title: A clear case for conscience in healthcare practice.
abstract: The value of conscience in healthcare ethics is widely debated. While some sources present it as an unquestionably positive attribute, others question both the veracity of its decisions and the effect of conscientious objection on patient access to health care. This paper argues that the right to object conscientiously should be broadened, subject to certain previsos, as there are many benefits to healthcare practice in the development of the consciences of practitioners. While effects such as the preservation of moral integrity are widely considered to benefit practitioners, this paper draws on the work of Hannah Arendt to offer several original arguments in defence of conscience that may more directly benefit patients, namely that a pang of conscience may be useful in rapidly unfolding situations in which there is no time to reflect satisfactorily upon activities and that, given the hierarchical nature of healthcare institutions, a right to defy authority on the basis of conscience may benefit junior staff who lack the institutional power to challenge the orders of superiors.
authors.affiliation: Paediatric Intensive Care Unit, Bristol Royal Hospital for Children, Upper Maudlin Street, Bristol, UK. gbirchley@blueyonder.co.uk
authors.forename: Giles
authors.initials: G
authors.lastname: Birchley
mesh_terms: D003242:Conscience; D003657:Decision Making / Q000941:ethics; D004992:Ethics, Medical; D006297:Health Services Accessibility / Q000941:ethics*; D006806:Human Rights; D006801:Humans; D028681:Moral Obligations; D011787:Quality of Health Care / Q000941:ethics*; D016079:Refusal to Treat / Q000941:ethics