The Pharmacist’s Personal and Professional Integrity (Conscientious Objection and Emergency Contraception)

(Conscientious Objection and Emergency Contraception)

Howard Brody, Susan S Night

The American Journal of Bioethics
The American Journal of Bioethics

Extract
We conclude that, although a “duty to refer” may not describe very well an actual, working policy that effectively balances the duties of personal and professional integrity for the objecting pharmacist, Card’s (2007) mandatory-service policy fails at a basic level to respect the dual dictates of personal and professional integrity. A policy that attempts to maximize the extent to which both duties can be fulfilled might be denounced by Card as a “moderate” policy in the sense that he finds objectionable. Nonetheless, it is ethically the soundest option.


Brody H, Night SS. The Pharmacist’s Personal and Professional Integrity (Conscientious Objection and Emergency Contraception). Am J Bioeth. 2007;7(6):16-17.

The Physician as a Conscientious Objector

J David Bleich

Fordham Urban Law Journal
Fordham Urban Law Journal

Extract
Patient autonomy certainly deserves both moral respect and legal protection, but to demand of a physician that she act in a manner she deems to be morally unpalatable not only compromises the physician’s ethical integrity, but is also likely to have a corrosive effect upon the dedication and zeal with which she ministers to patients.


Bleich JD. The Physician as a Conscientious Objector. Fordham Urban Law J. 2002;30(1): 245-265 .

Insider Trading: Conscience and Critique in Bioethics

Laurie Zoloth-Dorfman, Susan B Rubin

HEC Forum
HEC Forum

Extract
The problem of conscience in ethics consultation is a central part of the creation and selection of the particular standards to which we hold ourselves accountable and the very process by which we come to know,choose, and act on what is right. Finding such standards and agreeing on how to maintain personal and professional integrity forces each of us to regard in the most serious terms the core issues of our work and its meaning. And though external sources such as our profession, religion, or community may all at times influence our sense of appropriate and inappropriate behavior, on some level, each of us must also face these questions personally. At a certain point, we face a confrontation with what we are culturally shaped by modernity to “see” as our own privatized internal guide – our conscience. Turning towards conscience is turning towards a particular kind of confrontation with ourselves.


Zoloth-Dorfman L, Rubin SB. Insider Trading: Conscience and Critique in Bioethics. HEC Forum. 1998 March;10(1):24-33.

Institutional identity, integrity, and conscience

Keven Wm Wildes

Kennedy Institute of Ethics Journal
Kennedy Institute of Ethics Journal

Abstract
Bioethics has focused on the areas of individual ethical choices — patient care — or public policy and law. There are however, important arenas for ethical choices that have been overlooked. Health care is populated with intermediate arenas such as hospitals, nursing homes, hospices, and health care systems. This essay argues that bioethics needs to develop a language and concepts for institutional ethics. A first step in this direction is to think about institutional conscience.


Wildes KW. Institutional identity, integrity, and conscience. Kennedy Inst Ethics J. 1997 Dec;7(4):413-419.

Descriptive and Normative Ethics: Conscientious Objection

Tina PH Baker

Nursing Management
Nursing Management

Abstract
Conscientious objection preserves the personal integrity and wholeness of a health care professional’s character and personality. Professionals are obligated not only to codes of ethics and standards of care that guide their practices, but also to personal values. When professional and personal values conflict with health care delivery, nurses are compelled to object on moral grounds on behalf of themselves and the public they serve.


Baker TP. Descriptive and Normative Ethics: Conscientious Objection. Nurs Manag. (Harrow). 1996;27(10):32DD-32FF

The Pro-Life Maternal-Fetal Medicine Physician: A Problem of Integrity

Jeffrey Blustein, Alan R Fleischman

The Hastings Center Report
The Hastings Center Report

Abstract
If the practice of maternal-fetal medicine sometimes results in abortion, can a physician strongly opposed to abortion maintain his own integrity and still practice in this field? . . . In the final analysis, we are not persuaded that a physician with strong pro-life convictions can be a participant in the practice of maternal-fetal medicine without betraying her or his integrity. We respect the attempts of thoughtful pro-life maternal-fetal physicians to reconcile their deeply held moral or religious beliefs with their profession’s standards of care, but it may be best for all concerned if individuals with strong objections to abortion avoided the practice of modern perinatal medicine.


Blustein J, Fleischman AR. The Pro-Life Maternal-Fetal Medicine Physician: A Problem of Integrity. Hastings Cent Rep. 1995;25(1):22-26.

Doing what the Patient Orders: Maintaining Integrity in the Doctor-Patient Relationship

Jeffrey Blustein

Bioethics
Bioethics

Extract
Conclusion

Physicians’ appeals to conscience, understood as fear of loss of integrity, should not be taken lightly. Integrity provides the basis for a unified, whole, and unalienated life, and its moral value, while dependent on the presence of other good traits in the agent, is not reducible to them. . . a physician can consistently be concerned about his or her own integrity without claiming to know better than the patient what is in the patient’s best interests. . . . The conception of integrity I have proposed . . . allows for the possibility of integrity-preserving compromise. . . . I have also considered the common practice of patient referral from the standpoint of physician integrity, and asked whether a physician who refuses to treat a patient as a matter of conscience can consistently refer the patient to another physician for the same treatment. . . in a dispute between physicians and their patients, there may be other values and principles at stake than the ones expressed in their conflicting positions, and a physician might well decide that referral in such a case is an appropriate response to a morally complex situation.


Blustein J. Doing what the Patient Orders: Maintaining Integrity in the Doctor-Patient Relationship. Bioethics. 1993;7(4):289-314.

(Editorial) A Nurse’s Conscience

Leah L Curtin

Nursing Management
Nursing Management

(This lengthy editorial was repeated verbatim in 1993. It includes the following)
Extract
“No nurse should be required to give any drug if (a) she is not competent to give it or (b) she has problems of conscience with regard to its administration. If, for these reasons, a nurse refuses to give a drug, another nurse may do so. The original nurse should receive inservice and/or counseling. If she still has conscientious objections, she should not be coerced. The patient’s right to have/refuse a drug should be protected by meticulous adherence to the principles and procedures of informed consent. However, his right to the drug is not greater than another human being’s (the nurse’s) obligation to practice with integrity. Therefore, if one nurse will not give the drug – the head nurse, coordinator or supervisor should give the drug.” If none of these nurses can, in conscience, administer the drug, then the physician who ordered it must give It himself or find another physician who will do it for him..


Curtin LL. (Editorial) A Nurse’s Conscience. Nurs Manag. 1983 Feb;14(2):7-8