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.
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.
A physician has an obligation to order necessary diagnostic tests for a patient on Medicaid with whom he or she has an established patient-physician relationship regardless of whether the cost of the necessary test will be reimbursed.