Turning Queer Villages into Ghost Towns: A Community Perspective on Conversion Therapies

relevant religious group. A broader answer is that such complicity is prima facie wrong because of the just mentioned harms, but also because there is a nonconsequentialist duty to not be complicit in such norms, where this duty holds quite apart from any harmful consequences that such complicity might cause. Which answer is correct? The second issue concerns patient partialism. Insofar as these cases involve trade-offs between the well-being of the patient and the well-being of others who might be harmed by the relevant norms, is it morally permissible for the patient’s physician or therapist to favor the well-being of their patient over the well-being of other people? Could such partialism even be morally required? And if it is permissible (or required), what differences in the well-being of these two parties does it permit (or require)? For example, is it permissible to provide such a therapy for one’s patient even though doing so will prevent only half the harm that it will indirectly cause to others? Or is patient impartialism, the view that harm to one’s own patient is not to be weighted any more than harm to other people, the correct view here? The third issue is whether patient contracts are permissible in these cases. They are an attractive option that can help to minimize some of the troubling outcomes. For example, if one of these conversion therapies includes an ongoing drug prescription, might it be permissible to renew this prescription only on the condition that the patient not misrepresent the physician or therapist as helping to “cure” people of homosexuality? Or are such contracts impermissible because of how they impinge on patient autonomy? The final issue concerns uncertainty. In many of these cases, the outcomes of providing this kind of therapy, including the effects on the patient, the effects on the relevant homophobic social norms, and the effects on other parties (especially gay members of the relevant group), will be difficult to predict. We need moral guidance about how to act when our evidence about any of these three kinds of facts (or any other morally relevant facts) is sparse. The natural place to start is with simple default policies. In cases where the evidence about these matters is sparse, is offering the therapy morally required, optional, or forbidden? By answering these four sets of questions, the authors can fill out their account. First, is complicity with homophobic social norms prima facie wrong solely because of its harmful consequences, or is it also wrong for nonconsequentialist reasons? Second, does a principle of patient partialism apply in these cases? If it does, what does the relevant partialist principle say? Third, are patient contracts permissible in these cases? If so, what kinds are permissible? And last, how should physicians and therapists proceed when there is insufficient evidence to make predictions about the effects of the envisioned therapy?