title: Adjudicating rights or analyzing interests: ethicists' role in the debate over conscience in clinical practice.
abstract: The analysis of a dispute can focus on either interests, rights, or power. Commentators often frame the conflict over conscience in clinical practice as a dispute between a patient's right to legally available medical treatment and a clinician's right to refuse to provide interventions the clinician finds morally objectionable. Multiple sources of unresolvable moral disagreement make resolution in these terms unlikely. One should instead focus on the parties' interests and the different ways in which the health care delivery system can accommodate them. In the specific case of pharmacists refusing to dispense emergency contraception, alternative systems such as advanced prescription, pharmacist provision, and over-the-counter sales may better reconcile the client's interest in preventing unintended pregnancy and the pharmacist's interest in not contravening his or her conscience. Within such an analysis, the ethicist's role becomes identifying and clarifying the parties' morally relevant interests.
authors.affiliation: Divisions of Pediatric Inpatient Medicine and of Medical Ethics and Humanities, University of Utah School of Medicine, 100 N Mario Capecchi Drive, Salt Lake City, UT, 84113, USA. armand.antommaria@hsc.utah.edu
authors.forename: Armand H Matheny
authors.initials: AH
authors.lastname: Antommaria
mesh_terms: D016265:Conflict of Interest; D003242:Conscience; D003281:Contraceptives, Postcoital; D034462:Dissent and Disputes; D011307:Drug Prescriptions; D026689:Ethical Analysis; D026822:Ethicists; D033061:Ethics Consultation; D026690:Ethics, Clinical; D004992:Ethics, Medical; D004994:Ethics, Pharmacy; D006801:Humans; D004366:Nonprescription Drugs; D028701:Patient Rights / Q000941:ethics*; D055553:Prescription Drugs; D024382:Professional Role; D016079:Refusal to Treat / Q000941:ethics*
chemical_list: D003281:Contraceptives, Postcoital; D004366:Nonprescription Drugs; D055553:Prescription Drugs