A Defense of Institutional Conscience Rights for Secular Hospitals: Philosophical Justifications and Practical Applications

We have previously argued that clinicians should leverage conscience, rather than quasi-objective clinical standards, to justify their refusal to provide aggressive interventions to patients who were likely permanently unconscious. Such a move sidesteps perennial disagreements over concepts such as "futility," "harm," and "best interest"; and it is consistent with the growing acknowledgement of value pluralism in healthcare. In this paper, we make similar arguments about the conscience rights of <i>institutions</i>. We argue that, like individuals, healthcare <i>organizations</i> can leverage conscience claims to justify institution-wide prohibitions on some medical interventions that are legal and within the standard of care. Of course, faith-based healthcare institutions already enjoy institutional conscience protections. We argue that <i>secular</i> institutions can also claim conscience protections to refuse some kinds of interventions on the basis of system-level moral commitments.