Conscience and Conflict

Are there different spheres of conscience?

“…Recent scholarship suggests that understanding the role of conscience in medicine is a challenge. A common starting point for debate has been the examination of multiple definitions, views and claims of conscience [3–8]. In addition, given our pluralist society many scholars insist that agreement on the role and significance of conscience in medicine is not likely to be achieved and therefore the discussion might be better advanced by reframing the issue.…”

“…Night [7] and Barfield [11] underscore the importance of determining what informs conscience and how conscience is informed, respectively. Another central theme in the conscience debate is whether and when health care providers can refuse to provide or perform legally sanctioned and professionally endorsed medical treatments and procedures due to their personal values and beliefs [3,4,8,12–17]. Some academics even propose and/or support the creation of review boards that would ultimately deliberate, as would a jury, not only as to whether an individual's appeal to conscience was reasonable and justified [12,17–19], but also that it is genuine, sincere and consistent with previous decisions made by the individual [5,8].…”

“…Although this acknowledgement and acceptance exists within the academic community, there is simultaneous unrest as to whether such appeals should be made by health care providers whose vocation is to help patients according to codes of ethics and standards of care endorsed by the profession at large [3,5,10,12,13]. Scholars have argued against enabling health care providers to refuse to perform certain medical acts based on appeals to conscience and personal values.…”