A consequentialist case for permitting conscientious objection in healthcare

Journal article

Prominent consequentialists who write about conscientious objection (CO) in healthcare, Julian Savulescu and Udo Schüklenk, both argue for the ‘incompatibility thesis’—the view that healthcare professionals ought never to be entitled to exercise a CO to absolve themselves of the responsibility to perform professional duties. I argue, contra Savulescu and Schüklenk, that consequentialists should advocate for a compromise position under which healthcare professionals are entitled to conscientiously object to providing some services under some circumstances. The compromise advocated differs dramatically from the most prominent compromise position in the academic literature on CO in healthcare, Brock’s ‘conventional compromise’. The conventional compromise relies on referral, and I show that this is a problematic tool for consequentialists to rely on. I argue that the best approach to managing CO, from a consequentialist point of view, is to set up a system of region-based registers of available healthcare professionals who lack COs to procedures for which COs are permitted. Patients and healthcare professionals in the given region would be able to access—and be encouraged to consult—the register for their region before receiving any form of healthcare for which COs are permitted, thereby eliminating the need for referral in most circumstances.

Authors: Clarke, S

• Publication status: Published
• Peer review status: Peer reviewed
• Publisher: BMJ Publishing Group
• Journal: Journal of Medical Ethics
• Place of publication: England
• Publication date: 2025-09-25
• Acceptance date: 2025-09-06
• DOI: 10.1136/jme-2025-111262
• EISSN: 1473-4257
• ISSN: 0306-6800
• Pmid: 40998579
• Language: English