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Might a conscience clause be used for non-moral or prejudiced reasons?
  1. Zuzana Deans
  1. Correspondence to Dr Zuzana Deans, Centre for Ethics in Medicine, School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol BS8 2PS, UK; Zuzana.Deans{at}

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There have been various suggestions of what the criteria are for a justified conscientious refusal (eg, reasonable1 ,2 and genuine3), but none of them could be assessed with confidence.4 Cowley5 makes a case against using tribunals as a means of assessing the defensibility of physicians’ conscientious refusals, arguing that they would be a pointless bureaucratic exercise and instead supports the current British arrangement of not requiring objecting doctors to formally defend their position. He details two reasons for this: a predicted low number of cases in which an objector would have non moral reasons and a tribunal's inability to determine whether an objector's claim was genuine or reasonable. I want to focus on the first claim. Following this, I suggest approaching this matter by asking what the purpose of tribunals would be.

Cowley claims that the number of cases in which an objector's reasons for objecting are non-moral or based on prejudice would be too few to justify the cost of tribunals. This may be the case, though without carefully gathered empirical evidence we cannot be sure. Cowley's claim is that there is little scope for doctors to misuse a conscience clause to object …

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  • Competing interests None declared.

  • Provenance and peer review Commissioned; internally peer reviewed.

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