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Conscience and Ethics
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This section includes materials on and for teaching health professionals about conscience and ethics.
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Item Church Amendments, 42 U.S.C. § 300a-7(http://www.hhs.gov/ocr/civilrights/understanding/ConscienceProtect/, 1973) U.S. Department of Health & Human ServicesNo individual shall be required to perform or assist in the performance of any part of a health service program or research activity funded in whole or in part under a program administered by the Secretary of Health and Human Services if his performance or assistance in the performance of such part of such program or activity would be contrary to his religious beliefs or moral convictions.Item Alternatives to Animal Use in Research, Testing, and Education(U.S. Government Printing Office, 1986-02) Office of Technology Assessment, U.S. CongressIn this assessment, OTA analyzes the scientific, regulatory, economic, legal, and ethical considerations involved in alternative technologies in biomedical and behavioral research, toxicity testing, and education. Included is a detailed examination of Federal, State, and institutional regulation of animal use, and a review of recent developments in 10 other countries. The report was requested by Sen. Orrin Hatch, Chairman of the Senate Committee on Labor and Human Resources.Item Danforth Amendment to the Civil Rights Restoration Act, 20 USC § 1688. Neutrality with respect to abortion(http://www.justice.gov/crt/about/cor/coord/titleixstat.php#Sec.%201688.%20Neutrality%20with%20respect%20to%20abortion, 1988)Nothing in this chapter shall be construed to require or prohibit any person, or public or private entity, to provide or pay for any benefit or service, including the use of facilities, related to an abortion. Nothing in this section shall be construed to permit a penalty to be imposed on any person or individual because such person or individual is seeking or has received any benefit or service related to a legal abortion.Item 42 U.S.C. § 2000bb–1. Free exercise of religion protected(http://www.gpo.gov/fdsys/pkg/USCODE-2009-title42/html/USCODE-2009-title42-chap21B-sec2000bb-1.htm, 1993-11-16)(a) In general Government shall not substantially burden a person's exercise of religion even if the burden results from a rule of general applicability, except as provided in subsection (b) of this section. (b) Exception Government may substantially burden a person's exercise of religion only if it demonstrates that application of the burden to the person— (1) is in furtherance of a compelling governmental interest; and (2) is the least restrictive means of furthering that compelling governmental interest. (c) Judicial relief A person whose religious exercise has been burdened in violation of this section may assert that violation as a claim or defense in a judicial proceeding and obtain appropriate relief against a government. Standing to assert a claim or defense under this section shall be governed by the general rules of standing under article III of the Constitution.Item Public Health Service Act, 42 U.S.C. § 238n. Abortion-related discrimination in governmental activities regarding training and licensing of physicians(http://www.hhs.gov/ocr/civilrights/understanding/ConscienceProtect/, 1996) U.S. Department of Health & Human ServicesThe Federal Government, and any State or local government that receives Federal financial assistance, may not subject any health care entity to discrimination on the basis that-- (1) the entity refuses to undergo training in the performance of induced abortions, to require or provide such training, to perform such abortions, or to provide referrals for such training or such abortions; (2) the entity refuses to make arrangements for any of the activities specified in paragraph (1); or (3) the entity attends (or attended) a post-graduate physician training program, or any other program of training in the health professions, that does not (or did not) perform induced abortions or require, provide or refer for training in the performance of induced abortions, or make arrangements for the provision of such training.Item Conscience in the Mental Health Professional(1997) Galvin, Matthew R.; Stilwell, Barbara M.Item Balanced Budget Act, 42 U.S.C. § 1395w-22(j)(3). Prohibiting interference with provider advice to enrollees(http://www.gpo.gov/fdsys/pkg/USCODE-2010-title42/pdf/USCODE-2010-title42-chap7-subchapXVIII-partC-sec1395w-22.pdf, 1997)Subparagraph (A) shall not be construed as requiring a Medicare Choice plan to provide, reimburse for, or provide coverage of a counseling or referral service if the Medicare Choice organization offering the plan— (i) objects to the provision of such service on moral or religious grounds; and (ii) in the manner and through the written instrumentalities such Medicare Choice organization deems appropriate, makes available information on its policies regarding such service to prospective enrollees before or during enrollment and to enrollees within 90 days after the date that the organization or plan adopts a change in policy regarding such a counseling or referral service.Item The Indiana University Conscience Autobiography for Healthcare Professionals(1998) Galvin, Matthew R.Item Conscience Sensitive Medical Education(2002) Gaffney, Margaret M.; Galvin, Matthew R.; Stilwell, Barbara M.Medicine is a moral enterprise, and young people who enter professional school are presumed to be morally astute, as well as intellectually capable. Thoughtful students quickly grasp the fact that what we can do in medicine usually outpaces the consensus of what we ought to do, and one of the earliest questions these students ask is how they should go about honoring their individual consciences in the face of patients, peers or teachers who profess divergent values, or request services that jar the young professional’s sense of ought-ness. Medical educators readily acknowledge the need, indeed the moral requirement, to teach ethics, but struggle to ascertain the most effective, efficient and compelling way to present the material and engage the moral reasoning of students who are already inundated with basic and advanced science studies (Self & Baldwin, 1994). Students appreciate hearing about case stories, but do not want much in the way of philosophical theory. Most students at our institution have backgrounds in biology or chemistry; few have taken any courses in literature, philosophy, religion, ethics or other humanities. The handful of lectures and small-group case-based discussions related to ethical dilemmas in medicine offered in the curriculum are helpful, but often fail to prepare the young physician adequately for a life in which moral questions daily will present themselves. We are piloting an approach to moral teaching in medicine based on an examination of conscience formation and functioning, and the understanding of the intersection of personal conscience with professional medical and ethical values. We believe that conscience theory and language may be a useful addition to the traditional approaches to dilemma resolution that involve principles, theories, and case based reasoning. In this paper we will explore traditional ethical resolution methods, give a brief history and overview of Conscience Theory, and then show through case example how using Conscience Theory may allow a richer examination of the most poignant and troubling dilemmas physicians face.