Under what conditions, if any, do medical professionals enjoy a right of conscience? That is, when must a just state accommodate a physician’s, pharmacist’s, or other medical professional’s refusal to provide legally and professionally sanctioned services to which she morally objects; for example, by enacting laws that enable her to do so without fear of losing her job or her professional privileges? Recent assertions by several pharmacists of a right to conscientiously refuse to fill prescriptions for the so-called morning-after pill, and by a California fertility doctor of a right to conscientiously refuse to provide fertility treatment to a lesbian, have once again made this question a prominent topic of discussion amongst philosophers and professional ethicists. Nearly all argue (correctly, in my view) that if it entails the imposition of excessive burdens on others, then the state may justifiably refuse to recognize a professional’s right of conscience. However, a number of prominent applied ethicists also endorse a second constraint on the professional’s right of conscience, arguing that it extends only to certain kinds of beliefs; specifically, only those that are reasonable, or integral to the ethical practice of medicine, or not at odds with a principle of non-discrimination. This I think mistaken. As I will now demonstrate, if the fundamental moral importance of preserving an agent’s integrity provides the justificatory basis for a professional’s right of conscience, a position most of the authors I consider here explicitly adopt, then medical professionals enjoy a pro tanto or defeasible claim to accommodation by the state regardless of the content of the belief to which they wish to remain true.

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Publication Date

Fall 2010

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Copyright © 2010, American Philosophical Association. This article first appeared in APA Newsletter on Philosophy and Law: 10:1 (2010), 7-13.

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