Bioethics, 2013, Daniel Weinstock, “Conscientious refusal and health
professionals: does religion make a difference?”, pp. 1 – 8
This article explores the health care professionals’ objections of conscience due to religious matters.
Thesis: it is more difficult to ground an obligation on the part of healthcare systems to accommodate
religious objections than it is to accommodate the more recognizably ethical concerns of health care
Structure of the article:
• Avoid conflating freedom of conscience and religious freedom, because both
refer to different sets of moral consideration.
• The most convincing reason for granting a right to conscientious refusal in the
area of health care (four reasons).
• The results of both previous arguments to show that there are no analogous
reasons to accommodate religious claims for exemption in the healthcare sector.
• First limit of the thesis: the article only applies to ‘irreducibly’ religious
objections of conscience.
• Second limit of the thesis: although health care professionals who ask for an
exemption for irreducibly religious have no right to, there might be societal
reasons to accept them.
I – The difference between freedom of conscience and religious freedom.
As a question of general political morality, those two rights ought to be treated as protecting two
distinct sets of normative considerations.
(First set of normative considerations.) Conscience: refers to the citizen as a moral being capable of
reflecting upon the difficult moral questions they must face in the roles they occupy, including that of
‘citizen’. This is further expressed by the citizen’s ability to reflect upon moral issues and
controversies arising in their community (or elsewhere) and to arrive at judgments about what
should be done in such controversies.
Why should the state protect the individual’s ability to live by the dictates of their conscience?
1. When an individual is forced to violate their conscience by the state or the institutions they
belong to, they feel they have been disrespected in a fundamental way. The essence of a human being consists partly of their conscience and to disrespect this is to disrespect their
existence as a moral agent capable of reasoning and making moral decisions. (Internal argument)
2. The state has an interest in protecting and promoting the capacity for moral reflection on
the part of citizens. Democratic debate and deliberation are central to the best accounts of both
the justification for democracy and the best way to organize democratic institutions. Good
democracies are ones in which deliberation occurs not just among political representatives
but also among citizens themselves. THUS, good democracies require that citizens be
encouraged and enabled to think for themselves about complex issues of political morality.
(Second set of normative considerations.) Freedom of religion: is associated with Samuel Scheffler’s
theory. According to Scheffler, situating oneself within a tradition, whether it is religious or not, is a
way of overcoming obstacles and situating themselves within temporal contexts that transcend their
own individual lives. The practices that one takes in as a member of a tradition are central to the agent’s
ability to deal with his own temporal finitude. Members of those traditions feel strongly about the rules to
abide to, etc. so the state must be able to give those people the freedom to act the ways that are required
by the tradition to which they belong. Thus, there are internal reasons for those religious rights,
which means allowing the individuals to perform what they must according to their tradition. One
such tradition is religion, because it is extremely important in the lives of many individuals and
continues to transcend despite the evolution of science.
What of the external considerations?
- Those considerations (being the conceptual connection between democracy on one hand and the
morally alert citizen on the other) are not present in the same way for freedom of religion.
- Religions are not as intrinsically connected to the very idea of democracy as are the benefits of a
society in which citizens hold an independent moral judgment. An entirely secular society can
still be a democracy.
There are different sets of reasons to limit the state’s power over the individual contained in
the phrase “freedom of conscience and religion”, even though it may be tempting to regard
both as identical phenomena. FINAL REMARK: claims on the grounds of freedom of religion have to be reasonable, but there is no
reason not to see these considerations of “reasonability” being applied to the freedom of conscience as
ON THE ARGUMENT OF INTEGRITY: it may be argued that freedom of conscience and religion have
to be treated in the same way on the grounds of integrity (both as directly linked to the individual’s
integrity and thus must be respected in the same way). HOWEVER, Weinstock argues that the kinds of
integrity that are in play in conscience and religion protections are actually quite different.
• Freedom of conscience protects the process and the
results of moral reflection.
• Freedom of religion protects the agent’s ability to
continue to participate in rites and practices, and to
follow communal rules, the principal function o