The implausibility of the ‘Impracticality’ and ‘Professional Role’ Arguments: a critique of the views of Lauren Notini and Justin Oakley

In their paper, Lauren Notini and Justin Oakley aim to show that it is neither practical nor professionally required or permissible for doctors to have substantive engagement with the religious beliefs of patients with decision-making capacity. This critical engagement rejects their two arguments - the impracticality argument and the professional role argument. It notes in particular the interdependence of the two arguments over against the authors' claim that they are independent. The impracticality argument, when placed under pressure leans on the professional role argument; and the professional role argument draws on the alleged strength of the impracticality argument. Moreover, the impracticality argument is committed to excluding far too much from professional competence, including substantive engagement with any kind of belief at all. Just as there are no good reasons to exclude a competence for substantive religious discussion from the definition of medical professionalism so there is no reason to exclude engagement with belief generally. The practicality argument is furthermore inherently parochial and unstable. Defences of it are unconvincing. Moreover, the implications of their claim that doctors, unlike social workers or psychologists, should not engage in substantive religious discussion, are harmful to inter-professional teamwork. The professional role argument is criticised for, among other things, depending on an implausibly restrictive notion of medicine. Positively, this response explores a wider range of possibilities for substantive religious discussion than Notini and Oakley overtly consider and takes up the question they helpfully pose about possible obligations on doctors to refer patients to religiously competent colleagues.