The literature on conscience in medicine has paid little attention to what is meant by the word ‘conscience.’ This article distinguishes between retrospective and prospective conscience, distinguishes synderesis from conscience, and argues against intuitionist views of conscience. Conscience is defined as having two interrelated parts: (1) a commitment to morality itself; to acting and choosing morally according to the best of one’s ability, and (2) the activity of judging that an act one has done or about which one is deliberating (...) would violate that commitment. Tolerance is defined as mutual respect for conscience. A set of boundary conditions for justifiable respect for conscientious objection in medicine is proposed. (shrink)

Access to abortion services in the United States continues to decline. It does so not because of significant changes in legislation or court rulings but because fewer and fewer physicians wish to perform abortions and because most states now have "conscientious objection" legislation that makes it easy for physicians to refuse to do so. We argue in this paper that physicians have an obligation to perform all socially sanctioned medical services, including abortions, and thus that the burden of justification lies (...) upon those who wish to be excused from that obligation. That is, such persons should have to show how requiring them to perform abortions would represent a serious threat to their fundamental moral or religious beliefs. We use current California law as an example of legislation that does not take physicians' obligations into account and thus allows them too easily to declare conscientious objection. (shrink)

The ethics of corruption cannot be analysed without simultaneously addressing the legitimacy of public office or entrusted power. This paper introduces a concept of core unethical corruption, defined as violations of distributed ethical obligations for private gain. In other words, it is suggested that what is ethically wrong with corruption is that it entails the violation of certain obligations attributed to agents. By explicitly relating corruption to obligations, this approach helps make ethical sense of the concepts of public office or (...) entrusted power, attending to the question of their legitimacy. Since distributed obligations are implied by a wide range of ethical theories, the concept of core unethical corruption also reflects a (partial) overlapping consensus on the ethics of corruption. (shrink)