• conscientious objection
• abortion
• euthanasia
• ethics
• applied and professional ethics

In ‘The Truth Behind Conscientious Objection in Medicine’ Ben-Moshe criticises two different approaches to conscientious objection (CO) for holding that ‘the truth of claims of conscience is irrelevant to their justification.’1 He then presents his own account in which the ‘claims of conscience are true, or at least approximate moral truth to the greatest degree possible for creatures like us’.1 However, if this is the case, one might question why we would then accommodate such moral claims rather than seek to reform what he calls the ‘prevailing moral attitudes’ targeted by the relevant moral objection.

Consider Ben-Moshe’s own historical example of a German medical doctor who finds the experiments performed on Jewish prisoners held in Nazi concentration camps morally objectionable. What is important here? Recognising the claims made by this doctor are true, and thereby warranting their refusal to participate? Or recognising that the prevailing moral attitudes are indeed objectionable, and should not only be abandoned but opposed with more vigour than mere non-participation?

While nothing prevents Ben-Moshe from advocated for broader reform, part of the issue is that he seems to equate having a well-founded moral objection with CO. However, the fact that one’s moral conscience leads one to object to a particular practice is not a sufficient criteria for establishing a CO. Consider foxhunting prior to it being made illegal in the UK. Should all those who morally objected to this so-called sport be considered conscientious objectors in virtue of their non-participation? I would suggest not. It seems, then, that one might consider an expectation of involvement in the objected to activity to be a criterion for a moral objection to be considered in terms of CO.

A further, and central, problem with Ben-Moshe’s account is that it does not clearly acknowledge that questions of CO only arise in the context of some form of good faith disagreement. This occurs when both the prevailing moral attitudes and the related objections may be true or, at least, are held to be true when understood from within particular moral perspectives. While Ben-Moshe wishes to reduce the number of valid moral perspectives to one⁠—that of the impartial spectator—he nevertheless recognises that instances of good faith moral disagreement can take place and that they result in the most significant or challenging questions of CO.

We might, then, reconsider Ben-Moshe’s criticism of two other approaches to CO. If, as he suggests, his account privileges conscience claims when they are morally true—or, at least, when they ‘approximate moral truth to the greatest degree possible for creatures like us’1 —it must be the case that he accords the prevailing moral attitudes a similar status; at least in some cases they too must approximate to moral truth. While Ben-Moshe may be right to say that the accounts he criticises do not adjudicate CO claims on the basis of their truth or falsity, this does not mean that they are indifferent to such notions or to the validity of the moral objections that give rise to CO claims. Furthermore, advocates of these views are not indifferent to the truth of the prevailing moral attitudes that are the subject of moral concern, as Ben-Moshe seems to be. Rather, they recognise that the issue of CO arises if and when robust moral claims can be made on both sides of an issue, such that the question cannot be independently adjudicated or settled in terms of truth.

It is arguably the case then, that it is only when we encounter this type of moral impasse that we can entertain a particular issue as being a matter for CO. It is precisely because there is a good faith moral disagreement as to the moral truth of the matter that the issue of CO arises. That the moral disagreement between the prevailing moral attitude and the moral objections of certain individuals cannot be resolved can be considered another criterion of CO.

Thus far, we have identified two additional criteria for distinguishing CO from moral objections. There are likely to be more. However, they are likely to be concerned with the practical and political dimensions of the claim.ⁱ The instantiation of a CO should be perceived as a sociopolitical device for the resolution of (certain) good faith moral disagreements in particular social, cultural and historical contexts.ⁱⁱ As a result, when seeking to understand and account for the CO we cannot, as Ben-Moshe seems to suppose, disregard the way(s) in which such matters have actually arisen.1

To suggest that CO is a sociopolitical device for the resolution of (certain) good faith moral disagreements implies that such disagreements should be seen in collective, rather than individualistic, terms. When it comes to the recognition and accommodation of particular moral objections as COs what we are concerned with is not the piecemeal adjudication of individual points of view, but with the competing moral justifications and the perspectives of established social, cultural or political groups. Moreover, we usually become concerned with CO in the context of moral change. Thus, CO to abortion was established in the context of its decriminalisation and legalisation. Similarly, discussion of CO in relation to euthanasia has emerged as prevailing moral attitudes have begun to swing in its favour and as legislation has been enacted.

At this juncture, it is important to make a particular facet of CO explicit. Whenever we recognise a CO we establish a right of non-participation. Furthermore, we establish the parameters of such non-participation. Thus, it is a negative right, not a positive one, and one that may still require something of the objector. This is not necessarily true of moral objections per se. It seems clear that some moral objections, including those related to issues of CO, do warrant taking positive action. For example, some who consider abortion to be morally wrong are not morally satisfied by the fact that they do not have to involve themselves in it; they find themselves motivated to actively protest and campaign against the practice.

In this light, recall Ben-Moshe’s example of the German doctor, who holds ‘conclusively true’1 moral objections to the experiments being conducted on Jewish prisoners in Auschwitz. Are the moral objections of this doctor satisfied by establishing a negative right not to participate? Calling these objections conclusively true would seem to suggest that the ‘prevailing moral attitudes’ of Nazi Germany were conclusively false or immoral. In such cases are we not morally motivated to do more than simply not participate in the moral wrongs it enacts and perpetuates?

We might conclude, then, that while ones moral objections may motivate one to take action or, for that matter, may be deployed in the interests of receiving dispensation to do something that would otherwise be verboten, this is not the case for CO. Thus, even if one holds moral objections to the criminalisation of abortion or euthanasia this cannot be translated into a CO. The fact that some doctors, midwives and other individuals did provide abortion to women who wished to terminate their pregnancy at a time when it was widely criminalised is a demonstration of this point. They or, at least, some of them held moral objections to prevailing moral attitudes such they were motivated to act. A CO cannot provide a warrant for such actions and to represent these individuals as conscientious objectors to the criminalisation of abortion, as I think Ben-Moshe must, is to miss something important about both CO and the moral objections one might hold in relation to prevailing moral attitudes.