Wendy E. Parmet, JD and Claudia E. Haupt, PhD, JSD
Clinicians using governing authority to make public health policy are ethically obliged to draw upon scientific and clinical information that accords professional standards.
AMA J Ethics. 2023;25(3):E194-199. doi:
10.1001/amajethics.2023.194.
The social institutions of medicine and the state have a complex history of interaction in which doctors have been the originators of political ideals, goals, and social change but equally often have found themselves to be instruments of political authority.
Fifty-seven percent of women in a recent large study did not want to view their ultrasounds before their abortions, suggesting that mandated viewing interferes with uncoerced consent to care, a hallmark of medical ethics.
Instead of succumbing to the urge to portray cultural differences as a dichotomy between clashing opposites, we should endeavor to note our common humanity, acknowledge the plurality of viewpoints within a given culture, and appreciate that cultures can evolve without being untrue to themselves.
Protecting one’s moral integrity may require a conscience clause that protects positive conscience claims by permitting individuals to perform actions that are otherwise prohibited by legal or institutional rules.
Margaret Little, PhD and Anne Drapkin Lyerly, MA, MD
Society is best served by an approach to conscience that combines a progressive understanding of patients’ needs, a nuanced determination of when those needs translate into claims, and a limited role for conscientious refusal.