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Public reason’s private roles: legitimising disengagement from religious patients and managing physician trauma
  1. Heather Patton Griffin
  1. Theology, Medicine, and Culture Initiative, Duke Divinity School, Durham, NC 27708, USA
  1. Correspondence to Ms Heather Patton Griffin, Theology, Medicine, and Culture Initiative, Duke Divinity School, Durham, NC 27708, USA; heather.griffin{at}

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Greenblum and Hubbard argue that physicians are duty-bound by the constraints of Rawlsian ‘public reason’ to avoid engaging their patients’ religious considerations in medical decision-making.1 This position offers a number of appealing benefits to physicians. It will appear plausible because Rawls’s philosophical tradition of Political Liberalism enjoys the status of ideological orthodoxy in institutions tasked with forming the moral imaginations of physicians and other elites.2 3 It casts the physician in the role of a ‘reasonable person’ occupying the space of public reason whose medical and ethical judgments are opposed by ‘sectarian’ religious patients who refuse to be reasonable. This narrative authorises the exclusion of patient religious considerations from medical decision making when they do not ‘translate’ into reasons recognised by ‘reasonable’ medical professionals and manages the trauma of overwhelmed physicians by legitimising disengagement from difficult interactions with religious patients.

The authors’ arguments depend on concepts from Rawls’s Political Liberalism 4 and are presented as if the premises of Liberal theory are incontestable—despite the fact that a large body of philosophical literature challenging its premises and core concepts has existed for decades.3 5–7 This ‘nothing to see here, move along’ approach saves more space for anecdotes about religious people, at which …

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  • Competing interests None declared.

  • Patient consent for publication Not required.

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

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