Conflicts of conscience in health care : an institutional compromise

Bibliographic Information

Conflicts of conscience in health care : an institutional compromise

by Holly Fernandez Lynch

(Basic bioethics series)

MIT Press, c2008

  • : hbk

Available at  / 3 libraries

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Note

Includes bibliographical references and index

Contents of Works

  • A primer on conscience clauses
  • Defining medical professionalism
  • Moral diversity in medicine and the ideal of doctor-patient matching
  • Which institution?: licensing boards bearing the burdens of conscience and access
  • Measuring patient demand and determining which demands to meet
  • Measuring physician supply and limiting the grounds for physician refusal
  • Calibrating supply and demand
  • The "hard" cases: when the institutional solution fails
  • Physician obligations and sacrifices
  • Addressing skeptics, a model statute, and conclusions

Description and Table of Contents

Description

Physicians in the United States who refuse to perform a variety of legally permissible medical services because of their own moral objections are often protected by "conscience clauses." These laws, on the books in nearly every state since the legalization of abortion by Roe v. Wade, shield physicians and other health professionals from such potential consequences of refusal as liability and dismissal. While some praise conscience clauses as protecting important freedoms, opponents, concerned with patient access to care, argue that professional refusals should be tolerated only when they are based on valid medical grounds. In Conflicts of Conscience in Health Care, Holly Fernandez Lynch finds a way around the polarizing rhetoric associated with this issue by proposing a compromise that protects both a patient's access to care and a physician's ability to refuse. This focus on compromise is crucial, as new uses of medical technology expand the controversy beyond abortion and contraception to reach an increasing number of doctors and patients. Lynch argues that doctor-patient matching on the basis of personal moral values would eliminate, or at least minimize, many conflicts of conscience, and suggests that state licensing boards facilitate this goal. Licensing boards would be responsible for balancing the interests of doctors and patients by ensuring a sufficient number of willing physicians such that no physician's refusal leaves a patient entirely without access to desired medical services. This proposed solution, Lynch argues, accommodates patients' freedoms while leaving important room in the profession for individuals who find some of the capabilities of medical technology to be ethically objectionable.

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