Hippocratic Resistance: Conscientious Medicine and Strategic Ethics

Posted on December 31, 2023April 18, 2026 by Jon Butler, MDiv, MA, MSc

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

When I Am Vulnerable, Imitatio Dei?

Posted on August 31, 2022April 18, 2026 by Nooshig Luz Salvador, MD, MS, MA, ABOIM, LAc, NCCAOM

Abstract

An analysis of patient autonomy through the lens of the theology of vulnerability and the Trinitarian approach to holistic healthcare decisions.

Keywords: Autonomy, Vulnerability, Contemporary Bioethics, Human Dignity, imago Dei, Trinitarian Theology

Ten Critical Ethical, Conceptual, and Clinical Cautions Concerning the Diagnosis and Treatment of Gender Dysphoria and Transgender Identification

Posted on August 31, 2022April 18, 2026 by A. A. Howsepian, MD, PhD

Abstract

There is an urgent need for ethical, conceptual, and clinical clarity regarding the diagnosis and treatment of gender dysphoria and transgender identification. In this essay, I highlight ten critical concerns in this arena, namely, those involving: (1) conceptual parallels between sexual reassignment surgery and elective limb amputation; (2) the lack of long-term data that demonstrates reliable long-term relief from gender dysphoria in those undergoing hormonal or surgical treatment for gender dysphoria; (3) special problems with informed consent in the context of “gender affirming” treatments; (4) the importance of very high desistance rates of gender dysphoria and transgender identification, particularly in children, even without treatment; (5) the extensive differential diagnosis and the need for thorough and subtle assessments in the face of gender-related complaints; (6) a deep religiously based objection to transgender ideology involving the ordering of creation; (7) controversies concerning the existence of rapid-onset gender dysphoria; (8) the recent depathologizing of gender dysphoria; (9) the roles of genetics and environment in transgender identification and gender dysphoria; and (10) reflections on the role of psychotherapeutic treatment in patients with gender dysphoria and transgender identification.

Keywords: transgenderism, gender dysphoria, transsexualism, sexual reassignment surgery, gender affirming care

Personal Choices and Future Medical Need

Posted on August 31, 2022April 18, 2026 by Robert D. Orr, MD, CM and Ferdinand D. Yates, Jr, MD, MA (Bioethics)

Question: Should this man with alcoholism be considered for liver transplantation?
Story: Everett is a 62-year-old business executive with a 40-year history of constant moderate alcohol use. He has no history of violence, blackouts, or legal or work problems because of his drinking. It is reported that his wife has also been a problem drinker all during this time, and his two adult daughters are moderate to heavy drinkers. Rather suddenly nine months ago, he suffered liver decompensation. He was stabilized (reluctantly), stopped drinking, and was referred to our liver transplant program.

Revisiting Physician-Assisted Suicide: Reaffirming the Christian Hippocratic Legacy

Posted on December 19, 2021April 18, 2026 by Jacob Robert Morris, MD

Support for physician-assisted suicide is growing as a result of ever-expanding cultural pressure. Healthcare professionals should oppose this trend and recognize that physician-assisted suicide is a misguided answer to human suffering. For 25 centuries, the Hippocratic Oath has served as the ultimate credo of the medical professional, and serves as a more trustworthy guide for professional ethics than contemporary culture. In this essay, I reflect on the Hippocratic Oath from a Christian perspective and reaffirm that physician-assisted suicide, despite growing in cultural acceptance, remains a misled answer to human suffering and as such is dangerous for the profession of medicine. Physician-assisted suicide corrupts the medical profession, relies on a distorted view of autonomy, and subverts true compassion. The way forward for the medical professional, in contrast, is an ethic of a “good death” comprised of healing, palliative care, and true compassion.