Whilst conscientious objections remain contentious in the bioethics literature, they are widely accepted by health practitioners, easily raised and protected by law. The new Victorian Voluntary Assisted Dying (VAD) legislation protects the right of health practitioners to refuse to participate in VAD and allows that doctors with a conscientious objection are not obligated to discuss or provide information on VAD, provide assessments or referrals. However, it is not clear what constitutes a conscientious objection, and what kind of reasons might distinguish between a justifiable conscientious objection and an abuse of this entitlement, such as a refusal to treat based on preference, prejudice or power imbalances.
A survey of staff attitudes to VAD at our health service, found that approximately 80% of the participating workforce (n=1624) supports VAD and only 8% hold personal ethical, philosophical or religious beliefs that would prevent them from being involved in providing access to VAD. However, 79% of participants indicated that they would only be involved in VAD given the option for consciences objection, and staff willingness to be involved decreased significantly for hands-on interactions such as witnessing and assisting with VAD.
Our results suggest that some objections to providing VAD may not be true conscientious objections, but rather less morally weighty preferences, such as an aversion to providing services. In this paper, we consider the justification and limits of conscientious and non-conscientious objections with reference to medical practitioners’ understanding of conscientious objections and our own recent research findings about attitudes to VAD.