Conscience in Reproductive Health Care: Prioritizing Patient Interests

Conscience In Reproductive Health Care Prioritizing Patient Interests

Carolyn McLeod, Conscience in Reproductive Health Care: Prioritizing Patient Interests, Oxford University Press, 2020, 204pp. $55.00 (hbk), ISBN 9780198732723.

Reviewed by Doug McConnell, University of Oxford


“Carolyn McLeod’s book is essential reading for ethicists interested in conscientious objection in healthcare. Her central argument is that the very nature of the fiduciary relationship between healthcare professional and patient requires the professional to prioritise the patient’s healthcare interests over their own interests. Her arguments apply to those who primarily want protection for their consciences and not those who publicly refuse to provide services as civilly disobedient acts aimed at changing the law or standards of practice. McLeod focusses on the reproductive services of abortion and emergency contraception (EC), but her views are readily extended to any case of conscientious refusal to provide ‘standard’ healthcare services, that is, legally permitted services considered good care by the professional institution. Although others have occasionally noted that fiduciary relationships count against accommodating conscientious refusals of service, McLeod shows that the restrictions that fiduciary relationships place on conscientious refusals are much more significant and pervasive than previously thought. McLeod’s line of argumentation is also novel in that it focusses primarily on what professionals owe their patients rather than what they owe their profession.”

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