The past decade has seen a burgeoning of scholarly interest in conscientious objection in healthcare. While the literature to date has focused primarily on individual healthcare practitioners who object to participation in morally controversial procedures, in this article we consider a different albeit related issue, namely, whether publicly funded healthcare institutions should be required to provide morally controversial services such as abortions, emergency contraception, voluntary sterilizations, and voluntary euthanasia. Substantive debates about institutional responsibility have remained largely at the level of (...) first-order ethical debate over medical practices which institutions have refused to offer; in this article, we argue that more fundamental questions about the metaphysics of institutions provide a neglected avenue for understanding the basis of institutional conscientious objection. To do so, we articulate a metaphysical model of institutional conscience, and consider three well-known arguments for undermining institutional conscientious objection in light of this model. We show how our metaphysical analysis of institutions creates difficulties for justifying sanctions on institutions that conscientiously object. Thus, we argue, questions about the metaphysics of institutions are deserving of serious attention from both critics and defenders of institutional conscientious objection. (shrink)

Truthmaking non-maximalism usually assumes that some truths do not have truthmakers. I suggest, however, that non-maximalism can be understood more specifically, and that different types of non-maximalism can be distinguished. To do so, I refer to two positions. The first is deflationary truthmaking, some of whose proponents assume that no truths have truthmakers. The second distinguishes between truths that do not have truthmakers but depend on being, and truths that do not have truthmakers and moreover do not depend on being. (...) Given the combinations of these positions, I propose a new classification indicating the positions available to a non-maximalist. I argue that one of these positions is particularly worth adopting because of its advantages over the other options. (shrink)