Extensions, Applications, and New Directions for Thinking About McLeod's Conscience in Reproductive Health Care

As the other entries in this section have surely made clear, Carolyn McLeod’s outstanding monograph, Conscience in Reproductive Health Care: Prioritizing Patient Interests (2020), is fertile ground for fruitful philosophical analyses of issues pertaining to conscience, trust, autonomy, and more, all of which are sure to be of great interest and benefit to scholars in areas such as bioethics, health policy, and feminist ethics. Conscience in Reproductive Health Care provides a compelling response to a timely bioethical dilemma: What do we do when healthcare providers refuse certain health services to patients on grounds of conscience? McLeod contends that healthcare providers, in light of their fiduciary responsibilities to patients, ought to prioritize their patients’ interests in receiving quality healthcare over their own interests in upholding their conscience. This view, which McLeod calls “the prioritizing approach” to conscientious objection, takes a stronger stance regarding the obligations that healthcare providers have to perform certain legally and medically accepted reproductive services (e.g., abortion services) than many mainstream approaches to the problem of conscientious refusal, which primarily focus on the centrality of compromise in adjudicating between providers’ and patients’ interests. With this unwitting commitment to upholding patient interests (and especially the interests of already vulnerable patients), McLeod has offered an account of providers’ duties which is well-equipped to uphold several core bioethical principles: the imperative to respect patient autonomy, the need to promote patient wellbeing, and the desire to avoid unnecessary harm to patients. For these and other reasons, McLeod has offered a compelling theory of when conscientious refusal is morally appropriate, which puts patients’ needs and interests at the forefront. In what follows, I will withhold a detailed discussion of McLeod’s main arguments and contributions, as these can be reviewed in McLeod’s contribution to this issue. Substantive analyses of McLeod’s book are also available to the reader in this issue, including commentaries from Alison Reiheld, Jennifer 10.3138/ijfab.15.2.15 15 2