• decision-making
• ethics
• moral and religious aspects
• religious ethics
• applied and professional ethics

We recently argued that—contrary to what we call the dominant view—physicians ought to avoid engaging patients on religious grounds.1 The six responses to our article present an array of concerns and have provided us with the opportunity to consider further aspects of our view. While we cannot reply to all the relevant issues, our aim here is to reply to the most significant concerns.

Against our Public Reason Argument, Nick Colgrove maintains that physicians are not relevantly akin to public officials and should therefore not be constrained by public reasons. Colgrove does not take issue with the idea that it may be reasonable for public officials to justify their policymaking according to public reasons because their policies affect a diverse population. But since ‘the [medical] decision being made is not binding for other patients,’ physicians need not be constrained by public reasons.2 Colgrove’s criticism hinges on the claim that deliberation ought to be constrained by public reason only if the outcome of such deliberation is a policy or a rule that a diverse group of people must follow (ie, to which they are bound).

We disagree with this claim. We do not believe, nor did we argue, that this is a necessary condition for when we are morally required to cite public reasons. Instead we believe that three facts together provide sufficient reason for why physicians should generally be constrained by public reasons: physicians are directly and indirectly paid by the state via Medicare and Medicaid; physicians allocate public resources; and physicians are regulated by the state.

Colgrove takes particular issue with our ‘Dr Chatterjee case’, which is meant to illustrate why citing religious reasons is inappropriate. And our explanation for why we find this case jarring …