What is Best for the Patient vs. Practitioner's Conscience

The following is an article summary. I encourage anyone to read the source. Reference is provided below.
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An increasing number of medical professionals are refusing care to patients on the grounds that the care sought is morally objectionable. The refusal of care is not only for the immediate actions the provider could offer but also their refusal to refer a patient to another provider. 45 states now have laws that include “conscience clauses” that remove legal penalties from physicians who refuse care due to conscientious objection. This is a right that nurses, pharmacists, and other medical professionals have begun to demand as well. At the center of this trend are ethical issues raised by technological advances, the abortion debate and the growing autonomy patients experience as mere consumers of medical product.

There have been two recent cases in Wisconsin. In the first instance a pharmacist, who viewed contraception as a form of abortion, not only refused to fill a prescription but also refused to return the prescription or send it to another pharmacy. The second instance involved a patient who had been raped and was refused emergency contraception due to the objections of the pharmacist. The patient became pregnant and then sought an abortion.

Both Gandhi and Martin Luther King, Jr. have remarked that one can ignore the law due to moral objections as long as one is prepared to face the consequences of breaking the law. But with recent legislative changes, the penalty is being removed without any concern for the needs of the patient.

The relationship between the medical professional and the patient has changed. Traditional social values of mutual responsibilities have been replaced with individual rights. Medical professionals are no longer being viewed as extraordinary in their responsibilities. The emphasis is becoming one of personal responsibility and the rights of the individual. The collective professional view of care has changed from what is best for the patient to what one can do for the patient within the framework of the care provider’s belief system.

The author warns that conscience is a slippery slope. Those who use paternalistic models to provide care are more dangerous than the incompetent care provider. The incompetent care provider at the least has a conscience. The paternalistic provider has a clear conscience for their actions with little, if any, input from the patient.

Reference
Charo, R. A. (2005). The celestial fire of conscience - refusing to deliver medical care. New England Journal of Medicine, 352(24), 2471-2473.