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Pragmatic defence of the register system: strengthening Clarkes consequentialist case for managing conscientious objection

Introduction

The debate over conscientious objection (CO) in healthcare remains deeply polarised, often framed as a clash between professional obligations and individual moral integrity. In their consequentialist defence of permitting CO, Steve Clarke proposes a region-based register of non-objecting professionals as a mechanism to minimise reliance on referrals—what they aptly term a ‘fight without fighting’ approach. This commentary supports Clarke’s core argument but seeks to strengthen it by addressing a potential vulnerability: the risk that such registers could exert social coercion in close-knit or ideologically homogeneous communities, discouraging professionals from listing themselves. I argue that this risk does not undermine the model but rather underscores the need for robust privacy protections and anonymous access protocols, thereby enhancing the system’s resilience and appeal from a consequentialist standpoint.

Clarke’s argument and the case for registers

Clarke’s proposal emerges from a consequentialist evaluation of the harms and benefits associated with CO. They identify significant…

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Posted in: Journal Article Abstracts on 02/13/2026 | Link to this post on IFP |
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