Asma Khan

Clinicians have an obligation to ensure that patients with adequate capacity can make autonomous decisions. Thus, patients who choose to forego treatment and leave hospitals “against medical advice” are typically allowed to do so. But what happens when they require clinicians’ assistance to physically leave? Is it incumbent upon clinicians to not only respect and fulfill patients’ requests with which they disagree, but to physically assist in their fulfillment? We attempt to develop an ethical framework wherein clinicians can honor patients’ wishes without necessarily sacrificing their own moral position.

In recent years, there have been a number of moral panics in Western societies about the existence of religious courts and tribunals in general and Shariah law in particular. In England and Wales, these concerns came to the fore following the 2008 lecture by the then Archbishop of Canterbury, Dr Rowan Williams, on ‘Civil Law and Religious Law in England’. In that lecture, Williams drew upon the work of the Canadian scholar Ayelet Shachar endorsing her concept of ‘transformative accommodation’. In this article, we return to the work of Shachar in the light of our recent empirical study which examined the divorce jurisdiction of three religious tribunals in detail: a Jewish Beth Din; a matrimonial tribunal of the Roman Catholic Church; and a Muslim Shariah Council. We suggest that the focus upon Shachar’s concept of ‘transformative accommodation’ by Williams and subsequent commentators is unfortunate given that Shachar actually proposes ‘transformative accommodation’ as just one variant of what she refers to as ‘joint governance’ (albeit her preferred variant). We propose that the umbrella concept of ‘joint governance’ and its other variants can be developed in a way that could prove to be more useful than ‘transformative accommodation’