Conscientious objection, 'proper medical treatment' and professionalism: the limits of accommodation for conscience in healthcare

In recent years there has been a marked increase in academic interest in the phenomenon of conscientious objection (CO) in healthcare. The resulting literature, which is already substantial and continually expanding, reflects a spectrum of opinion on the practice ranging from support through mere toleration to barely disguised (and occasionally open) hostility. Despite some forceful academic opposition, however, most scholars who engage with the issue recognise the appropriateness of accommodating CO at least to some extent. The usual way of explaining why it is necessary and/or desirable to accommodate CO involves citing the need to protect individuals from being obliged to violate their moral integrity in the course of performing their professional roles. The meaning of ‘moral integrity’ is itself the subject of detailed philosophical debate, and is not my focus in this chapter: here, I presuppose that ‘a physician’s interest in moral integrity is a very important interest that has substantial moral weight’ and that the primary reason for accommodating and exercising CO is that we recognise the value of moral integrity and wish to respect and preserve it.