Conscience Exemptions in Medicine:

A Hegelian Feminist Perspective


Victoria I. Burke


Keywords: patient-centered medicine, theoretical ethics, religion, critical theory, disagreement, social pathologies, positive rights, freedom



In this article, I defend the view that conscience exemption clauses for medical practitioners (doctors, nurses, technicians,

pharmacists) should be limited by patient protection clauses. This view was also defended by Mark Wicclair, in

his book on conscience exemptions in medicine (Cambridge UP, 2011). In this article, I defend Wicclair's view by

supplementing it with Hegelian ethical theory and feminist critical theory. Conscience exemptions are important to support

as a matter of human rights. They support an individual's right to protect their deepest value-commitments. A true understanding of

conscience is dialectical, however, and it requires patient protection clauses because they, too, protect individuals in their

deepest value-commitments. In this article, I show that the defense of patient protection clauses

is historically supported by the theory of “conscience [ Gewissen ]” developed by G.W.F. Hegel

in the nineteenth century (mostly in the Phenomenology of Spirit (1807)).