Conscience, conscientious objections, and medicine.

To inform the ongoing discussion of whether claims of conscientious objection allow medical professionals to refuse to perform tasks that would otherwise be their duty, this paper begins with a review of the philosophical literature that describes conscience as either a moral sense or the dictate of reason. Even though authors have starkly different views on what conscience is, advocates of both approaches agree that conscience should be obeyed and that keeping promises is a conscience-given moral imperative. The paper then considers exemplars of conscientious objection-Henry David Thoreau, Mohandas Gandhi, and Martin Luther King Jr.-to identify the critical feature of conscientious objection as willingness to bear the burdens of one's convictions. It concludes by showing that medical professionals who put their own interests before their patients' welfare violate their previous commitments and misappropriate the title "conscientious objector" because they are unwilling to bear the burdens of their choices and instead impose burdens on their patients and colleagues.