Conscience clauses: your right to a conscience ends at my right to safe, legal and effective health care
One of the challenges of socially inclusive policy is the appropriate, ethical and effective inclusion of one group whose interests and values are in diametric opposition to another group’s needs. In health policy, ‘conscience clauses’ have been inserted into policies to accommodate health professionals for whom certain procedures are morally untenable, despite these procedures and/or drugs being legal and medically safe, as well as fulfilling patient/client demands and needs. At present, these clauses pertain almost uniquely to sexual and reproductive health; however, extending clauses into other fields, such as adoption, euthanasia and journalism, has also been initiated. This chapter provides an introduction to the use of conscience clauses, which are then re-examined using three standards – liberty principles of harm; the zero sum; and the judicial-philosophical principle of ‘my rights end where yours begin’ (or in its original form ‘the right to swing your arm ends at the other man’s nose’) – with comment on ways policy can be simultaneously inclusive and protective of population wellbeing.