Robert F Card
Robert F. Card. A New Theory of Conscientious Objection in Medicine: Justification and Reasonability. New York & London: Routledge, 2020, 268 pp. ISBN-10:0367430819
This book argues that a conscientiously objecting medical professional should receive an exemption only if the grounds of an objector’s refusal are reasonable. It defends a detailed, contextual account of public reasonability suited for healthcare, which builds from the overarching concept of Rawlsian public reason.
The author analyzes the main competing positions and maintains that these other views fail precisely due to their systematic inattention to the grounding reasons behind a conscientious objection; he argues that any such view is plausible to the extent that it mimics the ‘reason-giving requirement’ for conscience objections defended in this work. Only reasonable objections can defeat the prior professional obligation to assign primacy to patient well-being, therefore one who refuses a patient’s request for a legally available, medically indicated, and safe service must be able to explain the grounds of their objection in terms understandable to other citizens within the public institutional structure of medicine. The book further offers a novel policy proposal to deploy the Reasonability View: establishing conscientious objector status in medicine. It concludes that the Reasonability View is a viable and attractive position in this debate.
A New Theory of Conscientious Objection in Medicine: Justification and Reasonability will be of interest to researchers and advanced students working in bioethics, medical ethics, and philosophy of medicine, as well as thinkers interested in the intersections between law, medical humanities, and philosophy.
Thomas A Cavanaugh
Thomas A. Cavanagh. Hippocrates’ Oath and Asclepius’ Snake:The Birth of the Medical Profession. New York: Oxford University Press, 2018. 177 pp.
T. A. Cavanaugh’s Hippocrates’ Oath and Asclepius’ Snake: The Birth of the Medical Profession articulates the Oath as establishing the medical profession’s unique internal medical ethic – in its most basic and least controvertible form, this ethic mandates that physicians help and not harm the sick. Relying on Greek myth, drama, and medical experience (e.g., homeopathy), the book shows how this medical ethic arose from reflection on the most vexing medical-ethical problem – injury caused by a physician – and argues that deliberate iatrogenic harm, especially the harm of a doctor choosing to kill (physician assisted suicide, euthanasia, abortion, and involvement in capital punishment), amounts to an abandonment of medicine as an exclusively therapeutic profession. The book argues that medicine as a profession necessarily involves stating before others what one stands for: the good one seeks and the bad one seeks to avoid on behalf of the sick, and rejects the view that medicine is purely a technique lacking its own unique internal ethic. It concludes noting that medical promising (as found in the White Coat Ceremony through which U. S. medical students matriculate) implicates medical autonomy which in turn merits respect, including honoring professional conscientious objections.
Lauris Christopher Kaldjian
Lauris Christoper Kaldjian. Practicing Medicine and Ethics: Integrating Wisdom, Conscience and Goals of Care. New York: Cambridge University Press, 2014, 296 pp. ISBN 10- 1107012163
To practice medicine and ethics, physicians need wisdom and integrity to integrate scientific knowledge, patient preferences, their own moral commitments, and society’s expectations. This work of integration requires a physician to pursue certain goals of care, determine moral priorities, and understand that conscience or integrity require harmony among a person’s beliefs, values, reasoning, actions, and identity. But the moral and religious pluralism of contemporary society makes this integration challenging and uncertain. How physicians treat patients will depend on the particular beliefs and values they and other health professionals bring to each instance of shared decision making. This book offers a framework for practical wisdom in medicine that addresses the need for integrity in the life of each health professional. In doing so, it acknowledges the challenge of moral pluralism and the need for moral dialogue and humility as professionals fulfil their obligations to patients, themselves, and society.
Roger Trigg. Equality, Freedom & Religion. Oxford: University Press; 2012 Jan 13, 224 pp. ISBN- 9780199576852.
Is religious freedom being curtailed in pursuit of equality, and the outlawing of discrimination? Is enough effort made to accommodate those motivated by a religious conscience? All rights matter but at times the right to put religious beliefs into practice increasingly takes second place in the law of different countries to the pursuit of other social priorities. The right to freedom of belief and to manifest belief is written into all human rights charters. In the United States religious freedom is sometimes seen as ‘the first freedom’. Yet increasingly in many jurisdictions in Europe and North America, religious freedom can all too easily be ‘trumped’ by other rights.
Roger Trigg looks at the assumptions that lie behind the subordination of religious liberty to other social concerns, especially the pursuit of equality. He gives examples from different Western countries of a steady erosion of freedom of religion. The protection of freedom of worship is often seen as sufficient, and religious practices are separated from the beliefs which inspire them. So far from religion in general, and Christianity in particular, providing a foundation for our beliefs in human dignity and human rights, religion is all too often seen as threat and a source of conflict, to be controlled at all costs. The challenge is whether any freedom can preserved for long, if the basic human right to freedom of religious belief and practice is dismissed as of little account, with no attempt to provide any reasonable accommodation. Given the central role of religion in human life, unnecessary limitations on its expression are attacks on human freedom itself.
Revised and Expanded Edition
J. Budziszewski. What We Can’t Not Know. San Francisco: Ignatius Press, 2011, 315 pp. ISBN/UPC: 9781586174811
In this new revised edition of his groundbreaking work, Professor J. Budziszewski questions the modern assumption that moral truths are unknowable. With clear and logical arguments he rehabilitates the natural law tradition and restores confidence in a moral code based upon human nature. What We Can’t Not Know explains the rational foundation of what we all really know to be right and wrong and shows how that foundation has been kicked out from under western society. Having gone through stages of atheism and nihilism in his own search for truth, Budziszewski understands the philosophical and personal roots of moral relativism. With wisdom born of both experience and rigorous intellectual inquiry, he offers a firm foothold to those who are attempting either to understand or to defend the reasonableness of traditional morality.
Abdulaziz Sachedina A. Islamic Biomedical Ethics: Principles and Application. Oxford: University Press, 2009, 296 pp. Print ISBN-13: 9780195378504. DOI:10.1093/acprof:oso/9780195378504.001.0001
This book undertakes to correlate practical ethical decisions in modern medical practice to principles and rules derived from Islamic juridical praxis and theological doctrines. This study links these rulings to the moral principles extracted from the normative religious texts and historically documented precedents. Western scholars of Islamic law have pointed out the importance of the historical approach in determining the rules and the juristic practices that were applied to the cases under consideration before the judicial opinions were issued within a specific social, economic, and political context. These decisions reflected aspects of intellectual as well as social history of the Muslim community engaged in making everyday life conform to the religious values. Ethical decisions are an important part of interpersonal relations in Islamic law. Practical guidance affecting all facets of individual and collective human life, have been provided under the general rules of “Public good” and “No harm, no harassment.” However, no judicial decision that claims to further public good is regarded authoritative without supporting documentation from the foundational sources, like the Qur‘an and the Sunna (the exemplary tradition of the Prophet). Hence, Muslim jurists, in order to infer fresh rulings about matters that were not covered by the existing precedents in the Qur‘an and the Sunna, undertook to develop rational stratagems to enable them to solve problems faced by the community. This intellectual activity led to the systematic formulation of the principles of Islamic jurisprudence, which has assumed unprecedented importance in connection with the distinct field of medical ethics in the Islamic world that shares the modern medical technology with the West. The book argues that there are distinct Islamic principles that can serve as sources for Muslim biomedical ethics that can engage in dialogue with both secular and other religiously oriented bioethics in the context of universal medical practice and research.
“Abdulaziz Sachedina is the leading Islamic thinker writing in Engish today. Thus, his Islamic Biomedical Ethics is a welcome addition to the already extensive literature in the field because of his great knowledge of the classical and modern Islamic legal and ethical sources, his authentic religious commitment to the truth of Islam, and his willingness to engage perspectives from other traditions in what is becoming a genuinely multicultural field of moral discourse.” David Novak, author of Jewish Social Ethics
Institute of Medicine
Institute of Medicine (US) Committee on Understanding the Biology of Sex and Gender Differences, Theresa M. Wizemann, Mary-Lou Pardue, eds. Exploring the Biological Contributions to Human Health: Does Sex Matter? Washington, DC: The National Academies Press.
One of the most compelling reasons for looking at what is known about the biology of sex differences is that there are striking differences in human disease that are not explained at this time.
Being male or female is an important basic human variable that affects health and illness throughout the life span. Differences in health and illness are influenced by individual genetic and physiological constitutions, as well as by an individual’s interaction with environmental and experiential factors. The incidence and severity of diseases vary between the sexes and may be related to differences in exposures, routes of entry and the processing of a foreign agent, and cellular responses. Although in many cases these sex differences can be traced to the direct or indirect effects of hormones associated with reproduction, differences cannot be solely attributed to hormones.
Therefore, sex should be considered when designing and analyzing studies in all areas and at all levels of biomedical and health-related research. The study of sex differences is evolving into a mature science. There is now sufficient knowledge of the biological basis of sex differences to validate the scientific study of sex differences and to allow the generation of hypotheses with regard to health. The next step is to move from the descriptive to the experimental phase and establish the conditions that must be in place to facilitate and encourage the scientific study of the mechanisms and origins of sex differences. Naturally occurring variations in sex differentiation can provide unique opportunities to obtain a better understanding of basic differences and similarities between and within the sexes.
Barriers to the advancement of knowledge about sex differences in health and illness exist and must be eliminated. Scientists conducting research on sex differences are confronted with an array of barriers to progress, including ethical, financial, sociological, and scientific factors.
The committee provides scientific evidence in support of the conclusions presented above and makes recommendations to advance the understanding of sex differences and their effects on health and illness.