Conscience and Controversial Clinical Practices
At times patients request interventions that their physicians cannot in good conscience provide. Sometimes such interventions are both legal and approved by professional bodies.
In 2007, Curlin and colleagues published a report titled “Religion, Conscience and Controversial Clinical Practices” in the New England Journal of Medicine. The report described US physicians’ ideas about what they are obligated to do when patients request legal medical interventions to which their physicians have religious or other moral obligations.
That report and others have kindled debates about physician conscience. These debates concern the ends of medicine, the scope of professional obligations, and the role of physician moral judgment and discernment in the contemporary practice of medicine.
In March 2008 we hosted a conference, funded by the Greenwall Foundation, on this subject. Six of the papers from that conference, along with an introduction, were published in a special issue of Theoretical Medicine and Bioethics, fall 2008, edited by Dr. Curlin. Click here to read those papers. In September 2008, Dr. Curlin gave expert testimony before the President’s Council on Bioethics (click here to read the transcript) on the same subject.
In addition, we have listed below several publications by Program faculty and colleagues that address the issue of physician conscience in the practice of medicine.
- Combs MP, Antiel RM, Tilburt JC, Mueller PS, Curlin FA. “Conscientious refusals to refer: findings from a national physician survey.” J Med Ethics. 2011.
- Rasinski KA, Yoon JD, Kalad YG, Curlin FA. “Obstetrician-gynaecologists’ opinions about conscientious refusal of a request for abortion: results from a national vignette experiment.” J Med Ethics. 2011.
- Yoon JD, Rasinski KA, Curlin FA. “Moral Controversy, Directive Counsel, and the Doctor’s Role: Findings From a National Survey of Obstetrician-Gynecologists.” Academic Medicine. 2010;85(9).
- Stulberg DB, Lawrence RE, Shattuck J, Curlin FA. “Religious hospitals and primary care physicians: conflicts over policies for patient care.” J Gen Intern Med. 2010;25:725-730.
- Yoon JD, Rasinski KA, Curlin FA. “Conflict and emotional exhaustion in obstetrician-gynaecologists: a national survey.” J Med Ethics. 2010;36:731-735.
- Lawrence RE, Curlin FA. “Autonomy, religion and clinical decisions: findings from a national physician survey.” J Med Ethics. 2009;35:214-218.
- Lawrence RE, Curlin FA. “Physicians’ beliefs about conscience in medicine: a national survey.” Acad Med. 2009;84:1276-1282.
- Lantos JD, Curlin FA. “Religion, conscience and clinical decisions.” Acta Paediatr.. 2008;97:265-266.
- Curlin FA. “Caution: conscience is the limb on which medical ethics sits.” Am J Bioeth. 2007;7:30-32.
- Lawrence RE, Curlin FA. “Clash of definitions: controversies about conscience in medicine.” Am J Bioeth. 2007;7:10-14.
- Curlin FA. Patient counseling and matters of conscience. Virtual Mentor; 2005.