Conscience, moral reasoning, and skepticism

Larry R Churchill

Perspectives in Biology and Medicine
Perspectives in Biology and Medicine

Abstract
There is much to admire in Lauris Kaldjian’s explication of conscience and its uses for medical practitioners. Yet his claim that conscience is the final and best assessment of moral judgments is flawed, because it diminishes the influence of moral reasoning that balances and often corrects conscience. Skepticism about conscientious judgments is an important feature of ethics. Kaldjian’s close linkage of conscience with moral integrity blunts the necessary recognition that one’s conscience can be mistaken. His defense of physician refusals to refer patients gives insufficient weight to the idea that patients’ actions in seeking services may also reflect conscientious judgments. Analyses of cases near the end of this essay present no problems with respecting physicians’ conscientious refusals to provide services themselves, but they also mostly leave moral room for physicians to make referrals. Examination of these cases suggests other ways to resolve moral conflicts than recourse to one’s conscience.


Churchill LR. Conscience, moral reasoning, and skepticism. Perspect Biol Med. 2019 Summer;62(3):519-526.

(Editorial) Physician assisted suicide, euthanasia, or withdrawal of treatment: Distinguishing between them clarifies moral, legal, and practical positions

Larry R Churchill, Nancy MP King

British Medical Journal, BMJ
British Medical Journal

Extract
. . . In unanimous rulings last month, [United States] Chief Justice Rehnquist, writing for the court, held that there is no fundamental right to assistance in committing suicide1 and that, legally, distinguishing between refusing life saving medical treatment and requesting assistance in suicide “comports with fundamental legal principles of causation and intent.”

. . . Attempts to decriminalise assisted suicide in Britain have so far fallen well short of legislation.. . . Pressure groups in favour of voluntary euthanasia seem to accept that it will be difficult to achieve euthanasia legislation in one step but consider that assisted suicide represents a more attainable goal. From an opinion survey of Scottish doctors, the medical profession seems less resistant to assisting suicide than to practising euthanasia. . .

. . . it remains to be seen whether societal acceptance of physician assisted suicide will increase and how it will affect both social support for vulnerable and dying citizens and trust between patients and their doctors.


Churchill LR, King NMP. (Editorial) Physician assisted suicide, euthanasia, or withdrawal of treatment: Distinguishing between them clarifies moral, legal, and practical positions. Br Med J. 1997 Jul 19;315(7101):137-138.