Historically associated with military service, conscientious objection has become a significant phenomenon in health care. Mark Wicclair offers a comprehensive ethical analysis of conscientious objection in three representative health care professions: medicine, nursing and pharmacy. He critically examines two extreme positions: the 'incompatibility thesis', that it is contrary to the professional obligations of practitioners to refuse provision of any service within the scope of their professional competence; and 'conscience absolutism', that they should be exempted from performing any action contrary to their conscience. He argues for a compromise approach that accommodates conscience-based refusals within the limits of specified ethical constraints. He also explores conscientious objection by students in each of the three professions, discusses conscience protection legislation and conscience-based refusals by pharmacies and hospitals, and analyzes several cases. His book is a valuable resource for scholars, professionals, trainees, students, and anyone interested in this increasingly important aspect of health care.

"The subject of this book is conscientious objection in health care and the principal aim is to provide an ethical analysis of conscience-based refusals by physicians, nurses, and pharmacists. Before considering ethical issues, however, it is essential to understand what conscientious objection is, which calls for conceptual analysis. A person engages in an act of conscientious objection when she refuses to perform an action, provide a service, and so forth on the grounds that doing so is against her conscience. In the context of health care, physicians, nurses, and pharmacists engage in acts of conscientious objection when they: 1) refuse to provide legal and professionally accepted goods or services that fall within the scope of their professional competence, and 2) justify their refusal by claiming that it is an act of conscience or is conscience-based"--Provided by publisher.

In Conscience in Reproductive Health Care, Carolyn McLeod responds to a growing worldwide trend of health care professionals conscientiously refusing to provide abortions and similar reproductive health services in countries where these services are legal and professionally accepted. She argues that conscientious objectors in health care should have to prioritize the interests of patients in receiving care over their own interest in acting on their conscience. McLeod defends this 'prioritizing approach' to conscientious objection over the more popular 'compromise approach' in bioethics--without downplaying the importance of health care professionals having a conscience or the moral complexity of their conscientious refusals. She begins with a description of what is at stake for the main parties to the conflicts generated by conscientious refusals in reproductive health care: the objector and the patient. Her central argument for the prioritizing approach is that health care professionals who are charged with gatekeeping access to services such as abortions are fiduciaries for their patients and for the public they are licensed to serve. As such, they have a duty of loyalty to these beneficiaries and must give primacy to their interests in gaining access to care. McLeod provides insights into ethical issues extending beyond the question of conscientious refusal, including the value of conscience and the fundamental moral nature of the relationships health care professionals have with current and prospective patients.

This book argues that a conscientiously objecting medical professional should receive an exemption only if the grounds of an objector’s refusal are reasonable. It defends a detailed, contextual account of public reasonability suited for healthcare, which builds from the overarching concept of Rawlsian public reason. The author analyzes the main competing positions and maintains that these other views fail precisely due to their systematic inattention to the grounding reasons behind a conscientious objection; he argues that any such view is plausible to the extent that it mimics the ‘reason-giving requirement’ for conscience objections defended in this work. Only reasonable objections can defeat the prior professional obligation to assign primacy to patient well-being, therefore one who refuses a patient’s request for a legally available, medically indicated, and safe service must be able to explain the grounds of their objection in terms understandable to other citizens within the public institutional structure of medicine. The book further offers a novel policy proposal to deploy the Reasonability View: establishing conscientious objector status in medicine. It concludes that the Reasonability View is a viable and attractive position in this debate. A New Theory of Conscientious Objection in Medicine: Justification and Reasonability will be of interest to researchers and advanced students working in bioethics, medical ethics, and philosophy of medicine, as well as thinkers interested in the intersections between law, medical humanities, and philosophy.

A balanced proposal that protects both a patient's access to care and a physician's ability to refuse to provide certain services for reasons of conscience. Physicians in the United States who refuse to perform a variety of legally permissible medical services because of their own moral objections are often protected by “conscience clauses.” These laws, on the books in nearly every state since the legalization of abortion by Roe v. Wade, shield physicians and other health professionals from such potential consequences of refusal as liability and dismissal. While some praise conscience clauses as protecting important freedoms, opponents, concerned with patient access to care, argue that professional refusals should be tolerated only when they are based on valid medical grounds. In Conflicts of Conscience in Health Care, Holly Fernandez Lynch finds a way around the polarizing rhetoric associated with this issue by proposing a compromise that protects both a patient's access to care and a physician's ability to refuse. This focus on compromise is crucial, as new uses of medical technology expand the controversy beyond abortion and contraception to reach an increasing number of doctors and patients. Lynch argues that doctor-patient matching on the basis of personal moral values would eliminate, or at least minimize, many conflicts of conscience, and suggests that state licensing boards facilitate this goal. Licensing boards would be responsible for balancing the interests of doctors and patients by ensuring a sufficient number of willing physicians such that no physician's refusal leaves a patient entirely without access to desired medical services. This proposed solution, Lynch argues, accommodates patients' freedoms while leaving important room in the profession for individuals who find some of the capabilities of medical technology to be ethically objectionable.

This open access book discusses individual, collective, and institutional responsibilities with regard to vaccination from the perspective of philosophy and public health ethics. It addresses the issue of what it means for a collective to be morally responsible for the realisation of herd immunity and what the implications of collective responsibility are for individual and institutional responsibilities. The first chapter introduces some key concepts in the vaccination debate, such as ‘herd immunity’, ‘public goods’, and ‘vaccine refusal’; and explains why failure to vaccinate raises certain ethical issues. The second chapter analyses, from a philosophical perspective, the relationship between individual, collective, and institutional responsibilities with regard to the realisation of herd immunity. The third chapter is about the principle of least restrictive alternative in public health ethics and its implications for vaccination policies. Finally, the fourth chapter presents an ethical argument for unqualified compulsory vaccination, i.e. for compulsory vaccination that does not allow for any conscientious objection. The book will appeal to philosophers interested in public health ethics and the general public interested in the philosophical underpinning of different arguments about our moral obligations with regard to vaccination.

Today’s medicine is spiritually deflated and morally adrift; this book explains why and offers an ethical framework to renew and guide practitioners in fulfilling their profession to heal. What is medicine and what is it for? What does it mean to be a good doctor? Answers to these questions are essential both to the practice of medicine and to understanding the moral norms that shape that practice. The Way of Medicine articulates and defends an account of medicine and medical ethics meant to challenge the reigning provider of services model, in which clinicians eschew any claim to know what is good for a patient and instead offer an array of “health care services” for the sake of the patient’s subjective well-being. Against this trend, Farr Curlin and Christopher Tollefsen call for practitioners to recover what they call the Way of Medicine, which offers physicians both a path out of the provider of services model and also the moral resources necessary to resist the various political, institutional, and cultural forces that constantly push practitioners and patients into thinking of their relationship in terms of economic exchange. Curlin and Tollefsen offer an accessible account of the ancient ethical tradition from which contemporary medicine and bioethics has departed. Their investigation, drawing on the scholarship of Leon Kass, Alasdair MacIntyre, and John Finnis, leads them to explore the nature of medicine as a practice, health as the end of medicine, the doctor-patient relationship, the rule of double effect in medical practice, and a number of clinical ethical issues from the beginning of life to its end. In the final chapter, the authors take up debates about conscience in medicine, arguing that rather than pretending to not know what is good for patients, physicians should contend conscientiously for the patient’s health and, in so doing, contend conscientiously for good medicine. The Way of Medicine is an intellectually serious yet accessible exploration of medical practice written for medical students, health care professionals, and students and scholars of bioethics and medical ethics.

Should people with deeply held objections to certain practices be allowed to opt out of involvement with them? Should a Christian baker who objects to homosexuality be allowed to deny service to a customer seeking a cake for a gay wedding? Should a Catholic nurse be able to refuse to contribute to the provision of abortions without losing her job? The law increasingly answers no to such questions. But David Oderberg argues that this is a mistake. He contends that in such cases, opting out should be understood as part of a right of dissociation – and that this right needs better legal protection than it now enjoys.

Explores the multifaceted debate on the interconnection between conscientious objections, religious liberty, and the equality of women and sexual minorities.

This study examines the changing motives and patterns of conscientious objection as well as state policies toward objectors in the Western world.