Philosophy 318: Professional Ethics
Theodore Gracyk

Outline of  Davis Essay: Conscientious refusal of services

WARNING: Explanations in this outline are systematically changed to remove the focus on medicine and doctors.

Question: When is it morally right for professional A to refuse service to client B? This includes breaking off an existing professional-client relationship.

Key assumptions:

  1. A professional should not take steps to interfere in the lives of a particular person who is not the professional's client (where the general public ≠ a particular person).

  2. If a particular person is already having needs met by a (competent) professional, there is no duty to intervene and no right to interfere unless what they are doing is sufficiently wrong.  (Sufficiently wrong = it would be wrong not to interfere even if you had no relationship)

  3. It is wrong for a professional to purposely make a client worse off (i.e., to harm the client).

Given 3, you have to provide restitution and "make whole" any client you'd harm by your refusal.

Suppose client B comes to professional A and asks for service S, but A has a moral objection to S. Instead of looking at A's reasons, we can look at the consequences for B, and ban refusal when it harms B.

Given 1-3 above, it would be wrong to prevent B from locating another professional unless service S is sufficiently wrong. But refusing or quitting a particular client doesn't make the client worse off if other professional are readily available to that client and willing to provide the service.

In practice, ASK 5 QUESTIONS:

A. Is the refusing professional obligated to REFER the client?

YES, unless the behavior/choice would be sufficiently wrong to justify intervention with a person where you have no relationship. In that case, you do no wrong by refusing to refer, because it's a version of interference.

B. Does it matter if you are in the minority view in the profession?

YES, it matters. If your view is the standard view, and the chance of locating a cooperative professional is very small, then your refusal together with your failure to refer does not make the client worse off, because their result is the standard result. YOU won't make them worse off by refusing.

C. What if you're the only available professional, and your objection is mild?

Then your refusal and/or referral would make the client worse off, but you'd lack the justification to interfere in the client's life, so you must do your best to help to client achieve the goal.

D. Must the professional explain the objection to the client?

YES. You can't, by silence, create the false impression that you are unable to do the thing, or that other professionals will all refuse, too. But the professional must be careful not to coerce/manipulate the client.

E. Is the professional's objection of a sort that the person is morally wrong to enter the profession?

Sometimes you are obligated to quit, or not enter, a profession or specialization in it. If the process is routine for the profession, and your objection is mild but you are not willing to refer clients to other professionals (or provide the service when no others are available) then you should quit or not enter the field.

  • If your objections are mild, you can simply refer the client to others. If you are in the small minority and you are open in advance to clients about your refusal of certain serviced, then your refusal is excused by the fact that your refusal won't harm any clients (they can easily locate some other professional, and you will help them locate someone).

  • If your objection is sufficient to the point that you will also interfere with complete strangers, then you may enter the field and purposely work to prevent people from receiving that professional service. 




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            Last updated May 28, 2015