ARTICLE
As Rousseau presents it , “ There is therefore at the bottom of our hearts an innate principle of justice and virtue , by which , in spite of our maxims , we judge our own actions or those of others to be good or evil ; and it is this principle that I call conscience ”. 1
According to Rousseau , then , conscience has a natural tendency to perceive and follow the right order of nature , and a good teacher should guide a young person ’ s conscience to do what it is naturally predisposed to do . Continuing Rousseau ’ s words :
“ Too often does reason deceive us ; we have only too good a right to doubt her ; but conscience never deceives us ; she is the true guide of man ; it is to the soul what instinct is to the body ; he who obeys his conscience is following nature and he need not fear that he will go astray … Let us obey the call of nature ; we shall see that her yoke is easy and that when we give heed to her voice we find a joy in the answer of a good conscience ”. 2
Freedom of conscience and conscientious objection today
Freedom of conscience is today protected by the United Nations Universal Declaration of Human Rights , which reads : “ Everyone has the right to freedom of thought , conscience and religion ” ( art . 18 ).
According to Strohm , this article should not be taken to imply freedom to act according to one ’ s conscience , but it refers only to “ matters of inward conviction .” 3 If this interpretation is correct , article 18 does not seem to raise any interesting philosophical or practical problem today , as very few people today would deny freedom in matters of inward conviction . More problematic is the moral and political debate about the freedom to act , or to refrain from acting , according to one ’ s conscience , especially where there are professional roles or legal obligations that would demand otherwise . In fact , appeals to conscience and freedom of conscience are often deployed to claim and justify “ conscientious objection ” to certain activities that someone would otherwise be required to perform .
According to those who are against a right to conscientious objection , professional obligations override any value conscience might have . 4 , 5 , 6 , 7 According to defenders of conscientious objection , professionals ’ consciences must be protected to the largest extent possible , i . e ., up to the point where respecting conscience would significantly jeopardise the physical or psychological health of patients . 8 , 9 Determining that point might , depending on circumstances — for example too high a percentage of objecting practitioners , which would make it nearly impossible to refer patients to non-objecting doctors — be very difficult to achieve . 10 Between these two stances , there are positions that are neither for nor against conscientious objection in principle , but propose tighter restrictions on those who advance conscientious objection . 11 Such restrictions would include for example the requirement to provide reasons for the objection , and to submit such reasons to public scrutiny or experts ’ assessment of the reasonability of the objection , 12 , 13 or the qualification that objection can only be justified if it is found to be consistent with the internal values of
14 , 15 the profession .
Personal views on what conscience is
Whatever the experts might say , most of us presume there is , however defined , an experienced feeling termed conscience , serving to alert us to any potential conflict between values , and then indicating which of these should guide our choices . There are differing definitions of conscience , and it is therefore important to distinguish between what it is and what it is not .
Conscience is no longer thought of by ethicists and psychologists as a voice that persuades us towards a particular course of action or releases us from past transgressions . Nor is it two voices , often discussed as a devil and an angel , that whisper conflicting advice in our ears . These conclusions have been based on the more foundational idea that conscience should not be considered separate and external to us , nor separate and internal to us . On the contrary , we are asked to now consider it to be integral to who we are as a human being , engaging with our whole person . It is something we do , not something we possess . And it is believed to be ultimately based in reason and thus able to be challenged and explained .
An examination of the literature from philosophers who look at the idea of conscience has settled on four main understandings of conscience . It can be thought of as :
1 . a faculty for self-knowledge and selfassessment , or as
2 . having an epistemic function in the sphere of morality , or as 3 . a motivational force , or again as a 4 . set of self-identifying moral beliefs
or a combination of any of these . It can be seen , therefore , how important it would be to have clearly in mind what exactly we are talking about when we talk of conscience and of freedom of conscience in varying circumstances . I would like to emphasise here the idea of ‘ freedom of conscience ’ just mentioned . This needs to be taken in two ways . One , the freedom to act on the promptings of one ’ s conscience , and two , the freedom to be able to deliberately influence what those promptings are , allied to the point made earlier about whether or not your conscience is locked and rigid or open to reasoned change .
Conscience in complementary medicine healthcare
Healthcare is widely understood and perceived as an ethical or moral activity – not just something technical . Healthcare practitioners It is not always easy to act in accordance
JATMS | Winter 2021 | 93