Hippocratic Resistance: Conscientious Medicine and Strategic Ethics

Posted on December 31, 2023April 24, 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

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.

The Pandemic, Empathy Fatigue, and Ethical Motivations: Kant on Conscience and Scotus on Love

Posted on December 1, 2021April 18, 2026 by Dennis L. Sansom, PhD

The social effects of the pandemic have exacerbated the ability and desire to overcome empathy fatigue and, consequently, have engendered more indifference towards others and isolationism among the population. These effects challenge society’s moral resolve to care for others. In this paper I present two ethical explanations of the basis of morality and moral action—Immanuel Kant’s ethic of pure will (conscience) and John Duns Scotus’ ethic of an ontology of love, and endeavor to show that a morality based solely on our rationally justifiable conscience does not adequately compel us to overcome empathy fatigue, whereas a morality based on an acknowledgement and affirmation of the lovableness of others can propel us to overcome empathy fatigue.