Protecting claims of conscience can function to fairly balance burdens among relevant parties without first having to resolve an underlying and intractable moral disagreement. Recently, a number of theorists have argued that the relevant criteria for protecting negative appeals to conscience in health care can (suitably modified) be equally well-satisfied in cases of positive appeals. I argue that, when it comes to certain practices, the justification of positive appeals to conscience does in fact depend upon contested claims in the debate (...) over the moral permissibility of those practices. This fact threatens to undermine one of the central functions of protecting appeals to conscience: that we can agree to disagree. (shrink)

A peer commentary on an AJOB article by Kyle Fritz called "Unjustified Asymmetry: Positive Claims of Conscience and Heartbeat Bills.".

Kyle Fritz argues for the following conditional statement: if healthcare providers should be allowed to conscientiously object to providing abortions in jurisdictions where abortions...

Conscientious refusal involves decisions by healthcare workers, on grounds of their conscience, to refuse to provide legal, professionally permissible and safe health interventions to patients. Conscientious provision involves decisions by healthcare workers, also on grounds of conscience, to provide safe and beneficial healthcare to patients that is prohibited by law or policy. Some bioethicists believe that the moral issues governing both are identical, and that if one permits conscientious refusals, one should also permit conscientious provisions. This article argues that this (...) assumption of symmetry is incorrect. To demonstrate this, it does the following: first, it establishes why it matters that we understand the difference between them; second, it describes three recent cases of conscientious provision in Canadian healthcare to help characterize its nature and scope; third, it situates these cases in a socio-economically nuanced analysis of the role of the conscientious provider under conditions or privilege and oppression; finally, it applies insights from the cases and the intersectional analysis to common criticisms of conscientious refusal to reinforce the fundamental asymmetries between conscientious refusal and conscientious provision. (shrink)

Should doctors ever be allowed to offer care that their state or employer forbids? What if their deeply held personal values or beliefs demand they treat patients in need? We’re used to hearing abo...

The controversy around the accommodation of conscientious objections in medicine persists, especially for such contentious services as abortions. COs are typically considered in their negativ...

Fritz argues that there is an “unjustified asymmetry” in legislation that allows physicians and health care institutions to refuse to provide elective abortions and other morally contested l...

We appreciate Fritz’s thoughtful analysis of the asymmetry between legal protections for negative and positive conscience claims and are particularly interested in further exploring the conc...

The target article by Kyle Fritz draws attention to the asymmetry debate, an under-analyzed issue within the broader debate over the proper role of physician conscience in healthcare. The as...

Abstract“Conscientious provision” refers to situations in which clinicians wish to provide legal and professionally accepted treatments prohibited within their (usually Catholic) health care institutions. It mirrors “conscientious objection,” which refers to situations in which clinicians refuse to provide legal and professionally accepted treatments offered within their (usually secular) health care institutions. Conscientious provision is not protected by law, but conscientious objection is. In practice, this asymmetry privileges conservative religious or moral values (usually associated with objection) over secular moral values (usually (...) associated with provision). In this article, we first argue for a legal right to one kind of conscientious provision: referral for procedures prohibited at Catholic hospitals. We then argue that a premise in that argument—the principle of comparably trivial institutional burdens—justifies legal protections for some additional forms of conscientious provision that include, for example, writing prescriptions for contraception or medical abortions. However, this principle cannot justify legal protections for other forms of conscientious provision, for instance, the right to perform surgical abortions or gender-affirming hysterectomies at Catholic hospitals. (shrink)