Book Review: The Conscience Wars; Rethinking the Balance between Religion, Identity, and Equality

Christopher Cowley

Conscience Wars

Edited by Susanna Mancini and Michel Rosenfeld. Pp. 493. Cambridge: Cambridge University Press. 2018. £76. ISBN: 978-1107173309>

This volume is based on a conference held at the Cardozo School of Law in ew York in 2015, and brings together American and European law academics to discuss the distinctive ways in which conscience claims have ‘spread’ in the public discourse over the last two or three decades. Conscientious objection used to be an individual matter for e.g. draftees and doctors, aimed at recusing oneself from complicity with evil, in contrast to civil disobedience, which was a larger collective movement aimed at changing public opinion and the law. These days, however, conscience seems to be in the news much more, mostly associated with organized religious conservative agendas – hence the title’s reference to a ‘war’ playing out in parallel to the efforts in and around a country’s legislature. Perhaps the most famous recent case of mobilized public conscience was that of the US Supreme Court case of Burwell u Hobby Lobby (2014), in which the owners of a company successfully challenged the legal requirement (under the 2010 Affordable Care Act) that the company fund contraception for its female employees. The owners’ objection was religious, and was framed in terms of their right to religious expression. . .


Cowley C.  Book Review: The Conscience Wars; Rethinking the Balance between Religion, Identity, and Equality. New Bioethics. 2019 Sep; 25(3): 286-289, DOI:10.1080/20502877.2019.1647039

Selective Conscientious Objection in Healthcare

Christopher Cowley

Selective Conscientious Objection in Healthcare

Abstract

Most discussions of conscientious objection in healthcare assume that the objection is universal: a doctor objects to all abortions. I want to investigate selective objections, where a doctor objects to one abortion but not to another, depending on the circumstances. I consider not only objections to abortion, but also objections to the withdrawal of life-saving treatment at the request of a competent patient, which is almost always selective. I explore how the objector might articulate the selective objection, and what impact it might have on the patient, within the conceptual space of relevant statutes and professional guidelines.


Cowley C.  Selective Conscientious Objection in Healthcare. New Bioethics 2019 Sep; 25(3): 236-247, DOI:10.1080/20502877.2019.1649861.

Conscientious objection in healthcare and the duty to refer

Christopher Cowley

Journal of Medical Ethics

Abstract

Although some healthcare professionals have the legal right to conscientiously object to authorise or perform certain lawful medical services, they have an associated duty to provide the patient with enough information to seek out another professional willing to authorise or provide the service (the ‘duty to refer’). Does the duty to refer morally undermine the professional’s conscientious objection (CO)? I narrow my discussion to the National Health Service in Britain, and the case of a general practitioner (GP) being asked by a pregnant woman to authorise an abortion. I will be careful not to enter the debate about whether abortion should be legalised, or the debate about whether CO should be permitted—I will take both as given. I defend the objecting GP’s duty to refer against those I call the ‘conscience absolutists’, who would claim that if a state is serious enough in permitting the GP’s objection in the first place (as is the UK), then it has to recognise the right to withhold any information about abortion.


Cowley C. Conscientious objection in healthcare and the duty to refer.  Journal of Medical  Ethics 2017;43:207-212.