Three Arguments Against Institutional Conscientious Objection, and Why They Are (Metaphysically) Unconvincing

Journal of Medicine and Philosophy 49 (3):298-312 (2024)
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Abstract

The past decade has seen a burgeoning of scholarly interest in conscientious objection in healthcare. While the literature to date has focused primarily on individual healthcare practitioners who object to participation in morally controversial procedures, in this article we consider a different albeit related issue, namely, whether publicly funded healthcare institutions should be required to provide morally controversial services such as abortions, emergency contraception, voluntary sterilizations, and voluntary euthanasia. Substantive debates about institutional responsibility have remained largely at the level of first-order ethical debate over medical practices which institutions have refused to offer; in this article, we argue that more fundamental questions about the metaphysics of institutions provide a neglected avenue for understanding the basis of institutional conscientious objection. To do so, we articulate a metaphysical model of institutional conscience, and consider three well-known arguments for undermining institutional conscientious objection in light of this model. We show how our metaphysical analysis of institutions creates difficulties for justifying sanctions on institutions that conscientiously object. Thus, we argue, questions about the metaphysics of institutions are deserving of serious attention from both critics and defenders of institutional conscientious objection.

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Author Profiles

Xavier Symons
Harvard University
Reginald Mary Chua
University of Notre Dame Australia

Citations of this work

Philosophical Acts of Wonder in Bioethics.Alexander Zhang - 2024 - Journal of Medicine and Philosophy 49 (3):221-232.

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References found in this work

What is conscience and why is respect for it so important?Daniel P. Sulmasy - 2008 - Theoretical Medicine and Bioethics 29 (3):135-149.
The metaphysics of harm.Matthew Hanser - 2008 - Philosophy and Phenomenological Research 77 (2):421-450.
When should conscientious objection be accepted.Morten Magelssen - 2012 - Journal of Medical Ethics 38 (1):18-21.
Two theories of group agency.David Strohmaier - 2020 - Philosophical Studies 177 (7):1901-1918.

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