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Protection of Conscience Project

Service, not Servitude
Periodicals & Papers



Childress JF. Appeals to Conscience. Ethics 89, no. 4 (1979): 315.

James F. Childress

  • Unfortunately the phrase "appeals to conscience" is ambiguous. First, it may indicate an appeal to another person's conscience in order to convince him to act in certain ways. Second, it may mean the invocation of one's own conscience to interpret and justify one's conduct to others. Third, it may indicate the invocation of conscience in debates with oneself about the right course of action, conscience being understood as a participant in the debate, a referee, or a final arbiter. Although it is possible to distinguish these three meanings of "appeals to conscience," they are usually intertwined in our moral discourse. Nevertheless, I shall concentrate on the second meaning, referring to the other two only when it is necessary to fill out the picture.  Appeals to conscience in the second sense raise important issues of justification and public policy which can be considered apart from the other meanings of appeals to conscience. . .

Leff AA.  Unspeakable ethics, unnatural law.  Duke Law Journal, Vol. 1979, No. 6, Symposium on Law and Ethics (Dec., 1979), pp.1229-1249

Arthur Allen Leff

  • I want to believe-and so do you-in a complete, transcendent, and immanent set of propositions about right and wrong, findable rules that authoritatively and unambiguously direct us how to live righteously. I also want to believe-and so do you-in no such thing, but rather that we are wholly free, not only to choose for ourselves what we ought to do, but to decide for ourselves, in dividually and as a species, what we ought to be. What we want, Heaven help us, is simultaneously to be perfectly ruled and perfectly free, that is, at the same time to discover the right and the good and to create it. . .

No case for an abortion bill. Br Med J. 1979 July 28; 2(6184): 230.

  • Like its predecessors, Mr. John Corrie's Bill to amend the Abortion Act reflects the continuing opposition to "abortion on request" among some MPs and members of the public. The Bill's main proposals include changing the upper age limit for termination from 28 to 20 weeks, altering the wording of the clause on conditions from "risk" to "grave risk" to the life of the pregnant woman, widening the conscience clause, and licensing pregnancy advisory services. So yet again time is being found by the House of Commons for a private member's Bill though it has yet to debate the careful examination of the working of the Act by Mrs Justice Lane's committee. . .

Roche KP, Gould J.  Abortion (Amendment) Bill (Letter). Br Med J. 1979 July 28; 2(6184): 276

K.P. Roche, Jonathan Gould

  • Although we do not support the principle underlying the Abortion Bill of 1967, we most warmly welcome any mitigation of its misuses, including the currently proposed modification of the social clauses. Thus we would in this sense support the proposals contained in Mr Corrie's amending Bill. The conscience clause applies, in our opinion, to all doctors, not only to those engaged in obstetrics and gynaecology. Equally it applies to all nurses, both in operating theatres and wards, where many abortions may now be accomplished effectively. . .


Connolly PH. What are the medical schools up to? Abortions and admissions. Commonweal 1978 Sep 1;105(17):551-2   PMID: 11662636

P.H. Connolly

Christ Century 1978 Jul 5-12;95(23):671 'No abortions,' say Italian physicians. PMID: 11663864


Gingras G.  Doctors; conscience, care and pay. Can Med Assoc J 1978 Apr 8;118(7):853-4  PMID: 638916

Gustave Gingras

  • Salaried physicians equal incompetent doctors? Certainly not! Quality medical care depends on a practitioner's conscience, not the compensation method.

Among the members of the great family of health workers, only physicians are not all salaried. I readily understand that lawyers who, for the time being, are the most influential group among our political masters, would be all too happy to promote the concept of physicians' salary. . .

Lindheim BL, Cotterill MA. Training in induced abortion by obstetrics and gynecology residency programs.  Fam Plann Perspect 1978 Jan-Feb;10(1):24-8 PMID: 620766

Barbara L. Lindheim, Maureen A. Cotterill

  • Between 1970 and 1976, the annual number of legal abortions reported in the United States increased from 193,000 to 1.1 million. As a result, legal abortion is now the most commonly per- fomed of all nondiagnostic adult surgi- cal procedures.' Obstetrician-gynecolo- gists have primary responsibility for women s reproductive health care, and they perform the majority of abortions. . .

Seeksin KR.  Genuine appeals to conscience.  The Journal of Value Inquiry 197824, Volume 12, Issue 4, pp 296-300

Kenneth R. Seeskin

  • This article is written in response to a recent paper by my former colleague Carl. R. Kordig appearing in this journal, Kordig denies that the dictates of one's conscience are always either obligatory or morally permissible. With this thesis I have no quarrel. The recognition that a person's conscience can be mistaken, sometimes dangerously so, is at least as old as Hobbes and has been maintained by philosophers as diverse as Hegel,  Royce,  and Nowell- Smith.  Still, people do appeal to conscience in moral disputes and, as I will attempt to show, do so in a manner that is philosophically justifiable. My goal is not so much to attack what Kordig has said as it is to argue that his discussion is incomplete: some appeals to conscience are bogus but some are not.


D'Arcy E.  Conscience. J Med Ethics 1977 Jun;3(2):98-9 PMID: 874985

Eric D'Arcy

  • Historically, systematic thought about conscience arose from attempts to unravel the knotty problem of what was called 'the erroneous conscience': if conscience commands something which God's law forbids, what is the position ?  St Augustine, early in the fifth century, gave a famous answer: 'The command of a subordinate authority is not binding if it runs counter to the command of his superior; but conscience has no authority except that which it receives as God's delegate; if, therefore, conscience commands something which is against God's law, we are bound not to follow it'. . .

Faden R, Faden A.  False belief and the refusal of medical treatment. J Med Ethics 1977 Sep;3(3):133-6PMID: 926132

Ruth Faden, Alan Faden

  • May a doctor treat a patient, despite that patient's refusal, when in his professional opinion treatment is necessary? This is the dilemma which must from time to time confront most physicians. An examination of the validity of such a refusal is provided by the present authors who use the case history of a patient refusing treatment, for cancer as well as for a fractured hip, to evaluate the grounds for intervention in such circumstances. In such a situation the patient is said to have a 'false belief' and it is the doctor's duty to try to change that belief in the patient's interest. The false belief is considered here in terms of the liberty principle, the patient's mental competence and on what is called the 'harm principle' (harmn to other individuals or to society). Finally the concept of paternalism is examined. The authors conclude that the doctor must attempt to change a false belief, and if this fails he must examine the patient's mental competence to make the decision to refuse treatment. But in the last analysis the doctor may be under an obligation to respect the patient's refusal.

Hoyos MD, Walrond ER.  West Indian National survey of doctors, nurses and social workers on liberalization of the Barbados abortion law. Med J 1977 Mar; 26(4):2-11 PMID: 847962

M.D. Hoyos, E.R. Walrond

  •  A postal questionnaire was sent to a representative sample of Barbados' doctors, nurses and social workers requesting their opinions on the liberalisation of the country's 108-year-old Abortion Law, and the possible effects of this. The survey showed that there were very few conscientious objectors. Eighty-five per cent of doctors and social workers thought the law should be liberalised, as against thirty per cent of nurses. Eighteen per cent of doctors and social workers felt that women would lose interest in family planning as a result of a liberalised law, while sixty per cent of nurses were of this view. Ninety per cent of nurses and sixty per cent of doctors and social workers held reservations about abortion on demand. These statistically significant differences of opinion between doctors and social workers on one hand and nurses on the other show that there is a need for advanced planning and education to minimize problems which may arise out of any Abortion Law Reform (AU)

J Am Pharm Assoc 1977 Nov;17(11):673 (Editorial) A matter of law and conscience. PMID: 925285


Nurs Times 1977 Jan 27;73(4):139 Quandary-4. Problems of conscience. PMID: 840683


Nurs Times 1977 Feb;73(8):281 Quandary-5. Problems of conscience. PMID: 840722


Nurs Times 1977 Mar 31;73(13):469 Quandary - 6. Problems of conscience. PMID: 854439


Nurs Times 1977 May 5;73(18):663 Quandary--7. Problems of conscience. PMID: 866213


Schweiker RS. Consideration of applicants to medical schools with respect to their views on abortion. Congr Rec (Dly Ed) 1977 Nov 4;123(181):S18859-61  PMID: 11663926


Schweiker RS. Support for Schweiker medical school admissions bill. Congr Rec (Dly Ed) 1977 Sep 21;123(147):S15310-3  PMID: 11663921


Sykepleien 1977 Jun 20;64(10):579-90 [Freedom of conscience as a principle] [Article in Norwegian] PMID: 586862


Alston JM, Versteeg L. (Letters) A question of conscience.  Br Med J 1976 Jul 3;2(6026):43

J.M. Alston, Lillian Versteeg

  • Alston: The article by Mr R Walley (12 June, p 1456) is of the very greatest importance to the public and to the medical profession. The account which Mr Walley gave of the pressure put on him to agree to carry out abortion against his conscience is a more fully explained example of this method of appointing consultant gynaecologists than others recorded before. The Department of Health must make sure that women know how and where they can obtain, at the right time, an abortion if they wish to have one, and if the Department requires more abortions than its gynaecologists are able and willing to supply it must supplement them by the appointment of regional or area medical abortionists. . .
  • Versteeg:  Mr R Walley's "Personal Paper" (12 June, p 1456) shocked me profoundly. Those of us who recall the policy of appointing to mental institutions in Nazi Germany only those doctors prepared to take part in "euthanasia" of mentally defectives must recoil from the implications of the policy he encountered.

Damiani N. Minerva Ginecol 1976 Sep;28(9):728-32 [Role of the obstetrician in performing an abortion. Objections of conscience] [Article in Italian]  PMID: 1012605

N. Damiani

Diamond EF.  Do the Medical Schools Discriminate Against Anti-Abortion Applicants? Linacre Quarterly 29, 30_31 (1976)

Eugene F. Diamond

Friedman M.  Where's your conscience, Doctor? Dent Econ 1976 Feb;66(2):32-43 PMID: 1074399

M. Friedman

Hooker D, Neustatter WL, White M. A question of conscience (Letters).  Br Med J 1976 Jul 10;2(6029):108

David Hooker, W. Lindesay Neustatter

  • Hooker: I think Dr R Salm (26 June, p 1593) has got his thinking a little out of focus. The "will of the people, as expressed through Parliament," does not make abortion right any more than bashing old ladies on the head would be if made "legal" in this way. . .

  • Neustatter: May I endorse Dr R Salm's cogent reply (26 June, p 1593) to Mr R Walley's article (12 June, p 1456) on a question of conscience in regard to performing abortions? While I respect Mr Walley's sincerity, like Dr Salm I question his logic. . .

  • White:  I hope you will permit me to correct the inaccuracies in the letter from Dr R Salm (26 June, p 1593). He writes: "The will of the people as expressed through Parliament now lays down that certain abortion facilities shall be provided in the NHS." Parliament lays down no such thing. The Abortion Act of 1967 lays down that where certain conditions are complied with a doctor who performs an abortion will not have committed an illegal act. The Act, as David Steel repeated, is permissive, not mandatory. . .

Hudson JM, Pilling HH, Salm R.  A question of conscience (Letters).Br Med J 1976 Jul 24;2(6029):234-5

John M. Hudson, Herbert H. Pilling, R. Salm,

  • Hudson: Mr R Walley's remark (12 June, p 1456) concerning the absence of public support for him in the columns of the medical journals cuts me to the quick and I feel, therefore, in spite of my disinclination to write letters about anything, that I must write to you. Dr R Salm's letter (26 June, p 1593) saddened me because in it he fails to make clear that he understands the grave injury that Mr Walley and many others have suffered. . .

  • Pilling:  Some of your correspondents on this subject seem to be ignoring the fact that the NHS Acts and Regulations impose upcn all doctors employed in the Health Service a duty to make available to their patients any treatment which their condition may warrant, and in certain cases one such treatment is the termination of pregnancy. These cases are defined in the Abortion Act 1967 and the clear implication of section 1 (1) of that Act, taken in conjunction with the general duty outlined above, is that a doctor must consider whether any patient requesting a termination of pregnancy falls within the criteria set out in the Act, and if so he must make the appropriate treatment available to her. He need not, however, participate in the treatment. . .

  • Salm: Shorn of legal niceties the position is that since the passage of the Abortion Act a restricted abortion service has been provided in this country under the NHS. In my previous letter (26 June, p 1593) I was not concerned with the rights and wrongs of abortions . . .

Kordig CR. Pseudo-Appeals to Conscience.  Journal of Value Inquiry X(1976),7-17.

Carl R. Kordig

  • "Appeals to conscience" loom large in moral and political philosophy. Many consider action in obedience to conscience to be morally necessary or at least morally permissible. For many these are reasons for ethical and political toleration.

I will here criticize pseudo-appeals to conscience. I will criticize the view that the dictates of one's conscience are always either obligatory or permissible. Such pseudo-appeals are untenable. They result in an indefensible moral relativism. They lead to totalitarian intolerance. . .

Nurs Times 1976 Oct 28;72(43):1675 Quandary-1. Problems of conscience. PMID: 980872


Nurs Times 1976 Nov 25;72(47):1849 Quandary-2. Problems of conscience. PMID: 995689


Nurs Times 1976 Dec 23-30;72(51):2000 Quandary-3. Problems of conscience. PMID: 1012954


Salm R.  A question of conscience. (Letter) Br Med J 1976 Jun 26;1(6025):1593  PMID: 1276785

R. Salm

  • R. Walley's article (12 June, p 1456) makes sad reading, for he is both illogical and, if I may say so, a little selfish. I admire and indeed I share his respect for human life, but in my opinion his only genuine grievance is that the rules were changed while he was in training, his conscience preventing him from adapting to the new service requirements. However, he is illogical in complaining that he is being discriminated against. The will of the people, as expressed through Parliament, now lays down that certain abortion facilities shall be provided in the NHS, and the area health authorities have the duty to see that this regulation is implemented. . .

Walley R. A question of conscience. Br Med J 1976 Jun 12;1(6023):1456-8 PMID: 953536

Robert Walley

  • It was indeed a surprise to be informed by an eminent professor, after a hospital interview, that as a Roman Catholic gynaecologist "there is no place for you to practise within the National Health Service." One had always assumed, quite naively it seems, that the British "system" is based on fair play and, above all, respect for the individual conscience. It soon became quite obvious that in order to stay in the specialty in Britain I would have had to change a conscientiously held abhorrence to the direct taking of human life. I chose to leave country, home, and family in order to practise medicine in full freedom of conscience. . .


Ideasy JB, Slorach CCS, Theobald GW. Points from letters: Abortion (Amendment) Bill.  Br Med J. 1975 June 14; 2(5971): 620.

J.B. Ideasy, C.S.S. Slorach, G.W. Theobald

  • Dr. J. B. Ideasy (Bradford) writes: As a member of (the B.M.A. I wish to dissociate myself entirely from the views expressed in your leading article (17 May, p. 352).... You must be aware of the large body of opinion in the profession which is opposed to abortion on social grounds . . .

  • Dr. C. C. S. Slorach (East Kilbride) writes: I cannot allow your leading article (17 May, p. 352) to pass without comment. You are highly critical of Mr. James White's Abortion (Amendment) Bill, at present being considered by a select committee of the House of Conmons. . .

  • Mr. G. W. Theobald (Eastbourne) writes: . . . In your leading article (17 May, p. 352) you do not seem to be concerned with the freedom of gynaecologists, guaranteed by the 1967 Abortion Act, to refuse to be involved in "legal" abortions. It is fast becoming evident that no man or woman whose conscience prevents them from engaging in this practice can in future contemplate specializing in obstetrics and gynaecology, and this would apply to many practising Christians, not merely Roman Catholics, and presumably to orthodox Jews. . .

Kosnik AR. Forming the Christian Catholic conscience. Hosp Prog 1975 Aug;56(8):51-4  PMID: 1150211

A.R. Kosnik

Metcalfe JB. Abortion (Amendment) Bill (Letter). Br Med J. 1975 August 30; 3(5982): 544

J.B. Metcalfe

  • On re-reading my letter to you (19 July, p. 160) I can understand how Dr. J. B. Clarke (9 August, p. 373) has misunderstood me, but I do not believe that it will support Dr. C. B. Goodhart's conclusions (19 July, p. 160). Both writers' deductions rest on the assumption that I have confused my terms.

A "moral action" can result only from a free choice of the best available alternative and may be legal or illegal (I defined "best" in my letter of 19 July). A "legal action" is an actior in accordance with a code laid down by some authority and may be moral or immoral. . .

MSMW.  Motivation and conscience of the physician. West J Med. 1975 July; 123(1): 48–49

  • In a recent editorial in Science (Changing climate for medicine. Science 188:975, Jun 6,1975) Philip H. Abelson gives a masterly review of a "Changing Climate for Medicine." He calls attention once again to the fact that the essence of the practice of medicine is in the interaction between patient and physician. He notes that medicine will always remain an inexact science, that the best physicans are highly motivated and highly intuitive, and that much in patient care depends upon the motivation and conscience of the physician. . .

Neustatter WL, Clarek JB, Goodhart DB. Points from letters - Abortion (Amendment) Bill. Br Med J. 1975 August 9; 3(5979): 373.

W.L. Neustatter, J.B. Clarke, C.B. Goodhart

  • Dr. W. Lindesay Neutstatter (London W.1) writes: It is gratifying to see the stand the B.M.A. is making about the new Abortion Bill. Leaving aside the wider implications, it is most unsatisfactory that the very sensible phrase that the risks to the mother's life and health could be greater if the pregnancy continued than if it was terminated, which allowed for clinical judgement of weighing the pros and cons, should be replaced by an exercise in semantics as to where "grave" and "serious" risks begin . . .

  • Dr. J. B. Clarke (Wirral) writes: I wish to thank Dr. Isabel G. Smith and the Reverend J. B. Metcalfe (19 July, p. 160) for their honesty in being so explicit with their opinion that there is no ethical distinction between the prevention of conception and abortion. One may enter into debate as to when new life begins, but surely one cannot ignore the physiological fact of conception. . .

  • Dr. C. B. Goodhart (Cambridge) writes: The Reverend J. B. Metcalfe (19 July, p. 160) thinks that "it is the job of the legislators to specify an age after which abortion is deemed murder. This is not a moral decision but a political one based on what society will accept and what is enforceable." . . .

Pilpel HF, Patton DE. Abortion, conscience and the Constitution: an examination of federal institutional conscience clauses. Columbia Human Rights Law Rev 1975 Fall-Winter 1974-75;6(2):279-305  PMID: 11663597

Harriet F. Pilpel, Dorothy E. Patton

  • In January, 1973 the United States Supreme Court ruled for the first time on the constitutionality of state criminal abortion statutes. In Roe v. Wade the Court held that statutes which prohibited all abortions except those done to save the life of the woman unconstitutionally violated the woman's right of privacy. In the companion case, Doe v. Bolton, the Court invalidated a number of abortion-restricting statutory regulations.  Congress reacted swiftly. Eight days after Roe and Doe were handed down, an abortion-prohibiting constitutional amendment was introduced in the House of Representatives; subsequently, Congress considered other amendments to the Constitution and to federal laws. Although the 93rd Congress adjourned without acting on any of the proposed Constitutional amendments, it did enact several abortion-limiting laws. Some of these laws took the form of "entity conscience clauses." Such clauses in effect state that where abortion or sterilization are against the "conscience" of a hospital or other entity, that entity may refuse to perform these medical procedures. For many women and families such laws may constitute a barrier which limits the constitutional right which the Supreme Court recognized in Roe to decide whether or not to terminate a pregnancy.  This article discusses the recently enacted entity conscience clauses and examines them in terms of constitutional rights. . .

Stern MD. Abortion conscience clauses. Columbia J Law Soc Probl 1975 Summer;11(4):571-627 PMID: 11663680

Marc D. Stern

  • Introduction:  This paper considers some of the conflicts between competing constitutional rights which have developed as a result of the Supreme Court's decisions in Roe v. Wade and Doe v. Bolton, cases involving the power of states to limit abortion. In Roe and Doe, laws prohibiting abortions were held to infringe the fourteenth amendment guarantee of personal liberty. State regulatory power was not completely denied, but was greatly restricted.

Despite the rulings in Roe and Doe, physicians, nurses, and denominational hospitals opposed to abortions have continued to refuse to perform them. . . .

Wilkins RG.  Abortion and promiscuity (Letter).  Br Med J. 1975 July 26; 3(5977): 233

R.G. Wilkins

  • I was somewhat disquieted by the letter from Dr. Louise F. W. Eickhoff (12 July, p. 99). To refuse to terminate a pregnancy on a matter of conscience is both legally and ethically acceptable, as is a refusal in the absence of the requisite medical, psychiatric, and social indications. But to refuse a termination because the continuation of the pregnancy is held to be a valid means of managing a behavioural disorder, "promiscuity," is a more questionable matter. . .

Wilson MBH, Banwell GS.  Abortion (Amendment) Bill (Letters). Br Med J. 1975 July 12; 3(5975): 99

M.B.H. Wilson, G.S. Banwell, Angela M.H. Lynch

  • Wilson:  Dr. N. A. Chisholm writes (28 June, p. 748) that he is weary of reading letters on the "right of conscience" to abstain from giving medical help in abortion. Many would insist on the right and the duty to avoid terminating a particular pregnancy or taking steps likely to lead to a termination, but the duty to give medical help is implicit in the relationship between doctor and patient. . .
  • Banwell:  . . . Doctors who decline to abort a woman in early pregnancy and who do not plead conscientious objection are liable to criminal prosecution under the current Act, and protagonists of abortion on request have been enabled to point an accusing finger at N.H.S. gynaecologists. Plainly the Lane Conmittee was correct in pointing out deficiencies in the N.M.S., since it is meant to be providing an abortion iservice in early pregnancy for all women. Are any women not "entitled"-to quote from your leader? . . .