Conscience and Conscientious Actions in the Context of MCOs

James F Childress

Kennedy Institute of Ethics Journal
Kennedy Institute of Ethics Journal

Abstract
Managed care organizations can produce conflicts of obligation and conflicts of interest that may lead to problems of conscience for health care professionals. This paper provides a basis for understanding the notions of conscience and conscientious objection and offers a framework for clinicians to stake out positions grounded in personal conscience as a way for them to respond to unacceptable pressures from managers to limit services.


Childress JF. Conscience and Conscientious Actions in the Context of MCOs. Kennedy Inst Ethics J. 1997 Dec;7(4):403-411.

Civil disobedience, conscientious objection, and evasive noncompliance: a framework for the analysis and assessment of illegal actions in health care

James F Childress

The Journal of Medicine and Philosophy
The Journal of Medicine and Philosophy

Abstract
This essay explores some of the conceptual and moral issues raised by illegal actions in health care. The author first identifies several types of illegal action, concentrating on civil disobedience, conscientious objection or refusal, and evasive noncompliance. Then he sketches a framework for the moral justification of these types of illegal action. Finally, he applies the conceptual and normative frameworks to several major cases of illegal action in health care, such as “mercy killing” and some decisions not to treat incompetent patients.


Childress JF. Civil disobedience, conscientious objection, and evasive noncompliance: a framework for the analysis and assessment of illegal actions in health care. J Med Philos. 1985 Feb 01;10(1):63-83.

Appeals to Conscience

James F Childress

Ethics
Ethics

Abstract
Unfortunately the phrase “appeals to conscience” is ambiguous. First, it may indicate an appeal to another person’s conscience in order to convince him to act in certain ways. Second, it may mean the invocation of one’s own conscience to interpret and justify one’s conduct to others. Third, it may indicate the invocation of conscience in debates with oneself about the right course of action, conscience being understood as a participant in the debate, a referee , or a final arbiter. Although it is possible to distinguish these three meanings of “appeals to conscience,” they are usually intertwined in our moral discourse. Nevertheless, I shall concentrate on the second meaning, referring to the other two only when it is necessary to fill out the picture.1 Appeals to conscience in the second sense raise important issues of justification and public policy which can be considered apart from the other meanings of appeals to conscience. My concern is with what we might call “conscientious objection”.


Childress JF. Appeals to Conscience. Ethics. 1979 Jul;89(4):315-335.