Making decisions about decision-making: conscience, regulation, and the law

Med Law Rev. 2015 Spring;23(2):263-82. doi: 10.1093/medlaw/fwv010. Epub 2015 Apr 24.


The exercise of conscience can have far reaching effects. Poor behaviour can be fatal, as it has occurred in various medical scandals over the years. This article takes a wide definition of conscience as its starting point, and argues that the decision-making processes open to society--legal regulation and professional regulation--can serve to limit the options available to an individual and thus her ability to exercise her conscience. The article charts the law's changing attitude to legal intervention, which now seeks to limit the use of conscience by individuals, and addresses concerns that this may serve to 'de-moralise' medicine. It also examines the reasons for this legal change of approach.

Keywords: Autonomy; Conscience; Decision-making; Medical ethics; Medical law; Regulation.

MeSH terms

  • Conscience*
  • Decision Making / ethics*
  • Ethics, Medical*
  • Humans
  • Informed Consent / ethics
  • Informed Consent / legislation & jurisprudence
  • Legislation, Medical*
  • Moral Obligations*
  • Patient Rights / ethics*
  • Patient Rights / legislation & jurisprudence
  • Professional Autonomy*