Individual Rights vs. Institutional Identity: The Relational Dimension of Conscience in Health Care

Abstract

In the debates over the role of a provider’s conscience in the provision of health care, both sides engage the question in individualist terms, as though the only relevant choice is whether to enshrine a liberty right for the customer or a liberty right for the provider. Little attention is paid to the value of institutional identity. The conscience-driven practices of providers are not inherently less legitimate than the conscience-driven needs and preferences of health care customers, provided that goods and services to meet customers’ needs and preferences are accessible. In a functioning market, the viability of conscience requires us to give providers – and like-minded customers – an opportunity to live out their ideals. By more steadfastly defending the social space in which individuals and groups can live out the dictates of their consciences, even when (especially when) those dictates have been rejected by the majority, we will bolster the long-term prospects for the liberty of conscience. It is not just about the individual and the state. There is important space in between.

Keywords: health care, law of health care, law and conscience, conscience, health care providers