title: 'In good conscience': conscience-based exemptions and proper medical treatment.
abstract: Lack of clarity about the proper limits of conscientious refusal to participate in particular healthcare practices has given rise to fears that, in the absence of clear parameters, conscience-based exemptions may become increasingly widespread, leading to intolerable burdens on health professionals, patients, and institutions. Here, we identify three factors which clarify the proper scope of conscience-based exemptions: the liminal zone of 'proper medical treatment' as their territorial extent; some criteria for genuine conscientiousness; and the fact that the exercise of a valid conscience-based exemption carries certain duties with it. These restricting factors should reassure those who worry that recognising rights of conscience at all inevitably risks rampant subjectivity and self-interest on the part of professionals. At the same time, they delineate a robust conscience zone: where a claim of conscience relates to treatment with liminal status and satisfies the criteria for conscientious character, as well as the conditions for conscientious performance, it deserves muscular legal protection.
authors.affiliation: Law School and Centre for Bioethics and Medical Law, Lancaster University, Lancaster LA1 4YN, UK s.fovargue@lancaster.ac.uk.
authors.forename: Sara
authors.initials: S
authors.lastname: Fovargue
authors.affiliation: Law School, Strathclyde University, Glasgow, UK.
authors.forename: Mary
authors.initials: M
authors.lastname: Neal
mesh_terms: D000028:Abortion, Induced / Q000941:ethics / Q000331:legislation & jurisprudence; D001675:Bioethics; D003242:Conscience; D044363:Contraception, Postcoital / Q000941:ethics; D033041:Embryo Research / Q000941:ethics / Q000331:legislation & jurisprudence; D004995:Ethics, Professional; D005065:Euthanasia / Q000941:ethics / Q000331:legislation & jurisprudence; D006806:Human Rights; D006801:Humans; D017009:Professional Autonomy; D016079:Refusal to Treat / Q000941:ethics / Q000331:legislation & jurisprudence; D013727:Terminal Care / Q000941:ethics / Q000331:legislation & jurisprudence; D006113:United Kingdom
keywords: Conscience; conscience-based exemptions; conscientious objection; professional ethics; professional obligations; proper medical treatment