying the American Academy of Neurology as the authority to issue the standards of the diagnosis of brain death. The chapter concludes that allowing the personal choice of death determination gives a pragmatic compromise to the disputed definition and practice of diagnosing brain death. So long as all risks and imperfections of the diagnosis are accepted through the consenting process, there is nothing ethically objectionable to continuing the current practice of diagnosing brain death as a successful tool to facilitate heart-beating organ donation without violating the dead-donor rule. By contrast, precluding personal choice and imposing legal restrictions to consent and exemptions would further erode public trust. (shrink)

This paper examines how stances and understandings pertaining to whether home education is civically legitimate within liberal democratic contexts can depend on how one conceives normative roles of the secular state and the religious neutrality that is commonly associated with it. For the purposes of this paper, home education is understood as a manifestation of an educational philosophy ideologically based on a given conception of the good. -/- Two polar conceptions of secularism, republican and liberal-pluralist, are explored. Republican secularists declare (...) that religious expressions do not belong in the public sphere and justify this exclusion by promoting religious neutrality as an end in itself. But liberal-pluralists claim that religious neutrality is only the means to ensure protection of freedom of conscience and religion, which are moral principles. Each conception is associated with its own stance on whether exemptions or accommodations on account of religious beliefs have special legal standing and thereby warranted. The indeterminate nature of religion and the allegedly biased exclusion of secular beliefs, cited by some when denying religious exemptions, can be overcome by understanding all religious and conscientious beliefs as having equal standing as conceptions of the good. -/- Analysis of court documents from the Uwe Romeike et al asylum case are guided by these understandings, and relationships among themes are explored. -/- In summary, any stance regarding home education may depend on one’s view of secularism, particularly in relation to whether one views religious neutrality as a means to ensure protection of freedom of conscience or an end in itself. (shrink)

The literature on conscientious objection in medicine presents two key problems that remain unresolved: Which conscientious objections in medicine are justified, if it is not feasible for individual medical practitioners to conclusively demonstrate the genuineness or reasonableness of their objections? How does one respect both medical practitioners’ claims of conscience and patients’ interests, without leaving practitioners complicit in perceived or actual wrongdoing? My aim in this paper is to offer a new framework for conscientious objections in medicine, (...) which, by bringing medical professionals’ conscientious objection into the public realm, solves the justification and complicity problems. In particular, I will argue that: an “Uber Conscientious Objection in Medicine Committee” —which includes representatives from the medical community and from other professions, as well as from various religions and from the patient population—should assess various well-known conscientious objections in medicine in terms of public reason and decide which conscientious objections should be permitted, without hearing out individual conscientious objectors; medical practitioners should advertise their conscientious objections, ahead of time, in an online database that would be easily accessible to the public, without being required, in most cases, to refer patients to non-objecting practitioners. (shrink)

In this paper, we argue that providers who conscientiously refuse to provide legal and professionally accepted medical care are not always morally required to refer their patients to willing providers. Indeed, we will argue that refusing to refer is morally admirable in certain instances. In making the case, we show that belief in a sweeping moral duty to refer depends on an implicit assumption that the procedures sanctioned by legal and professional norms are ethically permissible. Focusing on examples of female (...) genital cutting, clitoridectomy and ‘normalizing’ surgery for children with intersex traits, we argue that this assumption is untenable and that providers are not morally required to refer when refusing to perform genuinely unethical procedures. The fact that acceptance of our thesis would force us to face the challenge of distinguishing between ethical and unethical medical practices is a virtue. This is the central task of medical ethics, and we must confront it rather than evade it. There are no data in this work. (shrink)

Conscientious objection in health care is a form of compromise whereby health care practitioners can refuse to take part in safe, legal, and beneficial medical procedures to which they have a moral opposition (for instance abortion). Arguments in defense of conscientious objection in medicine are usually based on the value of respect for the moral integrity of practitioners. I will show that philosophical arguments in defense of conscientious objection based on respect for such moral integrity are extremely (...) weak and, if taken seriously, lead to consequences that we would not (and should not) accept. I then propose that the best philosophical argument that defenders of conscientious objection in medicine can consistently deploy is one that appeals to (some form of) either moral relativism or subjectivism. I suggest that, unless either moral relativism or subjectivism is a valid theory—which is exactly what many defenders of conscientious objection (as well as many others) do not think—the role of moral integrity and conscientious objection in health care should be significantly downplayed and left out of the range of ethically relevant considerations. (shrink)

Some philosophers have argued for what I call the reason-giving requirement for conscientious refusal in reproductive healthcare. According to this requirement, healthcare practitioners who conscientiously object to administering standard forms of treatment must have arguments to back up their conscience, arguments that are purely public in character. I argue that such a requirement, though attractive in some ways, faces an overlooked epistemic problem: it is either too easy or too difficult to satisfy in standard cases. I close by briefly (...) considering whether a version of the reason-giving requirement can be salvaged despite this important difficulty. (shrink)

This is part of a symposium on conscientious objection and religious freedom inspired by the US Catholic Church's claim that being forced to pay for health insurance that covers abortions (the effect of 'Obamacare')is the equivalent of forcing pacifists to fight. This article takes issue with this claim, and shows that while it would be unjust on democratic principles to force pacifists to fight, given their willingness to serve their country in other ways, there is no democratic objection to (...) forcing those who believe abortion to be murder to pay for health insurance coverage that includes abortion. (shrink)

A dogma accepted in many ethical, religious, and legal frameworks is that the reasons behind conscientious objection (CO) in healthcare cannot be evaluated or judged by any institution because conscience is individual and autonomous. This paper shows that this background view is mistaken: the requirement to reveal and explain the reasons for conscientious objection in healthcare is ethically justified and legally desirable. Referring to real healthcare cases and legal regulations, this paper argues that these reasons should be evaluated (...) either ex ante or ex post and defends novel conceptual claims that have not been analyzed in the debates on CO. First, a moral threshold requirement: CO is only justified if the reasons behind a refusal are of a moral nature and meet a certain threshold of moral importance. Second, this paper considers the rarely discussed conceptual similarities between CO in healthcare and the legal regulations concerning military refusals that place the burden of proof on conscientious objectors. This paper concludes that conscientious objection in healthcare can be accommodated only in some cases of destroying or killing human organisms. (shrink)

In her paper, “The cost of conscience: Kant on conscience and conscientious objection,” Jeanette Kennett argues that a Kantian view of conscientious objection in medicine would bar physicians from refusing to perform certain practices based on conscience. I offer a response in the following manner: First, I reconstruct her main argument; second, I present a more accurate picture of Kant’s view of conscience. I conclude that, given a Kantian framework, a physician should be allowed to refuse to perform (...) practices that break the moral law and, thus, refuse practices that violate her conscience. (shrink)

Patients in Quebec can legally obtain medical assistance in dying (MAID) if they are able to give informed consent, have a serious and incurable illness, are at the end of their lives and are in a situation of unbearable suffering. Since the Supreme Court of Canada’s 2015 Carter decision, access to MAID, under certain conditions, has become a constitutional right. Quebec physicians are now likely to receive requests for MAID from their patients. The Quebec and Canadian laws recognize a physician’s (...) right to conscientious objection, but this right is contested both in the medical ethics literature and in the public sphere. This paper presents the results of a qualitative study conducted with twenty Quebec physicians who did not integrate MAID into their medical practice, either because they were opposed to or deeply ambivalent about MAID. The interviews aimed to explore the reasons – religious and secular – for opposition to or ambivalence towards MAID. The secular reasons given by participants were grouped into four main categories: 1) the ends of medicine and professional identity, 2) the philosophy of palliative medicine and resource allocation in palliative care, 3) benevolent paternalism, the “good death”, and the interests of future selves, 4) the risk of a slippery slope and the protection of vulnerable people. (shrink)

Bioethics, Volume 36, Issue 1, Page 63-70, January 2022.

This essay offers a revisionist defense of classical utilitarianism from an infamous objection to it, which is derived from American science fiction writer, Ursula Le Guin’s, short story, “The Ones Who Walk Away from Omelas.” To that effect, the reply takes inspiration from Le Guin and John Stuart Mill in appealing to the natural law theoretical concept of conscience. I argue that a conscientious utilitarian ethic can escape Le Guin’s objection more satisfactorily than other popular utilitarian ethics. Along the (...) way, this essay discusses at length conscience and its place in moral epistemology, both as it occurs in the natural law tradition and in Mill. The natural law account of conscience is defended and Mill’s account is critiqued. Consequently, this paper also provides an interesting synthesis of utilitarianism with natural law ethics. (shrink)

The debate regarding the role of conscientious objection in healthcare has been protracted, with increasing demands for curbs on conscientious objection. There is a growing body of evidence that indicates that in some cases, high rates of conscientious objection can affect access to legal medical services such as abortion—a major concern of critics of conscientious objection. Moreover, few solutions have been put forward that aim to satisfy both this concern and that of defenders of conscientious (...) objection—being expected to participate in the provision of services that compromise their moral integrity. Here we attempt to bring some resolution to the debate by proposing a pragmatic, long-term solution offering what we believe to be an acceptable compromise—a quota system for medical trainees in specialties where a conscientious objection can be exercised, and is known to cause conflict. We envisage two main objectives of the quota system we propose. First, as a means to introduce conscientious objection into countries where this is not presently permitted. Second, to minimise or eliminate the effects of high rates of conscientious objection in countries such as Italy, where access to legal abortion provision can be negatively affected. (shrink)

According to the common view, conscientious objection is grounded in autonomy or in ‘freedom of conscience’ and is tolerated out of respect for the objector's autonomy. Emphasising freedom of conscience or autonomy as a central concept within the issue of conscientious objection implies that the conscientious objector should have an independent choice among alternative beliefs, positions or values. In this paper it is argued that: (a) it is not true that the typical conscientious objector has such (...) a choice when they decide to act upon their conscience and (b) it is not true that the typical conscientious objector exercises autonomy when developing or acquiring their conscience. Therefore, with regard to tolerating conscientious objection, we should apply the concept of autonomy with caution, as tolerating conscientious objection does not reflect respect for the conscientious objector’s right to choose but rather acknowledges their lack of real ability to choose their conscience and to refrain from acting upon their conscience. This has both normative and analytical implications for the treatment of conscientious objectors. (shrink)

In a recent article in this journal, Abram Brummett argues that new and future assisted reproductive technologies will provide challenging ethical questions relating to lesbian, gay, bisexual and transgender (LGBT) persons. Brummett notes that it is likely that some clinicians may wish to conscientiously object to offering assisted reproductive technologies to LGBT couples on moral or religious grounds, and argues that such appeals to conscience should be constrained. We argue that Brummett's case is unsuccessful because he: does not adequately interact (...) with his opponents’ views; equivocates on the meaning of ‘natural’; fails to show that the practice he opposes is eugenic in any non‐trivial sense; and fails to justify and explicate the relevance of the naturalism he proposes. We do not argue that conscience protections should exist for those objecting to providing LGBT people with artificial reproductive technologies, but only show that Brummett's arguments are insufficient to prove that they should not. (shrink)

In current legal and political atmospheres, when governments are embracing notions such as pollution prevention and the three ”R’s” – reduce, reuse and recycle, while discarding command and control types of regulatory enforcement, some may be surprised to learn that since 1971 Pennsylvania law has permitted the exemption of corporate assets from capital stock valuation for the purpose of paying capital stock taxes, if the assets are devoted to pollution control or abatement. Straightforward though the idea of tax (...) class='Hi'>exemption for pollution control assets may seem, the execution of the statutory exemption, together with the regulation which was promulgated thereunder, yields a wide variety of hermeneutic fruit under the scrutiny of the judiciary and the advocacy of lawyers. (shrink)

In this paper I uncover and critically analyze a methodological assumption in the literature on conscientious refusals in health care. The assumption is what I call the “Priority of Conscience Principle,” which says the following: to determine the moral status of any act of conscientious refusal, it is first necessary to determine the nature and value of conscience. I argue that it is not always necessary to discuss conscience in the debate on conscientious refusals, and that discussing (...) conscience is even problematic, since it can lead authors to beg the question. (shrink)

In this article, I address what kinds of claims are of the right kind to ground conscientious refusals. Specifically, I investigate what conceptions of moral responsibility and moral wrongness can be permissibly presumed by conscientious objectors. I argue that we must permit HCPs to come to their own subjective conclusions about what they take to be morally wrong and what they take themselves to be morally responsible for. However, these subjective assessments of wrongness and responsibility must be constrained (...) in several important ways: they cannot involve empirical falsehoods, objectionably discriminatory attitudes, or unreasonable normative beliefs. I argue that the sources of these constraints are the basic epistemic, relational, and normative competencies needed to function as a minimally decent health-care professional. Finally, I consider practical implications for my framework, and argue that it shows us that the objection raised by the plaintiffs in Zubik v. Burwell is of the wrong sort. (shrink)

Conscientious objection in healthcare has come under heavy criticism on two grounds recently, particularly regarding abortion provision. First, critics claim conscientious objection involves a refusal to provide a legal and beneficial procedure requested by a patient, denying them access to healthcare. Second, they argue the exercise of conscientious objection is based on unverifiable personal beliefs. These characteristics, it is claimed, disqualify conscientious objection in healthcare. Here, we defend conscientious objection in the context of abortion provision. (...) We show that abortion has a dubitable claim to be medically beneficial, is rarely clinically indicated, and that conscientious objections should be accepted in these circumstances. We also show that reliance on personal beliefs is difficult to avoid if any form of objection is to be permitted, even if it is based on criteria such as the principles and values of the profession or the scope of professional practice. (shrink)

Answers to the questions of what justifies conscientious objection in medicine in general and which specific objections should be respected have proven to be elusive. In this paper, I develop a new framework for conscientious objection in medicine that is based on the idea that conscience can express true moral claims. I draw on one of the historical roots, found in Adam Smith’s impartial spectator account, of the idea that an agent’s conscience can determine the correct moral norms, (...) even if the agent’s society has endorsed different norms. In particular, I argue that when a medical professional is reasoning from the standpoint of an impartial spectator, his or her claims of conscience are true, or at least approximate moral truth to the greatest degree possible for creatures like us, and should thus be respected. In addition to providing a justification for conscientious objection in medicine by appealing to the potential truth of the objection, the account advances the debate regarding the integrity and toleration justifications for conscientious objection, since the standard of the impartial spectator specifies the boundaries of legitimate appeals to moral integrity and toleration. The impartial spectator also provides a standpoint of shared deliberation and public reasons, from which a conscientious objector can make their case in terms that other people who adopt this standpoint can and should accept, thus offering a standard fitting to liberal democracies. (shrink)

Pamela Hieronymi has authored a very insightful book that focuses on one of the most influential articles in 20th century philosophy: P. F. Strawson’s ‘Freedom and Resentment’ (1962). Hieronymi’s principal objective in Freedom, Resentment, and the Metaphysics of Morals is to reconstruct and evaluate the central argumentative strategy in Strawson’s essay. The author’s aim is ‘to show that it can withstand the objections that are both the most obvious and the most serious, leaving it a worthy contender’ (3). In the (...) present commentary, I summarize the main results of Hieronymi’s analysis. I engage with the book’s main themes, noting in due course certain unclarities and some shortcomings, while emphasizing the many valuable insights it offers. (shrink)

Currently, the preferred accommodation for conscientious objection to abortion in medicine is to allow the objector to refuse to accede to the patient’s request so long as the objector refers the patient to a physician who performs abortions. The referral part of this arrangement is controversial, however. Pro-life advocates claim that referrals make objectors complicit in the performance of acts that they, the objectors, find morally offensive. I argue that the referral requirement is justifiable, although not in the way (...) that people usually assume that it is. (shrink)

Bioethics, Volume 36, Issue 1, Page 54-62, January 2022.

Exemption from blameworthiness is often bound to implicit or explicit claims of diminished agency, or even non-agency. This poses a dilemma in navigating moral relationships affected by mental illness. While it is crucial for assessments of responsibility to be responsive to the significance of mental illness, must this responsiveness come at a cost to symmetrical moral relations? In this paper we argue, contra recent critiques, that Strawsonian accounts of responsibility are able to navigate this dilemma, and can accommodate significant (...) exculpation on the basis of mental illness while maintaining symmetrical relations. We understand this to be part of the larger recognition that while we have certain fundamental entitlements within our moral relationships, it is also possible to be over-entitled, and to expect too much of others. Our account draws, in particular, on the moral significance of difficulty. Difficulty is inherently scalar, and in drawing on this explanatory framework we explicate a theory of both excuse and exemption by degree. We argue for a significant realm of excuse on the basis of mental illness that is fully compatible with symmetrical relations. However, we also acknowledge the limits of this accommodation on Strawsonian grounds, and argue that these limits are justified and appropriate. (shrink)

Conscientious Sociology is an introductory but essential step towards the recognition of paradigmatic contestations and shifts in the post-1970s Social Sciences. It develops an ideal typology of three major paradigms, i.e. the Foundationalist, the Relativist and the Critical-Conscientious Paradigms by discussing and comparing their principles in four Meta-Theoretical domains: Ontology, Epistemology, Methodology, and Axiology. Hosseini, in his book, shows how the Conscientious paradigm deals with well known dilemmas which are not effectively resolved by two other paradigms; dilemmas (...) like how to create an objective account of reality whereas the subjectivities of actors and investigators are accommodated or what relationship must be set up between quantitative and qualitative methods. The book also further discusses the principles that Conscientious sociologist are expected to consider when engaging in empirical research. It finally, provides its readers with a unique perspective adopted from a radical Iranian social thinker, Ali Shariati whose ideas are portrayed as an insightful exemplar for Iranian critical sociologists. The book also contributes to the growing debates around the nature and future of critical sociology in the West by adding a Southern perspective. (shrink)

A model policy for conscientious objection in medicine.

Theorists of democratic multiculturalism have long-defended individuals’ religious exemptions from generally-applicable laws. Examples include Sikhs being exempt from motorcycle helmet laws, or Jews and Muslims being exempt from humane animal slaughter laws. This paper investigates religious exemptions for organisations. Should organisations ever be granted exemptions from generally-applicable laws in democratic societies, where those exemptions are justified by the organisation’s religion? The paper considers four arguments for this, which respectively rely on: the ‘transferring up’ to organisations of individuals’ claims to autonomy (...) or recognition; organisations’ own claims to autonomy or recognition; organisations’ status in the accountability-community; and organisations’ procedural constraints. The paper concludes that only the last argument works—and then, only with caveats. (shrink)

In a recent commentary, Kim and colleagues argued that minimal-risk research should be deregulated so that such studies do not require review by an institutional review board. They claim that regulation of minimal-risk studies provides no adequate counterbalancing good and instead leads to a costly human subjects oversight system. We argue that the counterbalancing good of regulating minimal-risk studies is that oversight exists to ensure that respect for persons and justice requirements are satisfied when they otherwise might not be.

The controversy around the accommodation of conscientious objections in medicine persists, especially for such contentious services as abortions. COs are typically considered in their negativ...

The aim of this paper is to offer a critical assessment of Buridan's proposed solution to the bridge-keeper paradox. First, I will outline his proposed solution to the paradox, and, second, carefully analyse each issue mentioned in the proposed solution. Finally, I will attempt to conclude that Burden has implicitly accepted a three-valued logic that does not allow him to conclude that Plato ought not do anything.

Emergency contraception — also known as the morning after pill — is marketed and sold, under various brand names, in over one hundred countries around the world. In some countries, customers can purchase the drug without a prescription. In others, a prescription must be presented to a licensed pharmacist. In virtually all of these countries, pharmacists are the last link in the chain of delivery. This article examines and ultimately rejects several standard moves in the bioethics literature on the right (...) of pharmacists conscientiously to refuse to dispense emergency contraception. Its central thesis is that the standard ‘moderate’ solution to this problem is mistaken. Thus, when all publicly relevant interests are given their due, it is not acceptable to allow refusals in the big city, where pharmacies are plentiful, but forbid them in rural settings, where pharmacies are scarce. Rather, there should be strong public policy requiring that all pharmacists dispense emergency contraception to customers who request it, regardless of pharmacists' moral or religious objections. (shrink)

Many philosophers and jurists believe that individuals should sometimes be granted religiouslygrounded exemptions from laws or rules. To determine whether an exemption is merited in a particular case, the religious claim must be weighed against the countervailing values that favour the uniform application of the law or rule. This paper develops and applies a framework for assessing the weight of religious claims to exemption, across two dimensions. First, the importance of the burdened religious practice, which is determined by (...) its level of obligatoriness and centrality, according to the beliefs of the individual claimant. Second, the extent of the burden on the practice, which depends on the cost the individual bears if she both undertakes the religious practice and obeys the law or rule, where costs are assessed using an impartial account of individual interests. Exemptions should be granted when claims are weighty on either of these dimensions and the countervailing value is relatively weak. The final section of the paper responds to an important objection to this approach, which concerns administrability. (shrink)

This study argues for the historical existence of Jesus of Nazareth as a radical Jewish pacifist who angered both the orthodox religious establishment and those who advocated violent insurrection against the Romans. The author asserts that Jesus' views were based on belief in a non-retributive, omnibenevolent God, challenging not only the Mosaic Law but assumptions about eternal punishment and the divine sanction of the state and its retributive institutions of war and punishment. The volume also interprets Paul as being the (...) first Christian revisionist. As a result, orthodox Christianity, through the influence of Paul (and thus Augustine, Aquinas, Luther, and Calvin), has mistakenly promoted the "just war" and "divinely ordained state" doctrines in the name of a thinker whose conclusions were in the opposite direction. (shrink)

Building on the theory of humor advanced by Yves Cusset in his recent book Rire: Tractatus philo-comicus, I argue that we can understand the phenomenon in terms of what Jean-Luc Nancy, following Roland Barthes, has called the exemption from sense. I attempt to show how the humorous sensibility, understood in this way, is entirely incompatible with the experience of others as contemptible. I conclude by developing some of the normative implications of this, focusing specifically on the question whether it (...) is ever morally permissible to treat others with contempt. (shrink)

Supporters of neutrality as benign neglect argue that a neutral state should not grant any type of recognition to cultural or religious groups. Liberal multiculturalists argue instead that due to the non-neutral nature of public institutions, democratic states must adopt policies that recognize and accommodate the distinctive needs of ethnocultural groups. This article examines a different way of conceiving the principle of neutrality. In this conception, developed by Alan Patten in the framework of liberal multiculturalism, a state can only be (...) neutral when it extends equivalent levels of assistance/hindrance to rival conceptions of the good. Neutrality is thus reinterpreted to become a principle justifying the religious exemptions. The article highlights some aspects of this theory that should be reconsidered.// -/- Les défenseurs de la neutralité bienveillante soutiennent qu’un État neutre ne doit accorder aucun type de reconnaissance aux groupes culturels ou religieux. Les multiculturalistes libéraux avancent pour leur part que, en raison de la nature non neutre des institutions publiques, les États démocratiques doivent adopter des politiques vi-sant la reconnaissance et l’accommodement des besoins distinctifs des groupes ethnoculturels. Cet article examine une manière diffé-rente de concevoir le principe de neutralité. Dans cette conception, développée par Alan Patten dans le cadre du multiculturalisme libé-ral, un État ne peut être neutre que s’il assiste ou entrave de manière équivalente les différentes conceptions du bien. La neutralité est ainsi réinterprétée pour devenir un principe permettant de justifier les exemptions religieuses. L’article souligne certains aspects de cette théorie qui méritent d’être repensés. (shrink)

Steve Clarke, Nathan Emmerich, Francesca Minerva and Toni Saad have offered nuanced and insightful commentaries on my paper ‘The truth behind conscientious objection in medicine’.1 I cannot, in this brief response, do justice to all of the objections and suggestions that they have raised. I have tried to focus my response on what I take to be my interlocutors’ main concerns with my Smithian account, with the hope that we can continue the conversation elsewhere. Clarke argues that both Smith (...) and I ‘underestimate the difficulties involved in overcoming the distorting influence of “self-love” on moral judgement’ and ‘fail to recognise how easy it is for us to mistake a self-interested view for an impartial one’.2 His thought is that cognitive bias and ideological commitments will prevent many of us from identifying the standpoint of the impartial spectator and from realising that we are not impartial.1 I agree that successfully adopting the standpoint of the impartial spectator is not an easy task. However, moral reasoning more generally is difficult and susceptible to bias. This does not mean that we should cease such reasoning; rather, we ought to do our best, and we are, at times, successful. Clarke discusses the entrenched attitudes of Antebellum white racists. However, attitudes about slavery have changed, and cognitive biases can change too. In other words, moral progress is possible. Moreover, as I argue in the paper, one of the advantages of the impartial-spectator approach is that it ‘provides a standpoint from which shared deliberation is possible and public reasons are available’.1 Thus, we can appreciate, with relative ease, whether an objector is reasoning from this standpoint. Clarke further argues that we should entertain the idea of employing ‘experts who are trained to overcome cognitive bias and to set aside ideological commitments’ and …. (shrink)

In a recent paper published in this journal, Giubilini, Douglas and Savulescu argue that we have given insufficient weight to the moral importance of fairness in our account of the best policies for non-medical exemptions to childhood immunization requirements. They advocate for a type of policy they call Contribution, according to which parents must contribute to important public health goods before their children can receive NMEs to immunization requirements. In this response, we argue that Giubilini, Douglas and Savulescu give insufficient (...) weight to the moral importance parental liberty in ways that count against their preferred type of NMEs policy and threaten public support for mandatory vaccination laws and public health initiatives generally. (shrink)

According to a popular line of thought, being excluded from interpersonal life is to be exempted from accountability, and vice versa. In ordinary life, this is most often illustrated by the treatment of people with serious psychological disorders. When people are excluded from valuable domains on the basis of their arbitrary characteristics (such as race and sex), they are discriminated against, prevented from receiving the benefits of participation in those domains for morally irrelevant reasons. Exemption from accountability—via exclusion from (...) the interpersonal domain—seems to prevent exempted parties from receiving crucial human goods for morally irrelevant reasons. This chapter discusses two widely deployed ways of trying to ameliorate morally costly disabilities. Both fail to apply viably to various psychopathologies. The solution involves disentangling accountability and interpersonality in a way that also provides insights into our shared human nature. (shrink)

Abstract: Purpose - This study aimed to analyze the relationship between the determinants of organizational justice and their relationship to conscientious behavior from the point of view of officers working in the Palestinian police in Gaza Strip. Methodology - The study relied on the descriptive and analytical approach, using the questionnaire, targeting a stratified random sample of (400) officers, who hold the rank of captain and above, from the study population of 1550 officers. The study tool was distributed among (...) the sample members in all departments and governorates. Police in Gaza Strip. (353) questionnaires were retrieved, with a recovery rate of (88.3%). Findings - The existence of a positive correlation between the determinants of organizational justice and the behavior of conscience, and the existence of organizational justice in general in a medium degree and the order of its determinants is as follows: fairness of dealings and to a large degree, followed by fairness of procedures and a medium degree, and finally distribution fairness was to a small degree, while the behavior of conscience awareness came to a large extent. Significance - The existence of statistically significant differences between the respondents' averages of responding to the searched relationship due to the variables (type of administration, age group, job title, military rank, years of service). Recommendations - Work to take into account the fairness of distribution by providing adequate and fair salaries, granting bonuses for the additional efforts exerted, and budgeting in the distribution of duties and job burdens, as well as recommending attention to the interests of employees when making decisions and involving them in formulating them, explaining their justifications, and creating an organizational climate dominated by a sense of justice. (shrink)

In a paper recently published in this journal, Navin and Largent argue in favour of a type of policy to regulate non-medical exemptions from childhood vaccination which they call ‘Inconvenience’. This policy makes it burdensome for parents to obtain an exemption to child vaccination, for example, by requiring parents to attend immunization education sessions and to complete an application form to receive a waiver. Navin and Largent argue that this policy is preferable to ‘Eliminationism’, i.e. to policies that do (...) not allow non-medical exemptions, because Inconvenience has been shown to maintain exemption rates low while not harming parents by forcing them to do something that goes against their beliefs. We argue that it is at least doubtful that Inconvenience is ethically preferable to Eliminationism: while the latter disregards the value of liberty, Inconvenience disregards the value of fairness in the distribution of the burdens entailed by the preservation of a public good like herd immunity. We propose a variant of Inconvenience, which we call ‘Contribution’, which we think is preferable to the versions of Inconvenience discussed by Navin and Largent in that it successfully strikes a balance between the values of parents’ liberty, fairness and expected utility. (shrink)