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Since the U.S. Supreme Court's decision in Dobbs vs. Jackson Women's Health Organization, a growing web of state laws restricts access to abortion. Here we consider how, ethically, doctors should respond when terminating a pregnancy is clinically indicated but state law imposes restrictions on doing so. We offer a typology of cases in which the dilemma emerges and a brief sketch of the current state of legal prohibitions against providing such care. We examine the issue from the standpoints of conscience, professional ethics, and civil disobedience and conclude that it is almost always morally permissible and praiseworthy to break the law and that, in a subset of cases, it is morally obligatory to do so. We further argue that health care institutions that employ or credential physicians to provide reproductive health care have an ethical duty to provide a basic suite of practical supports for them as they work to ethically resolve the dilemmas before them. [ABSTRACT FROM AUTHOR]

Pragmatic prospection is the ability to think deeply about the future in order to identify and to work productively toward goals. It involves imagining desirable future outcomes, setting sensible goals, making plans, and flexibly executing those plans. We conducted an exploratory survey of full-time working U.S. adults (N = 1541), measuring individual differences in pragmatic prospection along with life- and job-related outcomes. All data from the present survey are publicly available. Pragmatic prospection correlated positively with positive outcomes (e.g. life satisfaction, work productivity), correlated negatively with negative outcomes (e.g. anxiety, depression), and tracked with other adaptive personality traits associated with achievement and psychological adjustment (e.g. high conscientiousness, low neuroticism). These results point to pragmatic prospection as an important component of flourishing, both in the workplace and in daily life. [ABSTRACT FROM AUTHOR]

There is a pressing debate in the United States concerning the implied physicians' obligation to do no harm and the status of legalizing physician-assisted suicide (PAS). Key issues that underpin the debate are important to consider. These include: (1) foundational medical beginnings; (2) euthanasia's historical and legal background context; and (3) the key arguments held by those for and against legalization of PAS. This paper reviews the major claims made by proponents for the legalization of PAS and the associated complexities and concerns that help underscore the importance of conscience freedoms. Relief of suffering, respect for patient autonomy, and public policy arguments are discussed in these contexts. We argue here that the emphasis by healthcare providers should be on high quality and compassionate care for those at the end of life's journey who are questioning whether to prematurely end their lives. If medicine loses its chief focus on the quality of caring—even when a cure is not possible—it betrays its objective and purpose. In this backdrop, legalization of PAS harms not only healthcare professionals, but also the medical profession's mission itself. Medicine's foundation is grounded in the concept of never intentionally to inflict harm. Inflicting death by any means is not professional or proper, and is not trustworthy medicine. [ABSTRACT FROM AUTHOR]

Background: Understanding the interplay between psychosocial factors and polygenic risk scores (PRS) may help elucidate the biopsychosocial etiology of high alcohol consumption (HAC). This study examined the psychosocial moderators of HAC, determined by polygenic risk in a 10-year longitudinal study of US military veterans. We hypothesized that positive psychosocial traits (e.g. social support, personality traits, optimism, gratitude) may buffer risk of HAC in veterans with greater polygenic liability for alcohol consumption (AC). Methods: Data were analyzed from 1323 European-American US veterans who participated in the National Health and Resilience in Veterans Study, a 10-year, nationally representative longitudinal study of US military veterans. PRS reflecting genome-wide risk for AC (AUDIT-C) was derived from a Million Veteran Program genome-wide association study (N = 200 680). Results: Among the total sample, 328 (weighted 24.8%) had persistent HAC, 131 (weighted 9.9%) had new-onset HAC, 44 (weighted 3.3%) had remitted HAC, and 820 (weighted 62.0%) had no/low AC over the 10-year study period. AUDIT-C PRS was positively associated with persistent HAC relative to no/low AC [relative risk ratio (RRR) = 1.43, 95% confidence interval (CI) = 1.23–1.67] and remitted HAC (RRR = 1.63, 95% CI = 1.07–2.50). Among veterans with higher AUDIT-C PRS, greater baseline levels of agreeableness and greater dispositional gratitude were inversely associated with persistent HAC. Conclusions: AUDIT-C PRS was prospectively associated with persistent HAC over a 10-year period, and agreeableness and dispositional gratitude moderated this association. Clinical interventions designed to target these modifiable psychological traits may help mitigate risk of persistent HAC in veterans with greater polygenic liability for persistent HAC. [ABSTRACT FROM AUTHOR]

Catholic health care is often viewed as antithetical to secular conceptions of autonomy. This view can engender calls to protect "choice" in Catholic facilities. However, this view is built on a fundamental misunderstanding of the Ethical and Religious Directives for Catholic Health Care Services (ERDs). This commentary, which responds to "Principled Conscientious Provision: Referral Symmetry and Its Implications for Protecting Secular Conscience," by Abram Brummett et al., seeks to demonstrate the nuance of the ERDs as well as to address some of the challenges various Catholic identities have when interpreting and living out the ERDs so that all patients receive high‐quality, compassionate care. By highlighting the Church's desire to protect all people at every stage, I hope to dispel the caricatures that often result from misunderstandings by Catholics and non‐Catholics alike. [ABSTRACT FROM AUTHOR]

Institutional objection (IO) occurs when institutions providing health care claim objector status and refuse to provide legally permissible health services such as abortion. IO may be regulated by sources including law, ethical codes and policies (including State and local/institutional policies). We conducted a mixed-methods narrative review of the empirical evidence exploring IO to abortion provision globally, to inform areas for further research. MEDLINE (Ovid), Embase (Ovid), CINAHL (EBSCO), Global Health (CAB Abstracts), ScienceDirect and Scopus were searched in August 2021 using keywords including 'conscientious objection', 'faith-based organizations', 'religious hospitals' and 'abortion'. Eligible research focused on clinicians' attitudes and experiences of IO to abortion. The 28 studies included in the review were from nine countries: United States (19), Chile (2), Turkey (1), Argentina (1), Australia (1), Colombia (1), Ghana (1), Poland (1) and South Africa (1). The analysis demonstrated that IO was claimed in a range of countries, despite different legislative and policy frameworks. There was strong evidence from the United States that clinicians in religious healthcare institutions were less likely to provide abortions and abortion referrals, and that training of future abortion providers was negatively affected by IO. Qualitative evidence from other countries showed that IO was claimed by secular as well as religious institutions, and individual conscientious objection could be used as a mechanism for imposing IO. Further research is needed to explore whether IO is morally justified, how decisions are made to claim IO, and on what grounds. Finally, appropriate models for regulating IO are needed to ensure the protection of women's access to abortion. Such models could be informed by those used to regulate IO in other contexts, such as voluntary assisted dying. [ABSTRACT FROM AUTHOR]

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Most states have adopted conscience clauses since the Roe v. Wade paradigm in the 1970s; however, not all clauses are respective to pharmacists. The purpose of this report is to quantify the presence of conscientious objection among US states with respect to pharmacist's right to refuse to dispense. Fifty Boards of Pharmacy administrative codes were consulted for review. If Web sites were ambiguous or undeterminable, E-mail requests were sent on active legislation per National Association of Boards of Pharmacy contact information. Eleven states have conscience clauses present in their pharmacy administrative code—nearly double than last published in 2006. Requirements vary throughout the states including drug-specific limitations, requirement in writing, or notification in advance. Some states alternatively require duty to dispense. Less than one-fourth of United States boards of pharmacy provide a conscience clause or similar intended language in laws or policies. Within those states, pharmacists have a right to refuse to perform certain services based on religious, ethical, or moral objections. Imprecise language throughout the nation allows the rights to vary widely. [ABSTRACT FROM AUTHOR]

"Conscientious provision" refers to situations in which clinicians wish to provide legal and professionally accepted treatments prohibited within their (usually Catholic) health care institutions. It mirrors "conscientious objection," which refers to situations in which clinicians refuse to provide legal and professionally accepted treatments offered within their (usually secular) health care institutions. Conscientious provision is not protected by law, but conscientious objection is. In practice, this asymmetry privileges conservative religious or moral values (usually associated with objection) over secular moral values (usually associated with provision). In this article, we first argue for a legal right to one kind of conscientious provision: referral for procedures prohibited at Catholic hospitals. We then argue that a premise in that argument-the principle of comparably trivial institutional burdens-justifies legal protections for some additional forms of conscientious provision that include, for example, writing prescriptions for contraception or medical abortions. However, this principle cannot justify legal protections for other forms of conscientious provision, for instance, the right to perform surgical abortions or gender-affirming hysterectomies at Catholic hospitals., (© 2024 The Hastings Center.)

In the article "Principled Conscientious Provision: Referral Symmetry and Its Implications for Protecting Secular Conscience," Abram L. Brummett, Tanner Hafen, and Mark C. Navin reject what they call the "referral asymmetry" in U.S. conscientious objection law in medicine, which recognizes rights of conscientiously objecting physicians to withhold referrals for medical interventions but does not (yet) recognize rights of physicians to make referrals for medical interventions to which they are morally committed but to which their health care institutions are morally opposed. This commentary concentrates on a second asymmetry, namely, the relationship of a health care provider's referral or nonreferral to the medical standard of care. The commentary argues that this second asymmetry seems to require action more appropriately recognized as civil disobedience than conscientious provision of referral., (© 2024 The Hastings Center.)

In 2019, several US states passed "heartbeat" bills. Should such bills go into effect, they would outlaw abortion once an embryonic heartbeat can be detected, thereby severely limiting an individual's access to abortion. Many states allow health care professionals to refuse to provide an abortion for reasons of conscience. Yet heartbeat bills do not include a positive conscience clause that would allow health care professionals to provide an abortion for reasons of conscience. I argue that this asymmetry is unjustified. The same criteria that justify protecting conscientious refusals to provide abortion also justify protecting positive conscientious appeals regarding abortion. Thus, if the law provides legal exemptions for health care professionals who, as a matter of conscience, refuse to provide abortions where it is legal, it should also provide exemptions for health care professionals who, as a matter of conscience, feel obligated to provide abortions where it is illegal. [ABSTRACT FROM AUTHOR]

The article focuses on several headlines that announces the personal information of several million American consumers that had been compromised shocked the conscience of the nation. Topics include considered that Equifax, a credit reporting agency that compiled the personal financial information of consumers and sold it to businesses, had been hacked.

Extensive research efforts have been devoted to understanding the nature of Conscientiousness, the only Big Five personality trait that has been robustly linked to professional achievement and longevity. We proposed that Conscientiousness is associated with Personal Belief in a Just World (PBJW), that is, the extent to which an individual believes that her or his efforts will be rewarded. To investigate this proposition, we undertook a meta‐analysis synthesizing past findings regarding the relationship between PBJW and Conscientiousness; we confirmed a positive relationship between the two constructs (r =.16) based on 17 samples and 5,810 individuals. We further proposed a theoretical framework linking PBJW to specific facets of Conscientiousness. A survey of a representative sample of the US population (n = 311) confirmed that PBJW is positively correlated with the specific facets of Self‐efficacy, Achievement‐striving, and Self‐discipline. Internal Locus of Control mediated these associations, elucidating the underlying processes linking PBJW and Conscientiousness. [ABSTRACT FROM AUTHOR]

We argue that, in certain circumstances, doctors might be professionally justified to provide abortions even in those jurisdictions where abortion is illegal. That it is at least professionally permissible does not mean that they have an all-things-considered ethical justification or obligation to provide illegal abortions or that professional obligations or professional permissibility trump legal obligations. It rather means that professional organisations should respect and indeed protect doctors' positive claims of conscience to provide abortions if they plausibly track what is in the best medical interests of their patients. It is the responsibility of state authorities to enforce the law, but it is the responsibility of professional organisations to uphold the highest standards of medical ethics, even when they conflict with the law. Whatever the legal sanctions in place, healthcare professionals should not be sanctioned by the professional bodies for providing abortions according to professional standards, even if illegally. Indeed, professional organisation should lobby to offer protection to such professionals. Our arguments have practical implications for what healthcare professionals and healthcare professional organisations may or should do in those jurisdictions that legally prohibit abortion, such as some US States after the reversal of Roe v Wade ., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY. Published by BMJ.)

In the United States, healthcare providers have the federally protected right to conscientiously refuse to provide treatments or services that they feel violate their moral or religious values. This refusal of services is colloquially known as "conscientious objection," which has become a polarizing topic in today's medical and ethical landscape. Typically, physicians exercising their right to conscientious objection do not represent a barrier in access to care for most patient populations. This dynamic shifts, however, in rural America, where there are relatively few providers. In this commentary, we discuss some of the unique ramifications that are likely to occur when rural providers invoke conscientious objection in their medical practice and how this can in turn establish conscientious monopolies for the members of their communities., (© 2024 the author(s), published by De Gruyter, Berlin/Boston.)

In the medical field, conscientious objection is claimed by providers and pharmacists in an attempt to forgo administering select forms of sexual and reproductive healthcare services because they state it goes against their moral integrity. Such claim of conscientious objection may include refusing to administer emergency contraception to an individual with a medical need that is time-sensitive. Conscientious objection is first defined, and then a historical context is provided on the medical field's involvement with the issue. An explanation of emergency contraception's physiological effects is provided along with historical context of the use on emergency contraception in terms of United States Law. A comparison is given between the United States and other developed countries in regard to conscientious objection. Once an understanding of conscientious objection and emergency contraception is presented, arguments supporting and contradicting the claim are described. Opinions supporting conscientious objection include the support of moral integrity, religious diversity, and less regulation on government involvement in state law will be offered. Finally, arguments against the effects of conscientious objection with emergency contraception are explained in terms of financial implications and other repercussions for people in lower socioeconomic status groups, especially people of color. Although every clinician has the right and responsibility to treat according to their sense of responsibility or conscience, the ethical consequences of living by one's conscience are limiting and negatively impact underprivileged groups of people. It is the aim of this article to advocate against the use of provider's and pharmacist's right to claim conscientious objection due to the inequitable impact the practice has on people of color and individuals with lower incomes. [ABSTRACT FROM AUTHOR]

The article focuses on what Makes Conscientious Refusals Concerning Abortion Different. Topics discussed include Subsequent judicial decisions regarding abortion in the U.S. have continued to affirm merely a negative right from state interference, not an entitlement; and this claim raises the vexed question of who has the authority to define the professional standards of medicine in general, and women's health care.

The article focuses on the Wrong Argument for a Bad Law. Topics discussed include the passage specifies that qualified HCPs are permitted to provide an assisted death but are not obligated to; and the legalization makes the procedure permissible but not obligatory; and Clarifications of this sort neither grant exemptions since everyone is exempted from participation if they so choose nor thwart the purpose of the law.

The article focuses on Positive and Negative Claims to Conscience in Reproductive Health Care. Topics discussed include this interesting and well-argued piece by Kyle Fritz (2021) focuses on conscientious objections by health care providers (HCPs) to abortion; and bioethicists who have written on conscientious objection interpret the category narrowly so that it only includes cases where HCPs conscientiously refuse to provide health care services.

Abstract Previous research findings across a variety of nations show that affiliation with the conservative party is associated with greater longevity; however, it is thus far unclear what characteristics contribute to this relationship. We examine the political party/mortality relationship in the United States context. The goal of this paper is two-fold: first, we seek to replicate the mortality difference between Republicans and Democrats in two samples, controlling for demographic confounders. Second, we attempt to isolate and test two potential contributors to the relationship between political party affiliation and mortality: (1) socioeconomic status and (2) dispositional traits reflecting a personal responsibility ethos, as described by the Republican party. Graduate and sibling cohorts from the Wisconsin Longitudinal Study were used to estimate mortality risk from 2004 to 2014. In separate Cox proportional hazards models controlling for age and sex, we adjusted first for markers of socioeconomic status (such as wealth and education), then for dispositional traits (such as conscientiousness and active coping), and finally for both socioeconomic status and dispositional traits together. Clogg's method was used to test the statistical significance of attenuation in hazard ratios for each model. In both cohorts, Republicans exhibited lower mortality risk compared to Democrats (Hazard Ratios = 0.79 and 0.73 in graduate and sibling cohorts, respectively [p < 0.05]). This relationship was explained, in part, by socioeconomic status and traits reflecting personal responsibility. Together, socioeconomic factors and dispositional traits account for about 52% (graduates) and 44% (siblings) of Republicans' survival advantage. This study suggests that mortality differences between political parties in the US may be linked to structural and individual determinants of health. These findings highlight the need for better understanding of political party divides in mortality rates. Highlights • Republicans have greater longevity compared to Democrats, adjusting for demographics. • This relationship is partly explained by Republican's higher socioeconomic status. • This relationship is partly explained by Republican's personal responsibility ethos. [ABSTRACT FROM AUTHOR]

The article discusses candor in relation to the late Saint Thomas More's conscience and challenges involving lawyers' first freedoms under the U.S. Constitution's First Amendment, and it mentions how More is known as the patron saint of lawyers. Freedoms of speech, client selection, association, and religious expression are examined. The speech-related case National Institute of Family & Life Advocates v. Becerra and the marginalization of socially conservative lawyers are assessed.

Optimism and positive reappraising seemingly mediate religiosity's association with well-being. Yet past studies linking religiosity and cognitive coping typically use a bivariate design; thereby ignoring rival explanations. Given previous evidence that agreeableness and conscientiousness (personality traits that co-vary with optimism, positive reappraisal usage and religiosity) largely nullify the association between religiosity and social support, hierarchical regression modelling of cross-sectional survey data – Australia (N = 195), Japan (N = 931) and the USA (N = 5999) – is employed to incrementally validate religiosity's association with optimism and also positive reappraisals. Although religiosity remains a statistically significant predictor of these coping styles, including agreeableness and conscientiousness typically reduces the strength of association. These cross-cultural results lend weight to the hypothesis that religiosity is a potential, albeit small, influence on cognitive coping styles. Prospective research is now needed to establish whether changes in religiosity precede changes in coping as theorised. [ABSTRACT FROM AUTHOR]

Earlier this year, the U.S. Department of Health and Human Services announced its intent to strengthen enforcement of legal protections for health care providers' conscience rights. It proposed regulations that would give the DHHS Office of Civil Rights greater authority to ensure that recipients of federal funding comply with federal conscience laws. This recent development creates an opportunity for scholars and policy‐makers to revisit the perennial debate about whether and how law should protect health care providers' rights of conscience. Arguments about who should be protected, what actions should be protected, and whether there should be any limitations on the exercise of conscience rights have brought us no closer to a resolution. However, there is one remaining avenue for analysis that has, surprisingly, received very little attention—the question of how providers are protected, and from what consequences. Existing U.S. conscience laws immunize health care providers from a wide range of adverse consequences—including civil liability, criminal prosecution, administrative penalties, adverse action by employers, and discrimination by private actors, among others. However, academic and public policy debates rarely acknowledge the breadth of these protections. It is essential to disentangle this network of possible protections. [ABSTRACT FROM AUTHOR]

Abstract: Novel assisted reproductive technologies (ART) are poised to present our society with strange new ethical questions, such as whether lesbian, gay, bisexual, and transgender (LGBT) couples should be allowed to produce children biologically related to both parents, or whether trans‐women who want to experience childbirth should be allowed to receive uterine transplants. Clinicians opposed to offering such technologies to LGBT couples on moral grounds are likely to seek legal shelter through the conscience clauses enshrined in U.S. law. This paper begins by briefly discussing some novel ART on the horizon and noting that it is unclear whether current conscience clauses will permit fertility clinics to deny such services to LGBT individuals. A compromise approach to conscience is any view that sees the value of respecting conscience claims within limits. I describe and critique the constraints proposed in the recent work of Wicclair, NeJaime and Siegel as ultimately begging the question. My purpose is to strengthen their arguments by suggesting that in the controversial situations that elicit claims of conscience, bioethicists should engage with the metaphysical claims in play. I argue that conscience claims against LGBT individuals ought to be constrained because the underlying metaphysic—that God has decreed the LGBT lifestyle to be sinful—is highly implausible from the perspective of a naturalized metaphysic, which ought to be the lens through which we evaluate conscience claims. [ABSTRACT FROM AUTHOR]

The entire purpose of adding a Bill of Rights to the original Constitution was to ensure that the new powerful federal government did not infringe individual liberties of the people. Specifically, the Free Exercise Clause of the First Amendment was enacted to guarantee the right of every individual to worship according to the dictates of their own conscience. For many Americans of the founding era, the cause of American independence and belief in "the protection of divine providence," no matter the specific source, were inextricably linked. But despite this clear foundation, in 1990 a majority of the United States Supreme Court held in Employment Division v. Smith that as long as statutes are facially neutral and generally applicable, the burden on the free exercise of religion, even when severe, is only incidental and subject to the highly deferential standard of rational basis review. But this presents a major problem for the protection of free exercise rights. Not only does the faux scrutiny of the traditional rational basis test operate as a rubber stamp for government action, but its application to questions of free exercise rights offends the cultural traditions of the United States, the original intent of the Founders, and the logic of previous case law. This Article argues that the best solution for alleged free exercise violations to be subject to the baseline constitutional scrutiny of the rational basis "with bite" standard, which at the very least requires judges to consider the actual facts of a given case. Application of rational basis with bite is not only called for because free exercise rights are "significant rights," but because it will restore judges to their proper place as protectors of the unalienable right to free exercise embodied in the First Amendment to the U.S. Constitution. [ABSTRACT FROM AUTHOR]

The article discusses the author's views with regards to the issues to be considered by pharmacists in formulating their opinions relating to medical aid in dying. Topics covered include the highlights of the reported debates relating to assisted suicide, the important functions of organizational position statements from professional organizations, and the palliative care principles and guidance relating to medical aid in dying. It also discusses pharmacists' responses to medical aid in dying.

The article focuses on right to conscience of medical practitioners and related healthcare professionals with the decision of the U.S. Supreme Court in the case Roe v. Wade and Doe v. Bolton on the right to be free from governmental interference in procuring an elective abortion. It also mentions contemporary resistance to conscience protections for medical practitioners and conscience protections on both the state and federal levels.

The article discusses the legal right of healthcare professionals to use conscientious objection in the delivery of health care services. It highlights the differences and argue that professional associations should avoid sanctioning conscientious objection as an acceptable practice. It explains that health care professionals voluntarily choose their roles and are obliged to provide, perform, and refer standardized patient interventions according to the standards of the profession.

Some arguments against the law’s special treatment of religion are adapted from Rawls. These overlook the ways in which the abstract rights agreed to in the original position are given specific institutional form at the constitutional stage. Because the rights established in the original position are vaguely specified, liberty of conscience can’t be implemented without reliance on contestable values such as religion. Public reason, when refracted through the four-stage sequence (where it becomes less constraining at each stage of the sequence), is far less constraining than the proponents of liberal neutrality hope. Fulfilling the commitments made in the original position, for people in the world here and now, requires taking account of the values that those people hold. A Rawlsian position thus can support the American regime of religious accommodation. [ABSTRACT FROM PUBLISHER]

Job applicant faking, that is, consciously misrepresenting information during the selection process, is ubiquitous and is a threat to the usefulness of various selection tools. Understanding antecedents of faking is thus of utmost importance. Recent theories of faking highlight the central role of various forms of competition for understanding why faking occurs. Drawing on these theories, we suggest that the more applicants adhere to competitive worldviews (CWs), that is, the more they believe that the social world is a competitive, Darwinian‐type of struggle over scarce resources, the more likely they are to fake in employment interviews. We tested our hypothesis in three independent studies that were conducted in five different countries. Results show that CWs are strongly associated with faking, independently of job applicants’ cultural and economic context. More specifically, applicants’ CWs explain faking intentions and self‐reported past faking above and beyond the Dark Triad of personality (Study 1), competitiveness and the six facets of conscientiousness (Study 2). Also, when faking is measured using a response randomisation technique to control for social desirability, faking is more prevalent among applicants with strong vs. less strong CWs (Study 3). Taken together, this research demonstrates that competition is indeed strongly associated with undesirable applicant behaviors. [ABSTRACT FROM AUTHOR]

The current research sought to validate the Chernyshenko Conscientiousness Scales (CCS), a novel measure designed to assess six facets of conscientiousness. Data from 7,569 U.S. participants and 649 U.K. participants were analyzed to assess the internal reliability and factorial structure of the scales. Test–retest reliability, convergent and divergent validity, and criterion-related validity were also evaluated using a separate U.K. sample (n = 118; n = 80 for test–retest). The results showed that those items designed to measure industriousness, order, self-control, traditionalism, and virtue were best represented by a five-factor structure, broadly consistent with the five scales. However, the content and structure of the responsibility scale requires further investigation. Overall, the CCS has the potential to be a useful alternative to the faceted measures of conscientiousness that are currently available. However, future research is required to refine a number of problematic items and to clarify which facets can be better described as interstitial dimensions between conscientiousness and other Big Five domains. [ABSTRACT FROM AUTHOR]

The right to conscientious objection in the provision of healthcare is the subject of a lengthy, heated and controversial debate. Recently, a new dimension was added to this debate by the US Supreme Court's decision in Burwell vs. Hobby Lobby et al. which effectively granted rights to freedom of conscience to private, for-profit corporations. In light of this paradigm shift, we examine one of the most contentious points within this debate, the impact of granting conscience exemptions to healthcare providers on the ability of women to enjoy their rights to reproductive autonomy. We argue that the exemptions demanded by objecting healthcare providers cannot be justified on the liberal, pluralist grounds on which they are based, and impose unjustifiable costs on both individual persons, and society as a whole. In doing so, we draw attention to a worrying trend in healthcare policy in Europe and the United States to undermine women's rights to reproductive autonomy by prioritizing the rights of ideologically motivated service providers to an unjustifiably broad form of freedom of conscience. [ABSTRACT FROM AUTHOR]

Stakeholders in law, medicine, and religion are unable to reach consensus about how best to address conflicts between healthcare providers' conscientious objections to treatment and patients' rights to access medical care. Conscience laws that protect objecting providers and institutions from liability are criticized as too broad by patient advocates and as too narrow by defenders of religious freedom. This Article posits that some of the tension between these stakeholders could be mitigated by statutory recognition of a duty on the part of healthcare institutions or providers to disclose conscientiously motivated limitations on practice. While this solution would not guarantee a patient's access to treatment, referral, or information from any given provider, it would prevent some of the more egregious cases of denial of treatment--those where patients are not made aware that a legal and clinically defensible treatment option is excluded from a provider's or institution's scope of practice and so have no opportunity to seek care elsewhere. [ABSTRACT FROM AUTHOR]

Objective: Previous research has found that physicians are divided on whether they are obligated to provide a treatment to which they object and whether they should refer patients in such cases. The present study compares several possible scenarios in which a physician objects to a treatment that a patient requests, in order to better characterise physicians' beliefs about what responses are appropriate.Design: We surveyed a nationally representative sample of 1504 US primary care physicians using an experimentally manipulated vignette in which a patient requests a clinical intervention to which the patient's physician objects. We used multivariate logistic regression models to determine how vignette and respondent characteristics affected respondent's judgements.Results: Among eligible respondents, the response rate was 63% (896/1427). When faced with an objection to providing treatment, referring the patient was the action judged most appropriate (57% indicated it was appropriate), while few physicians thought it appropriate to provide treatment despite one's objection (15%). The most religious physicians were more likely than the least religious physicians to support refusing to accommodate the patient's request (38% vs 22%, OR=1.75; 95% CI 1.06 to 2.86).Conclusions: This study indicates that US physicians believe it is inappropriate to provide an intervention that violates one's personal or professional standards. Referring seems to be physicians' preferred way of responding to requests for interventions to which physicians object. [ABSTRACT FROM AUTHOR]

The present study examined correlates of work volition—the perceived capacity to make occupational choices despite constraints—with a diverse sample of 213 U.S. veterans. Veterans with higher levels of formal education, higher yearly incomes, were married, and were employed, endorsed greater work volition. Those who experienced lower posttraumatic stress disorder (PTSD) symptoms, endorsed lower levels of neuroticism, higher levels of conscientiousness, and higher levels of internal locus of control, also demonstrated greater levels of work volition. A structural model was run where PTSD symptoms, neuroticism, and conscientiousness were hypothesized to predict work volition via locus of control and compared with an alternative model. After identifying a best fitting model, bootstrapping analyses demonstrated that locus of control fully mediated the relations between PTSD symptoms, neuroticism, and conscientiousness to work volition. Specifically, the key reason PTSD symptoms, neuroticism, and conscientiousness were related to work volition was their effect on general locus of control. Practical implications are discussed. [ABSTRACT FROM AUTHOR]