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.
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.
When deciding whether a pregnant woman will take antidepressants that pose a slight risk to the fetus, the patient and doctor must each make value-based determinations about whether absolute protection of the fetus is more important than preventing the mother’s probable suffering.
All of us who are pursuing solutions to the obesity epidemic face clinical, ethical, and regulatory challenges. First among them is the significant role of individual lifestyle and behavior choices in causing obesity.
“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.