Joining a profession can complicate a person’s ethical situation. For example, lawyers are obligated to defend their clients even if their client is a moral monster. In the case of health care workers, moral complications can arise when they are expected to perform medical procedures they oppose on moral or religious grounds. They can also arise when they are asked to treat a patient when they have an objection to treating patients of that type, such as a transgender person or a CEO. There is the ethical issue of whether a health care worker has the right to refuse to perform a procedure or treat a patient based on these religious or moral objections.
Some might assume that health care workers have no moral right to refuse services, especially if they are thinking of procedures they find morally acceptable. For example, a pro-choice person is likely to think that a health care worker should not deny a patient an abortion on moral or religious grounds. But this assumption would be hasty. Entering a profession does not entail that a person automatically surrenders their moral rights or conscience. To think otherwise would be to embrace the discredited notion that “just following orders” or just doing one’s job provides a moral excuse. As health care workers are morally accountable for their actions, they also retain the moral agency and freedom needed to provide the foundation for that accountability. Those who support the moral right of refusal will find this appealing, but they must remember that this moral coin has another side.
Entering a profession, especially in health care, comes with moral and professional responsibilities. These responsibilities can, like all responsibilities, justly impose burdens and obligations. For example, doctors are not permitted to immediately abandon patients they dislike or because they want to move on right now to a better paying position. The ethics of a health worker refusing to perform a procedure based on their moral or religious views requires that each procedure be reviewed to determine whether it is one that a health care worker can justly refuse or one that is a justly imposed burden.
To illustrate, consider a state employed doctor asked to keep prisoners conscious and alive during torture. Most doctors would have moral objections to this and there is the question of whether this falls within the moral expectations of their profession. On the face of it, since the purpose of the medical profession is to heal and alleviate suffering, this is not something that a doctor is obligated to do. In fact, the ethics of the profession would dictate against it.
Now, imagine a health care worker who has sincere religious or moral beliefs that when a person can no longer sustain their life on their own, they must be released to God. The worker refuses to engage in procedures that violate their principles, such as keeping a patient on life support. While this could be a sincerely held belief, it seems to run counter to the ethics of the profession. As such, such a health care worker would seem to not have the right to refuse such services.
One could even imagine extreme cases as there is no requirement to prove that a sincerely held religious belief is true, one must only be convincing in one’s (alleged) sincerity. For example, imagine a health care worker who has a sincere religious belief that a patient must prove themselves worthy in the eyes of God by surviving with only the most basic care; anything beyond that is an affront to God’s will. The patient will survive if God wills it and humans should not interfere. Such views would not be accepted as justifying their actions and they should seek another profession if they cannot do their jobs.
Turning back to services like abortion and gender transition, the issue would be whether these are like asking a medical worker to participate in torture or expecting a medical worker to provide normal medical services. Those who oppose abortion will make the moral argument that performing abortion is as bad (or worse) than abetting torture. The pro-choice will contend it is a medical procedure.
In the case of gender transition, there are no moral appeal to concerns about killing. Rather, a person must appeal to the view that people should not modify their sex and should accept what they were born with. This seems to be more like my imaginary case of a health care worker who believes that people must prove themselves worthy in the eyes of God than like the torture case, especially if someone takes the view that God wants people to stick with their original sex. That said, it could be argued that such modifications are wrong in the same way that non-restorative cosmetic surgery is wrong as both aim to allow a person to be who they want to be. I do not, however, want to claim that the transitional process is as trivial as the gender affirming procedure of getting breast implants.
While I do not think I will change minds, the matter of moral objections needs due consideration. It is easy to simply embrace one’s views without considering the possibility of error.