Clinical Ethicist Albert Einstein College of Medicine Bronx, New York
Abstract: Conscientious objection in healthcare is often centered around an individual’s assertion of their right to moral integrity, yet its application to gender-affirming care raises significant ethical concerns for marginalized patients and community members. Increasingly, healthcare professionals’ refusals to provide medically indicated interventions such as hormone therapy or gender-affirming surgeries are influenced by ideological and political beliefs rather than a person’s moral deliberation. This presentation will examine the ethical implications of such objections, particularly their impact on patient autonomy, professional obligations, and healthcare equity. The discussion will explore whether conscientious objection in this ideological and political context constitutes a legitimate exercise of moral freedom or are such claims an unjustified denial of medically appropriate care that reinforces discrimination. Ideologically motivated objections risk undermining evidence-based medical care and disproportionately harming historically underserved and vulnerable patients, their families, and community members. As a counterpoint to the moral legitimacy of conscientious objection, there must also be equal consideration of healthcare professionals invoking a conscientious obligation to provide care. Given the uncertainty of legal protections for patients seeking gender affirming care as well as healthcare professionals providing that care, there exists an ethical obligation for individuals to reflect upon what our response will be and/or actions we will be willing to undertake. Moreover, this presentation will consider policy responses, including institutional obligations to ensure equitable access to care in the face of regulatory limits or absent those restrictions, when health professionals’ conscientious objections to providing medical care may lead to patient harms.
Keywords: Conscientious objection, gender affirming care
Learning Objectives:
After participating in this conference, attendees should be able to:
Evaluate the role of ideological influences in shaping healthcare professionals’ refusals to provide gender-affirming interventions.
Assess whether such claims constitute a legitimate exercise of conscientious objection or a discriminatory denial of care.
Identify strategies for professionals and institutions to ensure equitable access to gender-affirming care, including policy responses to mitigate harms caused by conscientious objections and supporting conscientious obligations to provide care.
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