The Spark of Conscience Inflames Debate: Conscientious Refusals in Health Care

Is conscience a feeling? Does conscience provide its own justification. If we require independent reason to verify that the judgment of conscience is correct, is conscience, then, superfluous.

Those were the questions posed by SCU Assistant Professor of Philosophy Shannon Vallor to kick off a panel on "The Nature of Conscience," part of a conference on conscientious refusals in health care Nov. 3 and 4, 2011, at Santa Clara University.

Vallor joined Kimberly Brownlee, senior lecturer in moral and political philosophy at Manchester University, and Daniel Weinstock, Canada Research Chair in ethics and political philosophy, Université de Montréal, in exploring the bases in philosophy for a person to exercise a conscientious refusal to perform a medical service. An example might be a pharmacist who refuses to fill a prescription for birth control because it violates his or her principles as a Catholic.

Brownlee pointed out that one problem with the exercise of conscience in such circumstances is that the issue may be essentially contestable and therefore subject to endless dispute.

Weinstock suggested that involving stakeholders in decision making might be one way to promote a sense of moral agency in the people affected by the decision; such a process might make dissenters feel able to carry out even policies with which they disagreed because their views had been heard.

"The Nature of Conscience" was one of four panels at the conference. The first looked at specific cases of conscientious refusal. Others explored the natue of moral conflict between health care professionals and patients and the moral and legal permissibility of conscientious refusals. Keynote addresses were delivered by Francoise Baylis, fellow of the Royal Society of Canada, and Albert Johnson, author of The Abuse of Casuistry: A History of Moral Reasoning.

The conference was sponsored by the Markkula Center for Applied Ethics, the SCU Department of Philosophy; the Ignatian Center for Jesuit Education, the Canadian Institutes of Health Research, and the University of Western Ontario.