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VOLUME 26 NUMBER 1 JANUARY 2017 CONTENTS

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Contributors 1

Special Section: Conscientious Objection in Healthcare: Problems and Perspectives

Guest Editorial: Conscientious Objection in Healthcare: Problems and Perspectives Alberto Giubilini and Julian Savulescu 3

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Conscientious Objection in Healthcare and Moral Integrity Mark Wicclair 7

170.106.202.126 Tolerance, Professional Judgment, and the Discretionary VOLUME 26 Space of the Physician NUMBER 1 Daniel P. Sulmasy 18 JANUARY 2017

Conscientious Objection and “Effective Referral” , on

Roger Trigg 32 02 Oct 2021 at 00:23:40 My Conscience May Be My Guide, but You May Not Need to Honor It Hugh LaFollette 44 The Legal Ethical Backbone of Conscientious Refusal

Christian Munthe and Morten Ebbe Juul Nielsen 59 Pages 1–180 JANUARY 2017 NUMBER1 VOLUME 26

, subject to the Cambridge Core terms of use, available at The Cost of Conscience: Kant on Conscience and Conscientious Objection Jeanette Kennett 69 The Inevitability of Assessing Reasons in Debates about Conscientious Objection in Medicine Robert F. Card 82 Two Concepts of Conscience and their Implications for Conscience-Based Refusal in Healthcare Steve Clarke 97 Conscientious Objection, Complicity in Wrongdoing, and a Not-So-Moderate Approach Francesca Minerva 109 How to Allow Conscientious Objection in Medicine

https://www.cambridge.org/core/terms While Protecting Patient Rights Aaron Ancell and Walter Sinnott-Armstrong 120 Conscientious Non-objection in Intensive Care Dominic Wilkinson 132 Refusing to Treat Sexual Dysfunction in Sex Offenders Thomas Douglas 143 A Quarterly Journal Devoted to Engaging a World Community

. Contents continued of Bioethicists https://doi.org/10.1017/S096318011600058X

Cambridge Core For further information about this journal please go to the journal website at: cambridge.org/cqh EDITORS Thomasine Kushner, PhD, University of California, Berkeley Steve Heilig, MPH, San Francisco Medical Society ASSOCIATE EDITORS Contents continued from back cover Matti Häyry, School of Law, University of Manchester, England Tuija Takala, University of Helsinki, Finland David C. Thomasma, PhD, Co-Editor, 1992–2002 Departments and Columns Neuroethics Network/Cambridge Consortium for Bioethics Education/International Responses and Dialogue Bioethics Retreat http://www.icmbioethics.com/cambridge-home.html When the Milk of Human Kindness Becomes a Luxury (and

https://doi.org/10.1017/S096318011600058X EDITORIAL BOARD Untested) Good: A Reply to Harris’s Unconditional Embrace . . Akira Akabayashi, Kyoto University, Japan of Mitochondrial Replacement Techniques William Andereck, Medicine and Human Values, California Pacific Medical Center, San Francisco Inmaculada de Melo-Martin 159 Daniel Callahan, The Hastings Center, Garrison, New York Arthur Caplan, Division of Medical Ethics, NYU Langone Medical Center, New York A Response to “Germline Modification and the Burden of Andrew Dobson, Keele University, England Denise Dudzinki, Department of Bioethics and Humanities, University of Washington School of Medicine Human Existence,” by John Harris (CQ 25(1)) Joseph J. Fins, Division of Medical Ethics, Weill Medical College of Cornell University, New York Leonard M. Fleck, Center for Ethics and Humanities, Michigan State University How to Welcome New Technologies: Some Comments on Paul J. Ford, Department of Bioethics, Cleveland Clinic the Article by Inmaculada de Melo-Martin James Giordano, Georgetown University Medical Center John Harris 166 Amnon Goldworth, Stanford University School of Medicine John Harris, University of Manchester, England Perspectives Gerrit K. Kimsma, Vrije Universiteit Amsterdam Principles of Ethical Leadership Illustrated by Institutional https://www.cambridge.org/core/terms Eric M. Meslin, Indiana University Center for Bioethics, Indianapolis Christine Mitchell, Center for Bioethics, Harvard Medical School Management of Prion Contamination of Neurosurgical Jonathan D. Moreno, Center for Bioethics, University of Pennsylvania School of Medicine, Philadelphia Instruments Rosamond Rhodes, Mount Sinai School of Medicine, New York Pablo Rodriguez del Pozo, Weill Medical College of Cornell University in Qatar Tim Lahey, Joseph Pepe, and William Nelson 173 Doris Schroeder, Centre for Professional Ethics, University of Central Lancashire, England Robyn Shapiro, Center for the Study of Bioethics, Medical College of Wisconsin Corrigendum Pavel Tichtchenko, Institute of Philosophy, Academy of Science, Moscow, Russia The Effects of Closed-Loop Medical Devices on the Autonomy Griffin Trotter, Center for Health Care Ethics, Saint Louis University and Accountability of Persons and Systems—CORRIGENDUM Mark R. Wicclair, University of Pittsburgh & West Virginia University Philipp Kellmeyer, Thomas Cochrane, Oliver Müller, Christine Mitchell, Tonio Ball, Joseph J. Fins, SECTION EDITORS and Nikola Biller-Andorno 180 Bioethics and Literature Ethics Committees and Consultants at Work Antonio Casada Rocha, University of the Basque Country, Spain Ruchika Mishra, California Pacific Medical Center, San Francisco Best Practices Guidelines for Publishing in the Bioethics Literature Bioethics (Re)Considered The Caduceus in Court Raymond DeVries, University of Michigan Jennifer Chandler, University of Ottawa, Canada Jill Fisher, University of North Carolina Ben A. Rich, University of California, Davis Health and Human Rights Bioethics and Information Technology Doris Schroeder, University of Central Lancashire, England , subject to the Cambridge Core terms of use, available at at available use, of terms Core Cambridge the to subject , Kenneth W. Goodman, University of Miami Dissecting Politics By Invitation Matti Häyry, Aalto University, Helsinki, Finland John Harris, University of Manchester, England Tuija Takala, University of Helsinki, Finland Professionalism The Great Debates David Barnard, Oregon Health and Science University D. Michah Hester, University of Arkansas Mark R. Wicclair, University of Pittsburgh and West Virginia University Alissa H. Swota, University of North Florida Pediatric Ethics 02 Oct 2021 at 00:23:40 at 2021 Oct 02 CQ Review Kellie R. Lang, Medical College of Wisconsin

, on on , Greg Loeben, A.T. Still University-School of Health Management Douglas J. Opel, Seattle Children’s Hospital The Cambridge Bioethics Education Working Groups: Connecting Bioethics Educators Around the World The purpose of the Cambridge Bioethics Education Working Groups is to encourage people and institutions to work together on developing bioethics education in their countries. These focus groups invite others to share their information and develop mutual projects to further how bioethics is taught in universities, hospitals, and for the general public. 170.106.202.126 journals.cambridge.org/bioethics Clinical Neuroethics ADVISORY BOARD EDITOR Grant Gillett

. IP address: address: IP . Thomasine Kushner University of Otago Medical School, New Zealand University of California, Berkeley John Harris [email protected] University of Manchester, England ASSOCIATE EDITOR Judy Illes James Giordano The University of British Columbia, Canada Georgetown University Medical Center Philipp Kellmeyer EDITORIAL BOARD University of Freiburg Medical Center, Germany Yves Agid Catherine Madison Institut du Cerveau et de la Moelle Épinière, France California Medical Center, San Francisco Jennifer Chandler Christine Mitchell

https://www.cambridge.org/core University of Ottawa, Canada Harvard Medical School Markus Christen Erik Parens University of Zurich, Switzerland The Hastings Center, Garrison, New York Joseph J. Fins John R. Shook Weill Medical College of Cornell University, New York University at Buffalo Paul J. Ford Alan Yee

Downloaded from from Downloaded Department of Bioethics, Cleveland Clinic California Pacific Medical Center Cambridge Quarterly of Healthcare Ethics

Volume 26, Number 1, January 2017 https://doi.org/10.1017/S096318011600058X . . CONTENTS

Contributors 1

Special Section: Conscientious Objection in Healthcare: Problems and Perspectives

Guest Editorial: Conscientious Objection in Healthcare: Problems and Perspectives Alberto Giubilini and Julian Savulescu 3

https://www.cambridge.org/core/terms Conscientious Objection in Healthcare and Moral Integrity Mark Wicclair 7 Tolerance, Professional Judgment, and the Discretionary Space of the Physician Daniel P. Sulmasy 18 Conscientious Objection and “Effective Referral” Roger Trigg 32 My Conscience May Be My Guide, but You May Not Need to Honor It Hugh LaFollette 44 The Legal Ethical Backbone of Conscientious Refusal Christian Munthe and Morten Ebbe Juul Nielsen 59

, subject to the Cambridge Core terms of use, available at at available use, of terms Core Cambridge the to subject , The Cost of Conscience: Kant on Conscience and Conscientious Objection Jeanette Kennett 69 The Inevitability of Assessing Reasons in Debates about Conscientious Objection in Medicine

Robert F. Card 82 02 Oct 2021 at 00:23:40 at 2021 Oct 02

, on on , Two Concepts of Conscience and their Implications for Conscience-Based Refusal in Healthcare Steve Clarke 97 Conscientious Objection, Complicity in Wrongdoing, and a 170.106.202.126 Not-So-Moderate Approach Francesca Minerva 109

How to Allow Conscientious Objection in Medicine While . IP address: address: IP . Protecting Patient Rights Aaron Ancell and Walter Sinnott-Armstrong 120 Conscientious Non-objection in Intensive Care Dominic Wilkinson 132 Refusing to Treat Sexual Dysfunction in Sex Offenders

Thomas Douglas 143 https://www.cambridge.org/core

Contents continued Downloaded from from Downloaded Contents continued

Departments and Columns https://doi.org/10.1017/S096318011600058X

. . Responses and Dialogue When the Milk of Human Kindness Becomes a Luxury (and Untested) Good: A Reply to Harris’s Unconditional Embrace of Mitochondrial Replacement Techniques Inmaculada de Melo-Martin 159 A Response to “Germline Modification and the Burden of Human Existence,” by John Harris (CQ 25(1)) How to Welcome New Technologies: Some Comments on the Article by Inmaculada de Melo-Martin

John Harris 166 https://www.cambridge.org/core/terms Perspectives Principles of Ethical Leadership Illustrated by Institutional Management of Prion Contamination of Neurosurgical Instruments Tim Lahey, Joseph Pepe, and William Nelson 173 Corrigendum The Effects of Closed-Loop Medical Devices on the Autonomy and Accountability of Persons and Systems—CORRIGENDUM Philipp Kellmeyer, Thomas Cochrane, Oliver Müller, Christine Mitchell, Tonio Ball, Joseph J. Fins, and Nikola Biller-Andorno 180

, subject to the Cambridge Core terms of use, available at at available use, of terms Core Cambridge the to subject , Best Practices Guidelines for Publishing in the Bioethics Literature

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https://www.cambridge.org/core Downloaded from from Downloaded EDITORIAL OFFICE: Editorial correspondence, including manuscript submission, should be addressed to Thomasine Kushner, PhD. To facilitate review, please submit manuscripts as electronic copy, preferably in MS Word, to kushnertk@ gmail.com. Books for review should be sent to Greg Loeben, 2532 N. 4th Street, #442 Flagstaff, AZ 86004. Books for review on neuroethics should be sent to Thomasine Kushner, 1001 Bridgeway #A1, Sausalito, CA 94965. SUBSCRIPTION INFORMATION: Cambridge Quarterly of Healthcare Ethics (ISSN 0963-1801) is published quarterly, in January, April, July, and October by Cambridge University Press, One Liberty Plaza, Floor 20, New York, NY 10006/ Cambridge University Press, Journals Fulfillment Department, UPH, Shaftesbury Road, Cambridge CB2 8BS, UK. Annual

https://doi.org/10.1017/S096318011600058X subscription rates for volume 26 (2017) USA, Canada, and Mexico/Elsewhere: Institutional rates, print and online: . . $607/£378; online only: $481/£300; print only: $602/£376. Individual rates, print only: $125/£76. Single part: $173/£108. Students and retirees: $103/£64. American Society for Bioethics and Humanities members: $82/£49. Prices include postage. Subscription offices: One Liberty Plaza, Floor 20, New York, NY 10006, USA; outside the USA, Canada, and Mexico: Cambridge University Press, Journals Fulfillment Department, UPH, Shaftesbury Road, Cambridge CB2 8BS, UK. Claims for missing issues should be made immediately after receipt of the next issue. Cambridge Quarterly of Healthcare Ethics and other Cambridge journals can be found at http://journals.cambridge.org. Cambridge Quarterly of Healthcare Ethics is a partner journal of the American Society for Bioethics and Humanities. Periodicals postage paid at New York, NY and additional mailing offices. POSTMASTER: Send address changes in the USA, Canada, and Mexico to Cambridge Quarterly of Healthcare Ethics, Cambridge University Press, One Liberty Plaza, Floor 20, New York, NY 10006, USA. Send address changes elsewhere to Cambridge Quarterly of Healthcare Ethics, Cambridge

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