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In defence of medical tribunals and the reasonability standard for conscientious objection in medicine
  1. Robert F Card1,2
  1. 1Department of Philosophy, SUNY-Oswego, Oswego, New York, USA
  2. 2Department of Medical Humanities and Bioethics, University of Rochester Medical Center, Rochester, New York, USA
  1. Correspondence to Dr Robert F Card, Department of Philosophy, SUNY-Oswego, 212 Campus Center, Oswego, NY 13126, USA; robert.card7{at}

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Cowley1 has recently objected to the idea of using a medical tribunal to make determinations regarding conscientious objections and has criticised using reasonability as a standard for any such tribunal. In prior work, I defend the view that in order for a conscientious objection in medicine to properly generate an exemption, the objector must state the reasons supporting the refusal and allow the grounding reasons and the objection to be subject to evaluation in terms of reasonability.2 Furthermore, I have suggested that this Reasonability View on conscientious objection can be carried out as a policy by establishing conscientious objector (CO) status within medicine; these matters could be adjudicated by a committee or tribunal similar to how determinations of military CO status are made in the USA.3 I argue that Cowley's discussion sells the idea of medical tribunals short and illustrates serious misunderstandings regarding how the reasonability standard should be deployed in practice.

The disanalogy between the UK and USA regarding abortion

Cowley focuses his discussion of medical tribunals specifically on abortion in the UK. He does not aim to take a stance on the morality of abortion nor does he wish to adopt a general position on the permissibility of conscientious objection in medicine. Furthermore, he assumes that a particular provider's refusal does not interfere with a pregnant woman's access to abortion services provided by a willing practitioner. Finally, Cowley notes the lack of political debate about abortion in the UK, stating the following regarding the Abortion Law that made abortion legal: “Since the Act became law in 1967, it has been tweaked but never seriously challenged in Parliament or in the press.”4 Cowley's aim is to criticise medical tribunals as a general notion and to defend the status quo wherein providers’ objections are not scrutinised in any way, yet his treatment involves a serious …

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  • Contributors The ideas and arguments in this paper were contributed solely by RFC.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.

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