Abstract

Within a consequentialist framework, Steve Clarke opposes the complete exclusion of conscientious objection (CO) rights from medical professional duties. More specifically, he proposes a compromise to reduce the practical and moral costs of direct doctor–patient conflict: a system of region-based, regularly updated registers listing clinicians who do not object to specified CO-permissible procedures, together with a recommendation that patients (or referring clinicians) consult this information in advance. In doing so, the system aims to limit harms associated with referrals and in-person refusals across many clinical encounters.1 The proposal is framed as a response to the ‘incompatibility thesis’ advanced by Savulescu and Schuklenk, which holds that healthcare professionals should not be entitled to CO rights.1 2 I endorse Clarke’s efforts to refocus the argument away from competing rights claims and towards an assessment of overall implications. I contend that the implementation of registration systems inside multidisciplinary teams (MDTs), integral to contemporary healthcare delivery, may have team-level spillover effects that are often overlooked. In head and neck cancer (HNC) care, decision-making is seldom a binary choice regarding service provision; rather, it encompasses trade-offs among clinical risk, functional preservation, long-term toxicity …