Three Arguments Against Institutional Conscientious Objection, and Why They Are (Metaphysically) Unconvincing.

IF 1.3 3区 哲学 Q3 ETHICS
Xavier Symons, Reginald Mary Chua
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Abstract

The past decade has seen a burgeoning of scholarly interest in conscientious objection in healthcare. While the literature to date has focused primarily on individual healthcare practitioners who object to participation in morally controversial procedures, in this article we consider a different albeit related issue, namely, whether publicly funded healthcare institutions should be required to provide morally controversial services such as abortions, emergency contraception, voluntary sterilizations, and voluntary euthanasia. Substantive debates about institutional responsibility have remained largely at the level of first-order ethical debate over medical practices which institutions have refused to offer; in this article, we argue that more fundamental questions about the metaphysics of institutions provide a neglected avenue for understanding the basis of institutional conscientious objection. To do so, we articulate a metaphysical model of institutional conscience, and consider three well-known arguments for undermining institutional conscientious objection in light of this model. We show how our metaphysical analysis of institutions creates difficulties for justifying sanctions on institutions that conscientiously object. Thus, we argue, questions about the metaphysics of institutions are deserving of serious attention from both critics and defenders of institutional conscientious objection.

反对制度性良心反对的三个论点,以及为什么它们(从形而上学角度)无法令人信服。
在过去的十年中,学术界对医疗保健领域依良心拒服兵役的兴趣日益浓厚。迄今为止,相关文献主要关注的是反对参与有道德争议程序的医疗从业者个人,而在本文中,我们考虑的是一个虽然相关但却不同的问题,即是否应要求公共资助的医疗机构提供有道德争议的服务,如堕胎、紧急避孕、自愿绝育和自愿安乐死。关于医疗机构责任的实质性争论主要停留在对医疗机构拒绝提供的医疗行为的一阶伦理争论层面;在本文中,我们认为关于医疗机构形而上学的更基本问题为理解医疗机构良心反对的基础提供了一个被忽视的途径。为此,我们阐述了制度良知的形而上学模式,并根据这一模式考虑了三个众所周知的破坏制度性依良心拒服兵役的论点。我们展示了我们对机构的形而上学分析如何为制裁出于良心拒服兵役的机构带来困难。因此,我们认为,有关制度形而上学的问题值得制度良心反对的批评者和捍卫者认真关注。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
2.90
自引率
6.20%
发文量
30
期刊介绍: This bimonthly publication explores the shared themes and concerns of philosophy and the medical sciences. Central issues in medical research and practice have important philosophical dimensions, for, in treating disease and promoting health, medicine involves presuppositions about human goals and values. Conversely, the concerns of philosophy often significantly relate to those of medicine, as philosophers seek to understand the nature of medical knowledge and the human condition in the modern world. In addition, recent developments in medical technology and treatment create moral problems that raise important philosophical questions. The Journal of Medicine and Philosophy aims to provide an ongoing forum for the discussion of such themes and issues.
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