When patient autonomy became a closely held value in medical ethics in the 1960s and '70s, the physician’s conscience-based right to refuse to deliver a given service began to be contested.
Julian Savulescu's writing on conscientious objection is guided by an emphasis on the principle of distributive justice that does not allow religion to have a special status as justification.
If employees of religious institutions whose consciences conflict with those of their employers were to be granted legal protection for positive claims of conscience, the religious freedom of institutions within which they work would be gravely compromised.
Rather than turning away children whose parents refuse to have them vaccinated, pediatricians should engage the parents in discussion about the importance and safety of vaccination.
Taking care of patients whose cultures, belief systems, and family hierarchy structures differ from those on which many U.S. laws and regulations involves strategies—particularly regarding end-of-life care and surrogate decision making.