Hippocratic Resistance: Conscientious Medicine and Strategic Ethics

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Abstract

Conscientious medicine enjoys a long history, with roots reaching back to the Hippocratic Oath. Conscientious objection (CO) as a particular manifestation of such practice carries broader implications for healthcare and society. While patients have the right to decline treatments, they are free to do so for a variety of reasons, even against medical advice (AMA). Healthcare professionals (HCPs), on the other hand, are viewed differently. When it comes to morally questionable interventions, they may be asked to put aside their own convictions out of a sense of obligation or duty. Critics claim that conscientious objection that delays or limits interventions can cause harm. Supporters of conscientious objection argue that there is a growing list of interventions that raise larger questions about the definition of harm and the very nature of humanity. Not only is objection justified in such cases, but it may also be essential to the honest practice of pluralistic medicine. This essay argues that conscientious objection is a defending characteristic of medical ethics as part of the healing identity, with strong historical roots. In addition to safety and policy, conscientious practice acts as an ethical line of defense that has protective qualities for society. Current literature on this topic speaks to the clinical challenges involved with balancing objection and access. This essay uses historical examples going back to Hippocrates to illustrate how respecting individual conscience is strategic for the collective endeavor of medical ethics.

Keywords: Autonomy, Authority, Nonmaleficence, Conscientious, Conscience, Medical Ethics, Integrity, Hippocrates

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Cite as: Jon Butler, “Hippocratic Resistance: Conscientious Medicine and Strategic Ethics,” Ethics & Medicine 39, no. 2–3 (2025): online first.

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About the Author

Jon Butler, MDiv, MA, MSc
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Jon Butler, MDiv, MA, MSc is a Chaplain Ethicist in the United States Army. He holds an MDiv and MA (Bioethics) from Trinity International University and an MSc (History) from the University of Edinburgh. The views presented here are those of the author and do not necessarily represent the views of the Department of Defense or the United States Army.

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