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The euthanasia Leviathan will brook no opposition

by Udo Schuklenk, Journal of Medical Ethics blog, 22 April 2016

Dr Schuklenk is a professor of philosophy at Queen’s University in Canada. He was a member of the “expert panel” commissioned by the Royal Society of Canada to report on assisted dying, and is scheduled to provide a keynote address at the Euthanasia 2016 conference in Amsterdam later this month.

Dr Schuklenk is the co-author (with Ricardo Smalling) of a paper recently published in the Journal of Medical Ethics entitled ‘Why medical professionals have no moral claim to conscientious objection accommodation in liberal democracies’.  He summarises his argument in this blog post:

The question arises why we should accommodate conscientiously objecting health care professionals in the first place.  It is somewhat taken as a given in much of the medical ethics literature that conscientious objectors are deserving of some kind of accommodation.  Arguments often focus on what makes a conscientious objection deserving of accommodation, and on what reasonable limits should be imposed on conscientious objectors, as opposed to the question of whether conscientious objectors deserve accommodation at all.

In our paper we develop a more radical argument for the view that health care professionals have no moral claim to conscientious objection accommodation in liberal democracies.  

Why should we accommodate privately held convictions that objecting professionals would like to prioritise over their professional obligations to patients?   That demand seems unprofessional in its own right.  The promise to serve the public good and the individual patient first goes right out of the window, there and then.  These professionals joined their profession voluntarily and they knew that the scope of professional practice and their obligations to patients wouldn’t be defined by them personally, and also that changes to scope would invariably occur over time.  The content of conscientious objections is by necessity arbitrary and encompasses any number of practical refusals to provide services.  No health care system should permit its monopoly service providers that sort of freedom when it comes to the delivery of the very same services that they voluntarily contracted to deliver.  Permitting such conscience accommodations ultimately subverts the very reasons for why society has professions in the first place.

Click here to read the full article.

Michael Cook critiques Dr Schuklenk’s extreme argument at Mercatornet:

Now here’s the interesting part: the writers [Schuklenk and Smalling] cite Leviathan, a pioneering political tract by the 17th century philosopher Thomas Hobbes, in support of their attack on the rights of conscience. It’s a tell-tale reference, for Hobbes is generally regarded as intellectual patron of the modern totalitarian state.

Unanimity is the hallmark of Hobbes’s state: “seeing a Commonwealth is but one person, it ought also to exhibit to God but one worship”. In these words are the seeds of both the Nazi Leviathan and the Communist Leviathan.

With this in mind, it is astonishing that Schuklenk and Smalling open their argument by citing Hobbes on the question of freedom of conscience. They point out that the subject of Hobbes’s sovereign has no need of an individual conscience, for “the law is the public conscience by which he hath already undertaken to be guided”. Doctors and other healthcare workers in Canada ought to heed this ominous allusion. The euthanasia Leviathan will brook no opposition. And they admit quite candidly their admiration for Hobbes:

“Of course, Hobbes is not quite our archetypical defender of liberal democracies, but the point he is making here is valid, it applies to the case of conscientious objectors in liberal democracies, too.”


In their call for the abolition of conscientious objection Schuklenk and Smalling are effectively turning the clock back to 1651, the year Hobbes published Leviathan. If Canadian MPs listen to them, 300 years of liberal democracy are at risk.

Click here to read the full article.


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