Conscience and the Way of Medicine.

Journal Article (Journal Article)

Disputes about conscientious refusals reflect, at root, two rival accounts of what medicine is for and what physicians reasonably profess. On what we call the "provider of services model," a practitioner of medicine is professionally obligated to provide interventions that patients request so long as the interventions are legal, feasible, and are consistent with well-being as the patient perceives it. On what we call the "Way of Medicine," by contrast, a practitioner of medicine is professionally obligated to seek the patient's health, objectively construed, and to refuse requests for interventions that contradict that profession. These two accounts coexist amicably so long as what patients want is for their practitioners to use their best judgment to pursue the patient's health. But conscientious refusals expose the fact that the two accounts are ultimately irreconcilable. As such, the medical profession faces a choice: either suppress conscientious refusals, and so reify the provider of services model and demoralize medicine, or recover the Way of Medicine, and so allow physicians to refuse requests for any intervention that is not unequivocally required by the physician's profession to preserve and restore the patient's health.

Full Text

Duke Authors

Cited Authors

  • Curlin, FA; Tollefsen, CO

Published Date

  • 2019

Published In

Volume / Issue

  • 62 / 3

Start / End Page

  • 560 - 575

PubMed ID

  • 31495798

Electronic International Standard Serial Number (EISSN)

  • 1529-8795

Digital Object Identifier (DOI)

  • 10.1353/pbm.2019.0033


  • eng

Conference Location

  • United States