Despite the natural desire in obstetrics for a happy outcome, sometimes the common aggressive interventions will not help maintain a pregnancy until viability.
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.
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.
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.
Navajo students whose beliefs forbid them from touching dead bodies need not forgo pursuing careers in medicine; some medical school administrators are teaching anatomy without cadavers.
A medical student’s desire to practice the specialty that he or she finds most interesting should not outweigh the right of patients in a pluralistic society to receive a full range of legal medical services.
“Difficult” patient-physician encounters have roots in uncertainty about individuals’ trustworthiness, clinicians’ skills and training, and medical science.
AMA J Ethics. 2017;19(4):391-398. doi:
10.1001/journalofethics.2017.19.4.mhst1-1704.