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Conflicts of Conscience in Health Care : An Institutional Compromise - Holly Fernandez Lynch

Conflicts of Conscience in Health Care

An Institutional Compromise

Paperback

Published: 30th September 2010
For Ages: 18+ years old
Ships: 3 to 4 business days
3 to 4 business days
RRP $14.99
$14.25

Choice Outstanding Academic Title, 2009. Physicians in the United States who refuse to perform a variety of legally permissible medical services because of their own moral objections are often protected by "conscience clauses." These laws, on the books in nearly every state since the legalization of abortion by "Roe v. Wade," shield physicians and other health professionals from such potential consequences of refusal as liability and dismissal. While some praise conscience clauses as protecting important freedoms, opponents, concerned with patient access to care, argue that professional refusals should be tolerated only when they are based on valid medical grounds. In "Conflicts of Conscience in Health Care, " Holly Fernandez Lynch finds a way around the polarizing rhetoric associated with this issue by proposing a compromise that protects both a patient's access to care and a physician's ability to refuse. This focus on compromise is crucial, as new uses of medical technology expand the controversy beyond abortion and contraception to reach an increasing number of doctors and patients. Lynch argues that doctor-patient matching on the basis of personal moral values would eliminate, or at least minimize, many conflicts of conscience and suggests that state licensing boards facilitate this goal. Licensing boards would be responsible for balancing the interests of doctors and patients by ensuring a sufficient number of willing physicians such that no physician's refusal leaves a patient entirely without access to desired medical services. This proposed solution, Lynch argues, accommodates patients' freedoms while leaving important room in the profession for individuals who find some of the capabilities of medical technology to be ethically objectionable.

Lynch's pragmatic approach is also innovative and refreshing in a policy arena that is often fraught with an overabundance of criticism with little substance on reform.

-Dhrubajyoti Bhattacharya, The Journal of Legal Medicine
Brilliant...This book is interdisciplinary bioethics as its finest.

-Choice * Reviews *
Lynch's pragmatic approach is also innovative and refreshing in a policy arena that is often fraught with an overabundance of criticism with little substance on reform.

-Dhrubajyoti Bhattacharya, The Journal of Legal Medicine * Reviews *

Series Forwardp. ix
Prefacep. xi
Acknowledgmentsp. xv
Introductionp. 1
Conscience Clauses and Professionalismp. 17
A Primer on Conscience Clausesp. 19
A Brief Historyp. 19
What Are Conscience Clauses Doing for Physicians?p. 24
Where the Conscience Clause Debate Has Gone Astrayp. 33
Defining Medical Professionalismp. 43
Discerning the Breadth of the Primacy Principlep. 44
The Consent Paradigmp. 48
The Patient-centric Paradigmp. 57
The Physician-centric Paradigmp. 65
The Gatekeeper Paradigmp. 70
Protecting Doctors and Patients: An Institutional Solutionp. 77
Moral Diversity in Medicine and the Ideal of Doctor-Patient Matchingp. 79
Rationales for Maintaining Physician Consciencep. 80
The Value of Doctor-Patient Morals Matchingp. 87
Which Institution? Licensing Boards Bearing the Burdens of Conscience and Accessp. 99
The Details of the Institutional Solutionp. 115
Measuring Patient Demand and Determining Which Demands to Meetp. 117
Measuring Physician Supply and Limiting the Grounds for Physician Refusalp. 145
Assessing the Validity of Moral Refusalsp. 147
Tests of Sincerityp. 159
Calibrating Supply and Demandp. 165
How Far Is Too Far When It Comes to Reasonable Access?p. 166
Ensuring and Preserving Reasonable Accessp. 178
The ôHardö Cases: When the Institutional Solution Failsp. 195
Justifications for Prohibiting Physician Refusal in ôHardö Casesp. 196
Problematic Disincentivesp. 204
Licensing Board Accountabilityp. 207
Physician Obligations and Sacrificesp. 215
Notice of Moral Beliefsp. 217
Informed Consentp. 219
Emergenciesp. 223
Referralp. 229
Self-Evaluation and Reason-Givingp. 236
Addressing Skeptics, a Model Statute, and Conclusionsp. 241
Appendix: Statutes, Regulations, and Case Lawp. 259
Notesp. 263
Referencesp. 317
Indexp. 335
Table of Contents provided by Publisher. All Rights Reserved.

ISBN: 9780262515054
ISBN-10: 0262515059
Series: Basic Bioethics
Audience: Professional
For Ages: 18+ years old
Format: Paperback
Language: English
Number Of Pages: 368
Published: 30th September 2010
Publisher: MIT Press Ltd
Country of Publication: US
Dimensions (cm): 22.9 x 15.2  x 1.6
Weight (kg): 0.49