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)

Social ontologists commonly think that our ideas about social entities, and about other people also inhabiting the social realm, play an important role in making those entities into what they are. At the same time, we know that our ideas are often indeterminate in character, which presumably would mean that this indeterminacy should carry over to the social realm. And yet social indeterminacy is a neglected topic in social ontology. It is argued that this neglect can be traced to how (...) a particular approach that favors ahistorical reconstructions in making sense of social entities has come to dominate social ontology. If we think beyond the parameters set by this approach, however, we can see that recognizing indeterminacy as a pervasive phenomenon in the social realm might open up new interpretative possibilities in relation to different social categories. This argument is at least partly in line with recent calls for a move towards nonideal social ontology. (shrink)