Conscientious objection: a morally insupportable misuse of authority

In this paper I claim that the conscience clause around abortion provision in England, Scotland, and Wales is inadequate for two reasons. First, the patient and doctor are differently situated with respect to social power. Doctors occupy a position of significant moral and epistemic authority with respect to their patients, who are vulnerable and relatively disempowered. Doctors are rightly required to disclose their conscientious objection, but given the positioning of the patient and doctor, the act of doing so exploits the authority of the medical establishment in asserting the legitimacy of a particular moral view. Second, the conscientious objector plays an unusual and self-defeating moral role. Since she must immediately refer the patient on to another doctor who is not conscientiously objecting, the doctor is complicit, via her necessary causal role, in the performance of the procedure. This means that doctors are not able to prevent abortions, but rather are required to ensure that they are carried out, albeit by others. Since dropping the disclosure and referral requirements would mean patients might not be able to accept legal medical care, we should instead drop the conscience clause, and encourage those opposed to abortion to select other specialities or professions. This would protect patients from judgement and doctors from complicity.