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.
To participate in a lethal injection is to occupy the medical role and use medical training for a purpose that is not part of the goals of medicine and that harms the recipient of treatment.
Qualifying conscience protections for institutions with requirements that they minimize hardship caused to the patient would prevent religious institutions from acting as a choke point on the path to services.
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.
Some question whether plastic surgeons bear responsibility for promoting suspect norms of beauty, given that certain types of cosmetic enhancements reinforce common conceptions of normality that are harmful to society.