Conflicts of interests (COIs) in medicine are typically taken to be financial in nature: it is often assumed that a COI occurs when a health care practitioner’s financial interest conflicts with patients’ interests, public health interests, or professional obligations more in general. Even when non-financial COIs are acknowledged, ethical concerns are almost exclusively reserved for financial COIs. However, the notion of ‘interests’ cannot be reduced to its financial component. Individuals in general, and medical professionals in particular, have different types of ‘interests’, many of which are non-financial in nature but can still conflict with professional obligations. The debate about health care delivery has largely overlooked this broader notion of ‘interests’. Here, we will focus on health practitioners’ moral or religious values as particular types of personal interests involved in health care delivery that can generate COIs, and on conscientious objection in health care as the expression of a particular type of COI. We argue that, in the health care context, the COIs generated by interests of conscience can be as ethically problematic, and therefore should be treated in the same way, as financial COIs.
Alberto Giubilini is a Postdoctoral Research Fellow at the Wellcome Centre for Ethics and Humanities, the Uehiro Centre for Practical Ethics, and on the Oxford Martin Programme on Collective Responsibility for Infectious Disease. He has a PhD in Philosophy from the University of Milan, and prior to joining the University of Oxford he worked in Australia at Monash University, University of Melbourne and Charles Sturt University. He has published on different topics in bioethics and philosophy, including the ethics of vaccination, procreative choices, end of life decisions, organ donations, conscientious objection in healthcare, the concept of conscience, human enhancement, and the role of intuitions and of moral disgust in ethical arguments. He has published a book on The Ethics of Vaccination (Palgrave MacMillan 2019) and one in Italian on the ethics of end of life decisions (Morals in the Time of Bioethics, Le Lettere 2011), and he co-edited a book on The Ethics of Human Enhancement (Oxford University Press 2016). Find more information and his full CV on his Academia profile.