Always Let Your Conscience Be Your Guide?

Ever since I first learned about “conscience clauses,” which allow
medical providers to refuse to provide medical treatment or referrals
based on their own personal beliefs, they have fascinated me. I find
pharmacist refusal clauses to be particularly interesting. While I
whole-heartedly support each and every person’s right follow his or her
conscience, I, as an RJ advocate, can’t help but notice that one
person’s conscientious refusal is another person’s barrier to obtaining
a necessary reproductive health service (for example, emergency
contraception).  In rural communities, which may only have one pharmacy
or pharmacist, a conscientious refusal can altogether prevent
women from obtaining the health care services they need. I find myself
thinking, “you are a pharmacist, dispensing prescriptions and
behind-the-counter medication is your job – so do your job.”
Nonetheless, I am uncomfortable compelling individuals to perform an
action merely because that action is a commonly accepted practice in
the profession.

A perfect case-in-point is the emerging “Refuse to Sign
campaign. Begun by clergy in Ohio, the Refuse to Sign Campaign seeks
“the separation of church and state by advocating equal marriage rights
for all people, regardless of sexual orientation, by encouraging faith
communities, and their leaders, not to sign state-issued marriage
licenses.” Some religious leaders are merely refusing to sign the
licenses; some are refusing to perform marriage ceremonies at all.
Following my pharmacist refusal logic, I should think that performing
marriage ceremonies is the clergy’s job, and they should do it. But I
don’t. I realize that the analogy isn’t a perfect fit, but it raises
some interesting questions for me. Can I both support a pastor’s right
to refuse to marry people and oppose a pharmacist’s right to refuse to
dispense prescriptions? Or does support of one logically require
support of the other?

Supporting the clergy’s refusal and opposing pharmacists’ refusal is
logically consistent from an RJ perspective – we support both the right
of all to enjoy equal protection of the law and we support equal access
to contraception. But is it logically inconsistent from a moral
perspective? If I believe, as I do, that everyone should follow his or her conscience, do I have to support the effects of doing so?

Like this story? Your $10 tax-deductible contribution helps support our research, reporting, and analysis.

For more information or to schedule an interview with contact

  • invalid-0

    Megan, you’re conflating two different issues.

    If a member of the clergy refuses to sign your state-issued marriage license, it does not interfere with your civil right to be married—because that is a matter of state and law. The refusal of the clergy only affects the religious status of the marriage, and that is not a right that you are (or should be) guaranteed in any way. If I am a spouse in a same-sex marriage, the Catholic Church sure as heck isn’t going to sign my license, and that’s perfectly fine and good.

    A pharmacist refusing you medication, however, is infringing your rights at the civil level. How is that any different from restaurant owners in the Jim Crow era refusing service to Blacks? If said owners had thought to justify their racial discrimination with a religious belief, would that have made it okay? I think not!

    People should be free to follow their conscience, but this freedom can be abused to the point that it infringes upon the freedom of others (much like the right to free speech can be abused via libel). It is a broad right, but not an absolute one. And given where these refusenik pharmacists are coming from, I have absolutely no sympathy for their position, and no patience for the supposed breach of their consciences. If giving a person a medication for which they have a legitimate prescription is such a violation of their personal moral code, then I conclude that they should never have entered such a “morally fraught” profession in the first place.

    • harry834

      on the reasons pharmacists and doctors give as to why they refuse to provide medical care. Not just repro, but others like HIV drugs, gender-ressignment, etc. And that same CNN story needs to examine these reasons given and weigh them next to medical facts. AND that same CNN story needs to show how the refusal = barrier. The fact is if your doctor can say no for "personal reasons" than we ought to have this CNN story examining these reasons and weighing them next to medical facts and realities.

      Call it, "conscience and consequences: the story of doctors who refuse to treat"


      Gupta, or someone else can host. 


    • crowepps

      How is that any different from restaurant owners in the Jim Crow era refusing service to Blacks? If said owners had thought to justify their racial discrimination with a religious belief, would that have made it okay? I think not!

      Actually, both slavery and Jim Crow segregation laws were justified Biblically.  Disagreement about the Biblical justification for slavery actually caused schism in many American churches, leading to the formation of "Southern Baptists" and "Northern Baptists", "Southern Methodists" and "Northern Methodists", and "Southern Presbyterians" and "Northern Prebyterians" as distinct groups.


      A servant of servants shall he be unto his brethren. So reads Noah’s curse on his son Ham, and all his descendants, in Genesis 9:25. Over centuries of interpretation, Ham came to be identified as the ancestor of black Africans, and Noah’s curse to be seen as biblical justification for American slavery and segregation. Examining the history of the American interpretation of Noah’s curse, this book begins with an overview of the prior history of the reception of this scripture and then turns to the distinctive and creative ways in which the curse was appropriated by American pro-slavery and pro-segregation interpreters.


      Jim Crow laws were justified with a number of different verses about how Jews shouldn’t marry "foreigners", even the one about not mixing different fibers in clothing.

      "By the 1880s most southern white evangelicals had combined the overthrow of Reconstruction with a sense of spiritual triumphalism and thereby determined that God’s plan for the South was a segregated, unequal society."


  • harry834

    "Conscience and Consequences: Why doctors refuse to treat patients"

  • independentminded

    has no business being a pharmacist in the first place. Shame on those “refusenik” pharmacists who refuse to dispense emergency contraception!