Herman Melville's account of Bartleby the scrivener has something to teach us about the interactive nature of refusal and the empathy necessary for an exchange of values in the setting of conscientious refusal.
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.
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.