Conscientious objection: a global health perspective
Conscientious objection is a critical topic that has been sparsely discussed from a global health perspective, despite its special relevance to our inherently diverse field. In this Analysis paper, we argue that blanket prohibitions of a specific type of non-discriminatory conscientious objection ar...
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2024-12-01
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| Series: | BMJ Global Health |
| Online Access: | https://gh.bmj.com/content/9/12/e017555.full |
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| author | Xavier Symons Kokila Lakhoo Ruben Ayala Karel-Bart Celie Makayla Kochheiser |
| author_facet | Xavier Symons Kokila Lakhoo Ruben Ayala Karel-Bart Celie Makayla Kochheiser |
| author_sort | Xavier Symons |
| collection | DOAJ |
| description | Conscientious objection is a critical topic that has been sparsely discussed from a global health perspective, despite its special relevance to our inherently diverse field. In this Analysis paper, we argue that blanket prohibitions of a specific type of non-discriminatory conscientious objection are unjustified in the global health context. We begin both by introducing a nuanced account of conscience that is grounded in moral psychology and by providing an overview of discriminatory and non-discriminatory forms of objection. Next, we point to the frequently neglected but ubiquitous presence of moral uncertainty, which entails a need for epistemic humility—that is, an attitude that acknowledges the possibility one might be wrong. We build two arguments on moral uncertainty. First, if epistemic humility is necessary when dealing with values in theory (as appears to be the consensus in bioethics), then it will be even more necessary when these values are applied in the real world. Second, the emergence of global health from its colonial past requires special awareness of, and resistance to, moral imperialism. Absolutist attitudes towards disagreement are thus incompatible with global health’s dual aims of reducing inequity and emerging from colonialism. Indeed, the possibility of global bioethics (which balances respect for plurality with the goal of collective moral progress) hinges on appropriately acknowledging moral uncertainty when faced with inevitable disagreement. This is incompatible with blanket prohibitions of conscientious objection. As a brief final note, we distinguish conscientious objection from the problem of equitable access to care. We note that conflating the two may actually lead to a less equitable picture on the whole. We conclude by recommending that international consensus documents, such as the Universal Declaration on Bioethics and Human Rights, be amended to include nuanced guidelines regarding conscientious objection that can then be used as a template by regional and national policymaking bodies. |
| format | Article |
| id | doaj-art-8102a4ff355c4643a18f0041047561a9 |
| institution | Kabale University |
| issn | 2059-7908 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Global Health |
| spelling | doaj-art-8102a4ff355c4643a18f0041047561a92024-12-29T03:20:08ZengBMJ Publishing GroupBMJ Global Health2059-79082024-12-0191210.1136/bmjgh-2024-017555Conscientious objection: a global health perspectiveXavier Symons0Kokila Lakhoo1Ruben Ayala2Karel-Bart Celie3Makayla Kochheiser4Plunkett Centre for Ethics, Sydney, New South Wales, AustraliaGlobal Bioethics Collaborative, Los Angeles, California, USADepartment of Policy and Advocacy, Operation Smile, Virginia Beach, Virginia, USADivision of Plastic & Reconstructive Surgery, USC Keck School of Medicine, Los Angeles, California, USAWeill Cornell Medical College, New York, New York, USAConscientious objection is a critical topic that has been sparsely discussed from a global health perspective, despite its special relevance to our inherently diverse field. In this Analysis paper, we argue that blanket prohibitions of a specific type of non-discriminatory conscientious objection are unjustified in the global health context. We begin both by introducing a nuanced account of conscience that is grounded in moral psychology and by providing an overview of discriminatory and non-discriminatory forms of objection. Next, we point to the frequently neglected but ubiquitous presence of moral uncertainty, which entails a need for epistemic humility—that is, an attitude that acknowledges the possibility one might be wrong. We build two arguments on moral uncertainty. First, if epistemic humility is necessary when dealing with values in theory (as appears to be the consensus in bioethics), then it will be even more necessary when these values are applied in the real world. Second, the emergence of global health from its colonial past requires special awareness of, and resistance to, moral imperialism. Absolutist attitudes towards disagreement are thus incompatible with global health’s dual aims of reducing inequity and emerging from colonialism. Indeed, the possibility of global bioethics (which balances respect for plurality with the goal of collective moral progress) hinges on appropriately acknowledging moral uncertainty when faced with inevitable disagreement. This is incompatible with blanket prohibitions of conscientious objection. As a brief final note, we distinguish conscientious objection from the problem of equitable access to care. We note that conflating the two may actually lead to a less equitable picture on the whole. We conclude by recommending that international consensus documents, such as the Universal Declaration on Bioethics and Human Rights, be amended to include nuanced guidelines regarding conscientious objection that can then be used as a template by regional and national policymaking bodies.https://gh.bmj.com/content/9/12/e017555.full |
| spellingShingle | Xavier Symons Kokila Lakhoo Ruben Ayala Karel-Bart Celie Makayla Kochheiser Conscientious objection: a global health perspective BMJ Global Health |
| title | Conscientious objection: a global health perspective |
| title_full | Conscientious objection: a global health perspective |
| title_fullStr | Conscientious objection: a global health perspective |
| title_full_unstemmed | Conscientious objection: a global health perspective |
| title_short | Conscientious objection: a global health perspective |
| title_sort | conscientious objection a global health perspective |
| url | https://gh.bmj.com/content/9/12/e017555.full |
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