Between Orders and Relationships: Autonomy and Conscientious Objection in Health Care

Abstract

Health professionals may refuse to provide health care because they consider it against their moral or religious beliefs by resorting to conscientious objection (CO). The right to abortion in the 1970s disrupted health professional practice, as well as the racing principle of patient autonomy, turning OC into a last resort for professionals to maintain hegemony over their practice. This article focuses on the link between the autonomy in doctor-patient relationship and the appearance of conscience-based refusals in health care, arguing that one of the problems is in the liberal notion of autonomy that interprets it as independence, where “others” are regarded as unwanted interferences, whether they are health professionals, loved ones, or an ethics committee. The perspective of relational autonomy is introduced, explaining the contributions that this alternative understanding might bring into CO in health care.