Bioethics Blogs

The Shortcomings of Conscientious Objection

Aidan Hayes doubts that the physician’s conscience alone justifies a refusal to provide treatment.


In the wake of the Supreme Court of Canada’s recent decision to strike down the nation’s law against “physician-assisted dying,” the Canadian Medical Association has urged that “physician[s] should not be compelled to participate in medical aid in dying.” Instead, the Canadian Medical Association suggests that physicians should be able to “follow their conscience.”

Similarly, statutes known as “conscience clauses,” which shield physicians and/or hospitals from the obligation to provide abortions or other controversial interventions, exist in most U.S. states. Similar clauses have been proposed in Canada both federally and provincially. Such clauses reflect the belief that individuals should not be obligated to act contrary to what their moral or religious conscience dictates.

But, while I agree there must be some standard that establishes when a physician may refuse to provide treatment on ethical grounds, conscience is too weak a standard. To enshrine conscience as such misunderstands the role that it plays in our moral reasoning, and thus squanders an opportunity for serious deliberation about values.

While conscience may be what initially leads us to believe that something is wrong, it is rarely, if ever, what actually makes something wrong.

“Cloak of Conscience” (Marble sculpture) by Anna Chromý, 2006-2011

Imagine that I am a physician, whose terminally ill patient requests that I assist them in dying. My conscience tells me that suicide is wrong, and thus I refuse the request (we shall leave aside the question of what next step this might entail).

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.