When is an Objection Conscientious?

Dr Giuliana Fuscaldo1, Professor Lynn Gillam1, Dr Lisa Mitchell1

1Eastern Health Clinical School Monash University, Australia

Voluntary Assisted Dying (VAD) became legally available in Victoria in July 2019. However, not all health practitioners are supportive of VAD and some have raised conscientious objections to providing VAD related services.   The Victorian legislation allows that a registered health practitioner with a conscientious objection to VAD can refuse to participate in a specified list of VAD related activities.

In current clinical practice, conscientious objections are widely accepted without much scrutiny or oversight. However, there is ongoing debate in the bioethics literature about when a refusal to provide a service amounts to a conscientious objection and what factors or reasoning might distinguish between a justifiable refusal and a breach of professional duties. This debate was recently illustrated in a media report that staff from a Victorian palliative care organisation refused to verify the death of patients under their care who   died at home following VAD. In one such case, an ambulance had to be called to verify the death. While the health service maintained that it is within their rights for staff to refuse to perform this task, others described the refusal to verify deaths following VAD as discrimination and ‘failing to do their job’.

In this paper we consider the refusal to certify death against some of the conditions proposed to permit conscientious objections; that participation seriously threatens moral integrity, that refusals are morally justified and only permitted where they do not threaten the common good. We consider the concern that participation amounts to complicity and whether avoiding ‘moral taint’ can justify some conscientious objections.


bio to come.

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