Three approaches to conscientious objection in health care: conscience absolutism, the incompatibility thesis, and compromise

Abstract

Conscience-based refusals to provide legal and professionally accepted health care goods and services appear to present a conflict between health care professionals and patients. On the one hand, patients seek goods and services to meet their health care needs and interests. On the other hand, health care professionals want to maintain their moral integrity, and doing so can prompt them to refuse to provide a good or service that will satisfy a patient's health needs and/or interests. Generally, an appropriate strategy for resolving such conflicts is to attempt to find a “reasonable compromise.” Addressing conscientious objection in pharmacy, Julie Cantor and Ken Baum endorse the search for a compromise: “most people can agree that we must find a workable and respectful balance between the needs of patients and the morals of pharmacists” (Cantor and Baum 2004: 2010). This approach is also recommended by the American Pharmacists Association (APhA). Its “Pharmacist Conscience Clause” states: “APhA recognizes the individual pharmacist's right to exercise conscientious refusal and supports the establishment of systems to ensure patient's [sic] access to legally prescribed therapy without compromising the pharmacist's right of conscientious refusal” (Winckler and Gans 2006: 12).