By Nathan Emmerich and Christine Phillips.
If one knows anything about the recent literature on conscientious objection in healthcare it is that there is a lot of it. Indeed, in the past few months two different journals have published special issues on the topic. Whilst this coverage is to be welcomed, and this complex topic continues to pose questions, it can sometimes feel as if the reality of practice escapes current work. In contrast, our recently published paper was prompted by a concrete, and rather specific, question: whether or not professional interpreters should be able to conscientiously object to participating in a consultation concerning the termination of pregnancy.
Whilst our engagement with this question no doubt has generalizable implications, it first arose as a result of an experience one of us had when an interpreter terminated their participation in a consultation because the issue of abortion had arisen. As with much else in bioethics, the issue of conscientious objection seems to have become highly individualised and many authors seem to construe the issue as a matter for individuals and a question of their integrity. However, to be a professional is to adopt a particular and socially defined role. To be or act as a professional is, in a sense, to adapt one’s individuality so as to conform with broader, collectively determined, professional responsibilities. Thus, our primary response to the question we have posed ourselves results from the Code of Ethics published by Australian Institute of Interpreters and Translators (AUSIT).
Interpreting is an unusual profession, not least because there is a sense in which the interpreter does not act independently. Insofar as their duties extend to relaying the words of others, they do not engage in any de novo speech acts. Thus, even if an interpreter knows that A is lying to B, it is their professional duty to convey that lie in the same way as it is uttered. Indeed, if that lie is subsequently believed it would be unethical for them to take it upon themselves to point this out. As such, interpreters adopt a morally neutral stance as to the content of the communications they facilitate and with regard to the situations they find themselves.
At least to us, this seems enough to deny that interpreters should have the ability to conscientiously object, particularly ‘in the moment.’ We also argue that the practicalities of the situation mean that employers, particularly public employers who provide a dedicated service to the healthcare sector, have no duty to organise their services so that they might accommodate such objections. Not only would doing so be challenging, there could be no guarantee the objectionable subject would not arise.
Furthermore, it remains open to interpreters not to work in healthcare settings. This is not the same as disbarring conscientious objectors from the profession per se, as some advocate in relation to healthcare. Interpreters with moral concerns about aspects of modern healthcare remain free to provide their services in other contexts. Nevertheless, at least as we understand it, those who act in this way should not be understood as conscientious objectors per se. Rather, they are simply taking morally motivated decisions about the kind of work they pursue. In the context of legislation for Voluntary Assisted Dying (and its nominative variations) being introduced in increasing numbers of jurisdictions, our conclusions have significance over and above the issue of abortion.
Finally, we would like to point out what we consider to be an additional point of significance when it comes to the arguments we have made. Even if we take the underlying ethical stance of professional interpreters into account, it remains the case that some professionals have the ability to conscientiously object whilst others do not, even though the circumstances are the same. Thus it is the case that comparable moral objections need not be accommodated as conscientious objections. This should not give cause for concern, at least to our mind. This is an acceptable position precisely because conscientious objection is more of a political phenomenon than is usually acknowledged in the current literature. No doubt other authors will continue to publish work on this topic; we hope that the political dimension of the issue is something that they will attended to.
Authors: Dr Nathan Emmerich and Professor Christine Phillips
Affiliation: The Medical School, College of Health and Medicine, Australian National University, Canberra, Australian Capital Territory, Australia
Competing interests: None declared.
Social media accounts of post authors: @bioethicsaus [NE]