Conscience, Soldiers, and ACOG

Bryan McGraw offers this response to my post on the American College of Obstetricians and Gynecologists' opinion on conscience:

First, it’s worth noting that the soldier analogy seems misconstrued and is, more importantly, not quite on point.  Soldiers (I used to be one) have a duty, in fact, to disobey an order that violates their moral obligations as codified in the law of war, rules of engagement, or what have you.  You’re right, I think, to suggest that the too-easy “all-or-nothing” paradigm doesn’t quite fit, though, since there are always borderline cases where soldiers have to make choices and, sometimes, face punishment when what their conscience tells them and what their superiors tell them are at odds.  We shouldn’t shy away from this inevitability and certainly shouldn’t expect our political order to avoid it in all cases.  But the soldier analogy seems pretty misleading, more generally, as a democratic political order is not at all like a military institution.  That is, it is not defined above all as a command-and-obey institution, but as rule of the people bound together under law whose parameters are set, in some fashion, by liberties (however one might define and derive these).  There seems to me a world of difference between the soldier questioning whether he really should train his fire on a particular building as he is commanded to and a physician questioning whether he should participate in a procedure he thinks immoral even if the majority (or at least the majority of policy-makers in one particular bureaucracy) deems it necessary.

More broadly, it seems to me that you’ve flipped the burden of justification here.  The most disturbing tendency in these sorts of debates is the tendency to ascribe to policy choices (whether they come out of Congress, the Supreme Court, or administrative bodies) a kind of moral omniscience and *only then* ask whether we want to offer or allow some accommodations to those choices.  It should be, it seems to me, quite the opposite: it is the exercise of coercive authority that needs justifying, not the opposite.  While you’re right to suggest that rooting claims of conscience in enduring moral truths is problematic from a pragmatic sort of view – recognition of those “enduring moral truths” is too often fleeting and inconsistent – that’s precisely the critique that ought to be leveled at ACOG.  They are *so sure* that untrammeled access to abortions is a good thing that they are willing to say that there is no reasonable moral claim on the part of OBs that could justify their opting out of such systems.  They are the ones – not the dissenters – that are pretending to a kind of moral omniscience.

I wonder if a more fruitful line of inquiry is to ask why it is that we allow organizations like ACOG to have the authority to make those sorts of decisions?  (Similar questions could be asked of bar associations, accrediting agencies, and so on).  Too often, they make claims that de facto make them look like political authorities (in the sense that they have authority, in some sense, to determine whether someone can practice law or medicine or what-not) but without the same sort of public accountability.