Bioethics Blogs

The ethics of conscientious objection: Caring for patients and supporting providers

Although conscientious objection arises in various
areas of medicine, notably end-of-life issues (e.g. physician assisted death), it
is ubiquitous in all aspects of reproductive medicine and women’s health care. Indeed,
it is discussed extensively in the academic bioethics literature, clinical
practice, healthcare law and policy (e.g. the Hobby Lobby Supreme Court case), and
in the popular press. Part of the reason conscientious objection is so
commonplace in reproductive medicine and women’s healthcare is because of the
controversial nature of abortion and emergency contraception.

The topic of conscientious objection forces us to
confront the boundaries of professional obligations and individual rights.
Which should be prioritized when they conflict? The common stance of most
professional medical organizations is that providers have an obligation to
refer if they oppose a practice/prescription based on personal beliefs (e.g.
providers should provide a referral if a patient requests an abortion and they
oppose abortion due to philosophical or religious reasons), but not if they
believe the practice/prescription doesn’t align with standard of care (e.g.
providers don’t have to provide a referral if a patient requests antibiotics
for the common cold).

The position of most medical organizations on
conscious objection raises some concerns. First, there are logistical and
feasibility concerns. While it may be easier to uphold providers’ conscientious
objection in densely populated areas, in rural areas where there may only be
one provider, thereby making it difficult to find someone to refer patients to.
It is burdensome for patients to travel far away to receive medical care that
they could receive locally if the provider did not have a conscientious

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.