TY - JOUR

T1 - Conscience and agent-integrity

T2 - a defence of conscience-based exemptions in the health care context

AU - Neal, Mary

AU - Fovargue, Sara Jane

N1 - This is a pre-copy-editing, author-produced PDF of an article accepted for publication in Medical Law Review following peer review. The definitive publisher-authenticated version Mary Neal, Sara Fovargue; Conscience and Agent-Integrity: A Defence of Conscience-Based Exemptions in the Health Care Context. Med Law Rev 2016; 24 (4): 544-570. doi: 10.1093/medlaw/fww023 is available online at: https://academic.oup.com/medlaw/article/2623371/Conscience

PY - 2016/12/31

Y1 - 2016/12/31

N2 - The issue of conscientious refusal by health care practitioners continues to attract attention from academics, and was the subject of a recent UK Supreme Court decision. Activism aimed at changing abortion law and the decision to devolve governance of abortion law to the Scottish Parliament both raise the prospect of altered provision for conscience in domestic law. In this article, building on earlier work, we argue that conscience is fundamentally connected to moral integrity and essential to the proper functioning of moral agency. We examine recent attempts to undermine the view of conscience as a matter of integrity and argue that these have been unsuccessful. With our view of conscience as a prerequisite for moral integrity and agency established and defended, we then take issue with the ‘incompatibility thesis’ (the claim that protection for conscience is incompatible with the professional obligations of healthcare practitioners). We reject each of the alternative premises on which the incompatibility thesis might rest, and challenge the assumption of a public/private divide which is entailed by all versions of the thesis. Finally, we raise concerns about the apparent blindness of the thesis to issues of power and privilege, and conclude that conscience merits robust protection.

AB - The issue of conscientious refusal by health care practitioners continues to attract attention from academics, and was the subject of a recent UK Supreme Court decision. Activism aimed at changing abortion law and the decision to devolve governance of abortion law to the Scottish Parliament both raise the prospect of altered provision for conscience in domestic law. In this article, building on earlier work, we argue that conscience is fundamentally connected to moral integrity and essential to the proper functioning of moral agency. We examine recent attempts to undermine the view of conscience as a matter of integrity and argue that these have been unsuccessful. With our view of conscience as a prerequisite for moral integrity and agency established and defended, we then take issue with the ‘incompatibility thesis’ (the claim that protection for conscience is incompatible with the professional obligations of healthcare practitioners). We reject each of the alternative premises on which the incompatibility thesis might rest, and challenge the assumption of a public/private divide which is entailed by all versions of the thesis. Finally, we raise concerns about the apparent blindness of the thesis to issues of power and privilege, and conclude that conscience merits robust protection.

KW - Conscience

KW - Conscience-based exemptions

KW - Incompatibility thesis

KW - Integrity

KW - Internal morality of medicine

KW - Professional obligations

U2 - 10.1093/medlaw/fww023

DO - 10.1093/medlaw/fww023

M3 - Editorial

VL - 24

SP - 544

EP - 570

JO - Medical Law Review

JF - Medical Law Review

SN - 0967-0742

IS - 4

ER -