Conflicts of Conscience in Health Care

Conflicts of Conscience in Health Care

Author: Holly Fernandez Lynch

Publisher: MIT Press

Published: 2010-08-13

Total Pages: 363

ISBN-13: 0262263637

DOWNLOAD EBOOK

A balanced proposal that protects both a patient's access to care and a physician's ability to refuse to provide certain services for reasons of conscience. 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.


Conscience in Reproductive Health Care

Conscience in Reproductive Health Care

Author: Carolyn McLeod

Publisher:

Published: 2020

Total Pages: 217

ISBN-13: 0198732724

DOWNLOAD EBOOK

In Conscience in Reproductive Health Care, Carolyn McLeod responds to a growing worldwide trend of health care professionals conscientiously refusing to provide abortions and similar reproductive health services in countries where these services are legal and professionally accepted. She argues that conscientious objectors in health care should have to prioritize the interests of patients in receiving care over their own interest in acting on their conscience. McLeod defends this 'prioritizing approach' to conscientious objection over the more popular 'compromise approach' in bioethics--without downplaying the importance of health care professionals having a conscience or the moral complexity of their conscientious refusals. She begins with a description of what is at stake for the main parties to the conflicts generated by conscientious refusals in reproductive health care: the objector and the patient. Her central argument for the prioritizing approach is that health care professionals who are charged with gatekeeping access to services such as abortions are fiduciaries for their patients and for the public they are licensed to serve. As such, they have a duty of loyalty to these beneficiaries and must give primacy to their interests in gaining access to care. McLeod provides insights into ethical issues extending beyond the question of conscientious refusal, including the value of conscience and the fundamental moral nature of the relationships health care professionals have with current and prospective patients.


Conscientious Objection in Health Care

Conscientious Objection in Health Care

Author: Mark R. Wicclair

Publisher: Cambridge University Press

Published: 2011-05-26

Total Pages: 267

ISBN-13: 1139500198

DOWNLOAD EBOOK

Historically associated with military service, conscientious objection has become a significant phenomenon in health care. Mark Wicclair offers a comprehensive ethical analysis of conscientious objection in three representative health care professions: medicine, nursing and pharmacy. He critically examines two extreme positions: the 'incompatibility thesis', that it is contrary to the professional obligations of practitioners to refuse provision of any service within the scope of their professional competence; and 'conscience absolutism', that they should be exempted from performing any action contrary to their conscience. He argues for a compromise approach that accommodates conscience-based refusals within the limits of specified ethical constraints. He also explores conscientious objection by students in each of the three professions, discusses conscience protection legislation and conscience-based refusals by pharmacies and hospitals, and analyzes several cases. His book is a valuable resource for scholars, professionals, trainees, students, and anyone interested in this increasingly important aspect of health care.


Moral Resilience

Moral Resilience

Author: Cynda Hylton Rushton

Publisher: Oxford University Press

Published: 2018-10-02

Total Pages: 321

ISBN-13: 0190619295

DOWNLOAD EBOOK

Suffering is an unavoidable reality in health care. Not only are patients and families suffering but also the clinicians who care for them. Commonly the suffering experienced by clinicians is moral in nature, in part a reflection of the increasing complexity of health care, their roles within it, and the expanding range of available interventions. Moral suffering is the anguish that occurs when the burdens of treatment appear to outweigh the benefits; scarce human and material resources must be allocated; informed consent is incomplete or inadequate; or there are disagreements about goals of treatment among patients, families or clinicians. Each is a source of moral adversity that challenges clinicians' integrity: the inner harmony that arises when their essential values and commitments are aligned with their choices and actions. If moral suffering is unrelieved it can lead to disengagement, burnout, and undermine the quality of clinical care. The most studied response to moral adversity is moral distress. The sources and sequelae of moral distress, one type of moral suffering, have been documented among clinicians across specialties. It is vital to shift the focus to solutions and to expanded individual and system strategies that mitigate the detrimental effects of moral suffering. Moral resilience, the capacity of an individual to restore or sustain integrity in response to moral adversity, offers a path forward. It encompasses capacities aimed at developing self-regulation and self-awareness, buoyancy, moral efficacy, self-stewardship and ultimately personal and relational integrity. Clinicians and healthcare organizations must work together to transform moral suffering by cultivating the individual capacities for moral resilience and designing a new architecture to support ethical practice. Used worldwide for scalable and sustainable change, the Conscious Full Spectrum approach, offers a method to solve problems to support integrity, shift patterns that undermine moral resilience and ethical practice, and source the inner potential of clinicians and leaders to produce meaningful and sustainable results that benefit all.


The Way of Medicine

The Way of Medicine

Author: Farr Curlin

Publisher: University of Notre Dame Pess

Published: 2021-08-15

Total Pages: 292

ISBN-13: 0268200874

DOWNLOAD EBOOK

Today’s medicine is spiritually deflated and morally adrift; this book explains why and offers an ethical framework to renew and guide practitioners in fulfilling their profession to heal. What is medicine and what is it for? What does it mean to be a good doctor? Answers to these questions are essential both to the practice of medicine and to understanding the moral norms that shape that practice. The Way of Medicine articulates and defends an account of medicine and medical ethics meant to challenge the reigning provider of services model, in which clinicians eschew any claim to know what is good for a patient and instead offer an array of “health care services” for the sake of the patient’s subjective well-being. Against this trend, Farr Curlin and Christopher Tollefsen call for practitioners to recover what they call the Way of Medicine, which offers physicians both a path out of the provider of services model and also the moral resources necessary to resist the various political, institutional, and cultural forces that constantly push practitioners and patients into thinking of their relationship in terms of economic exchange. Curlin and Tollefsen offer an accessible account of the ancient ethical tradition from which contemporary medicine and bioethics has departed. Their investigation, drawing on the scholarship of Leon Kass, Alasdair MacIntyre, and John Finnis, leads them to explore the nature of medicine as a practice, health as the end of medicine, the doctor-patient relationship, the rule of double effect in medical practice, and a number of clinical ethical issues from the beginning of life to its end. In the final chapter, the authors take up debates about conscience in medicine, arguing that rather than pretending to not know what is good for patients, physicians should contend conscientiously for the patient’s health and, in so doing, contend conscientiously for good medicine. The Way of Medicine is an intellectually serious yet accessible exploration of medical practice written for medical students, health care professionals, and students and scholars of bioethics and medical ethics.


Conflict of Interest in Medical Research, Education, and Practice

Conflict of Interest in Medical Research, Education, and Practice

Author: Institute of Medicine

Publisher: National Academies Press

Published: 2009-09-16

Total Pages: 436

ISBN-13: 0309145449

DOWNLOAD EBOOK

Collaborations of physicians and researchers with industry can provide valuable benefits to society, particularly in the translation of basic scientific discoveries to new therapies and products. Recent reports and news stories have, however, documented disturbing examples of relationships and practices that put at risk the integrity of medical research, the objectivity of professional education, the quality of patient care, the soundness of clinical practice guidelines, and the public's trust in medicine. Conflict of Interest in Medical Research, Education, and Practice provides a comprehensive look at conflict of interest in medicine. It offers principles to inform the design of policies to identify, limit, and manage conflicts of interest without damaging constructive collaboration with industry. It calls for both short-term actions and long-term commitments by institutions and individuals, including leaders of academic medical centers, professional societies, patient advocacy groups, government agencies, and drug, device, and pharmaceutical companies. Failure of the medical community to take convincing action on conflicts of interest invites additional legislative or regulatory measures that may be overly broad or unduly burdensome. Conflict of Interest in Medical Research, Education, and Practice makes several recommendations for strengthening conflict of interest policies and curbing relationships that create risks with little benefit. The book will serve as an invaluable resource for individuals and organizations committed to high ethical standards in all realms of medicine.


The Conscience Wars

The Conscience Wars

Author: Michel Rosenfeld

Publisher:

Published: 2018-07-05

Total Pages: 515

ISBN-13: 1107173302

DOWNLOAD EBOOK

Explores the multifaceted debate on the interconnection between conscientious objections, religious liberty, and the equality of women and sexual minorities.


What It Means to Be Human

What It Means to Be Human

Author: O. Carter Snead

Publisher:

Published: 2020

Total Pages: 337

ISBN-13: 0674987721

DOWNLOAD EBOOK

American law assumes that individuals are autonomous, defined by their capacity to choose, and not obligated to each other. But our bodies make us vulnerable and dependent, and the law leaves the weakest on their own. O. Carter Snead argues for a paradigm that recognizes embodiment, enabling law and policy to provide for the care that people need.


Practicing Medicine and Ethics

Practicing Medicine and Ethics

Author: Lauris Christopher Kaldjian

Publisher: Cambridge University Press

Published: 2014-05-26

Total Pages: 295

ISBN-13: 1107012163

DOWNLOAD EBOOK

This book explores medicine, ethics, and the challenge of moral diversity in health care. It explores how a health professional's moral beliefs and values influence the care he or she provides. It focuses on the need for a physician's wisdom, goals to guide patient care, and respect for conscience and integrity. The book culminates in a framework for practical wisdom in medicine that reflects the importance of integration (of an individual's beliefs, values, reasoning, actions, and identity), moral dialogue, humility, and professionals' obligations to patients, themselves, and society.


Opting Out: Conscience and Cooperation in a Pluralistic Society

Opting Out: Conscience and Cooperation in a Pluralistic Society

Author: David S. Oderberg

Publisher: London Publishing Partnership

Published: 2018-07-05

Total Pages: 155

ISBN-13: 0255367627

DOWNLOAD EBOOK

Should people with deeply held objections to certain practices be allowed to opt out of involvement with them? Should a Christian baker who objects to homosexuality be allowed to deny service to a customer seeking a cake for a gay wedding? Should a Catholic nurse be able to refuse to contribute to the provision of abortions without losing her job? The law increasingly answers no to such questions. But David Oderberg argues that this is a mistake. He contends that in such cases, opting out should be understood as part of a right of dissociation – and that this right needs better legal protection than it now enjoys.