ABSTRACT
Since assessment of providers’ grounding reasons is inescapable, there is strong reason to develop a reason-giving view such as the Reasonability View. This chapter develops the central concept of reasonability by first distinguishing intrinsic elements of reasonability—those that relate to the beliefs themselves—and extrinsic elements that concern the circumstances in which a conscientious exemption would occur. The primary intrinsic factors state that a provider’s belief must be genuine, consonant with relevant empirical evidence, and cast in terms of public reason. The latter condition serves to justify key elements of my view; citizens cannot reasonably expect that others as free and equal would endorse the accommodation of objections founded upon, say, clinically mistaken beliefs. The chapter then defends the extrinsic conditions, including the requirements to avoid needless harm and to assist patients in an emergency circumstance. The chapter then argues that any acceptable theory must embrace conscience holism by discussing conscientious refusals as well as positive actions in accord with one’s conscience—what Bernard Dickens and Rebecca Cook call “conscientious commitment.” The chapter defends the novel conclusion that reasonable acts of conscientious commitment should be granted an accommodation, even if the act conflicts with law or institutional policy.
