In January 2018, the US Department of Health and Human Services (HHS) announced the creation of the Conscience and Religious Freedom Division within the HHS Office of Civil Rights. In creating the division, the HHS aims to enforce existing laws that protect both conscience and religious freedom rights, ensuring that no clinicians are compelled to participate in work that violates their conscience.

In a perspective article published in the New England Journal of Medicine, Lisa H. Harris, MD, PhD, of the departments of obstetrics and gynecology and women’s studies at the University of Michigan in Ann Arbor, encourages fellow healthcare providers to “complicate their views” in order to best serve their consciences.

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“If we embrace rather than fear this complexity, we might better see the moral diversity in our work settings as sources of engagement, information, insight, cooperation, and help, rather than hostility, antagonism, and division,” Dr Harris wrote.

Complicating one’s views, according to Dr Harris, can be achieved by uniting polarized views; this unification can lead to the creation of an informed conscience. Dr Harris hopes that the ambiguity resulting from this type of self-reflection can be used to facilitate conversations between colleagues across political and ideological divides.

“Whether HHS leaders and staff embrace complexity or seek to further entrench existing social divisions will reveal whether their interest in conscience is a political strategy or an ethical commitment,” Dr Harris concluded.


Harris, LH. Divisions, new and old — conscience and religious freedom at HHS [published online March 14, 2018]. N Engl J Med. doi:10.1056/NEJMp1801154