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Protection of Conscience Project

Service, not Servitude
Periodicals & Papers


Blake DC. The hospital ethics committee. Health care's moral conscience or white elephant?Hastings Cent Rep 1992 Jan-Feb;22(1):6-11  PMID: 1544801

David C. Blake

  • In a morally fragmented society there is no good reason for ethics committees to assume any particular point of view, yet failure to do so compromises their ability to function in either a case-review or an educational capacity.  A casuist methodology might enable committees to fulfill both roles.

Burke EC. Professional perfidy, or whatever happened to conscience? Minn Med 1992 Mar;75(3):5 (Editorial) PMID: 1565086Δ


Campbell CS.  Religious ethics and active euthanasia in a pluralistic society. Kennedy Inst Ethics J 1992 Sep;2(3):253-77 (Review) PMID: 10121090

Courtney S. Campbell

  • Abstract: This article sets out a descriptive typology of religious perspectives on legalized euthanasia  - political advocacy, individual conscience, silence, embedded opposition, and formal public opposition  - and then examines the normative basis for these perspectives through the themes of sovereignty, stewardship, and the self. It also explores the public relevance of these religious perspectives for debates over legalized euthanasia, particularly in the realm of public policy. Ironically, the moral discourse of religious traditions on euthanasia may gain public relevance at the expense of its religious content. Nonetheless, religious traditions can provide a context of ultimacy and meaning to this debate, which is a condition for genuine pluralism. A table setting out the views of various denominations with regard to euthanasia is included.

Cavanaugh D, Raviele KM, Grimes DA.  Clinicians who provide abortions: the thinning ranks. Letters and author reply.  Obstet Gynecol. 1993 Feb;81(2):318-9; discussion 319-20.

Kathleen M. Raviele, Denis Cavanaugh, David A. Grimes

  • Raviele:  The comments in "Clinicians who provide abortions: The thinning ranks" (OBSTET GYNECOL 1992;80:719-23) emphasize the reasons for fewer and fewer physicians being willing to perform abortions as being poor pay, suboptimal working conditions, and tedium. However, could it be that some physicians who initially supported abortion have had a change of heart? . . .
  • Cavanaugh:  I have been relatively quiet on the subject of abortion for some time,  but the article by Grimes deserves a response, even though he will have the advantage of a reply.  The Cromwellian zeal of the social engineers will apparently never be satisfied. Not content with the performance of over 1.5 million elective abortions a year in this country, Dr. Grimes wants more people doing them. . . .
  • Grimes:  Drs. Raviele and Cavanagh raise important points, which I understand and respect. However, given our imperfect methods of contraception, the fallibility of couples' use of contraception, and the incidence of prenatally diagnosed disorders, the need for safe, legal abortion will persist. Because induced abortion is one of the most frequently performed operations in gynecology, who would they propose to provide this service to our patients? . . .

Field D.  The 'conscience clause' and moral dilemmas. Sr Nurse 1992 Sep-Oct;12(5):18-21 PMID: 1299899

D. Field


Goller PL, Burchfield H, Wilson R, Glenn MH, Schlais LK. Nurse Pract 1992 Oct;17(10):8-9 (Comment Letter) [Comment in: Nurse Pract. 1993 Jan;18(1):8. Nurse Pract. 1993 Mar;18(3):15-6. Comment on: Nurse Pract. 1991 Dec;16(12):7.] Readers advocate pro-conscience, not pro-choice. PMID: 1301025

Patricia L. Goller, Helen Burchfield, Rebecca Wilson, Martha H. Glenn, Lori K. Schlais, Lynn Barnard, Susan Wysocki

  • Goller, Burchfield, Wilson, Glenn, Schlais:  Lynn Barnard, a spokesperson for Planned Parenthood, presented a perspective on abortions in a letter to the editor in the December 1991 issue: they approve of abortion on demand and disapprove of anti-abortion legislation. According to that letter, abortion on demand is the only right position for nurse practitioners, anti-abortion laws are wrong. Life is not that simple, nor do I think this perspective is widely shared. . .
  • Barnard: In response to Patricia L. Goller et al.'s comments regarding the appropriatenessof pro-choice advocacy, I would like to reiterate the closing comments of my December 1991 letter to the editor: "Let those nurses who oppose abortion and choice dedicate their energies to the development of a societal system that truly cares for women and will support their decisions - no matter what they are."
  • Wysocki: I am writing in response to the letter by Patricia Goller et al.; I thought the Journal's readers would be interested in hearing the position of tl1e National Association of Nurse Practitioners in Reproductive Health (NANPRH) on reproductive choice.

Grimes DA. Clinicians who provide abortions: the thinning ranks. Obstet Gynecol 1992 Oct;80(4):719-23 [Comment in: Obstet Gynecol. 1993 Feb;81(2):318-9; discussion 319-20. Obstet Gynecol. 1993 Feb;81(2):318; discussion 319-20.] PMID: 1407901

David A. Grimes

  • Access to abortion services in the United States has become increasingly limited because of a decrease in rural hospital providers and a growing shortage of clinicians willing to offer this service. As of 1988, 83% of United States counties had no identified provider. The deficit in numbers of clinicians stems from the current imbalance between incentives and disincentives. The single most powerful incentive appears to be altruism. On the other hand, disincentives include poor pay, frequent harassment, low prestige, suboptimal working conditions, and tedium. In 1990 a symposium on abortion provision was held, sponsored by the National Abortion Federation and ACOG. Among the remedies suggested by the attendees were increasing the integration of abortion training into the mainstream of residency education, improving the pay and work environments for clinicians, and where feasible expanding the capacity of physician providers by using midlevel practitioners working under physician supervision.

Howe EG.  Caveats regarding slippery slopes and physicians' moral conscience.  J Clin Ethics 1992 Winter;3(4):251-5 PMID: 1463875

E.G. Howard


Nolan MT.  Natural law as a unifying ethic. J Prof Nurs 1992 Nov-Dec;8(6):358-61 PMID: 1430657 Δ

M.T. Nolan

  • Abstract:  Natural law asserts that there is an objective moral order that human intelligence can understand and that societies are bound in conscience to follow. In 1772, George Mason appealed to natural law in denouncing a slavery statute in Virginia. This same ethic was called on to convict Nazi war criminals of crimes against humanity in 1948. In the last decade, natural law has enjoyed a resurgence in the medical biomedical ethics literature. It has appeared less frequently in the nursing literature and has been summarily dismissed when it has appeared. Only one nurse ethicist used natural law in discussing ethical issues (organ transplantation). Although further development of this philosophy is required, this ethic shows great promise as a guide to decision making in nursing

Serrano GA, Garcia Casado ML. [Conscientious objection in the matter of abortion] Rev Enferm 1992 Mar;15(163):45-6 (Editorial)[Article in Spanish] PMID: 1565971

G.A. Serrano, M.L. Garcia Casado