In our jobs, we have all had tasks we didn’t want to do, but what happens when we are asked to perform a service that goes against our fundamental beliefs?
This ethical interplay is central to Philosophy professor Carolyn McLeod’s research about the practice of conscientious refusals – declining to provide services based on personal moral beliefs – by health professionals, particularly as it relates to reproductive health care. “This is my biggest interest right now and one I find not only socially important, but fascinating philosophically,” she says. “The topic forces us to wrestle with the importance of freedom of conscience and with the limits to that freedom, especially for professionals in society.”
McLeod, who holds a cross-appointment in Women’s Studies, is breaking new ground by applying feminist theory to the myriad questions conscientious objection in health care raises. Despite obvious implications for female reproductive health, including debates about abortion, contraception and in vitro fertilization, this angle has yet to be examined in detail in philosophical bioethics.
Questions about how to define conscience and understand how much authority to give it add further dimensions to the studies. “We tend to think of conscience as an inner-nagging voice that threatens us with negative moral feelings, such as shame or guilt,” McLeod says. This voice, and its associated feelings, can be informed by an oppressive social environment, including one that is sexist or homophobic. “There is the issue of why we should take conscience seriously – our own or other people’s – if, or even if, conscience is misguided,” she adds.
McLeod has written extensively about ‘reproductive autonomy’, which refers to our ability to choose whether and how we reproduce. Reproductive autonomy extends as far as choosing the care you receive during pregnancy to deciding what options to pursue, if any, for overcoming infertility. She has also
examined other concepts important in bioethics, including trust, self-trust, integrity, informed choice, objectification and commodification, and has published work about the ethical dimensions of miscarriage, in vitro fertilization, prenatal testing, embryo and oocyte donation and contract pregnancy.
For the past two years, McLeod has been the co-director of the International Network on Feminist Approaches to Bioethics (FAB), an interdisciplinary organization with members in more than 30 countries. The network helps researchers see how their work is relevant to health issues women face around the globe.
McLeod’s research goals vary from informing health policy directly to analysing particular moral issues with the aim of giving readers – who may include health policy makers, health professionals, students, lay people or academics – a deep understanding of how one ought to approach the issue in one’s personal or professional life.