Doctors, nurses, and pharmacists who refuse on grounds of conscience to participate in certain legal, expected, and standard practices have been accused of unprofessionally introducing their personal views into medicine. My first response is that they often are not engaging in conscientious objection because that involves invoking convictions external to those of the medical community. I contend that medicine, properly construed, is pathocentric, and so refusing to induce a pathology via abortion, contraception, euthanasia, etc., is actually being loyal to the internal morality of medicine. My second response is that even if such refusals are best considered conscientious objection, there is still no personal hijacking of medicine. Doctors refusing to induce pathologies need not refuse qua Christian, but can do so qua doctor. A pathocentric account of medicine provides a principled way of distinguishing conscientious objection from religious, idiosyncratic, and bigoted refusals. Patients’ refused pathology-inducing procedures are not medically harmed.

中文翻译：

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良心反对还是医学的内在道德？

出于良心拒绝参与某些法律、预期和标准实践的医生、护士和药剂师被指控不专业地将他们的个人观点引入医学。我的第一反应是，他们通常不会出于良心拒服兵役，因为这涉及援引医学界以外的信念。我认为，正确解释的医学是以病态为中心的，因此拒绝通过堕胎、避孕、安乐死等方式诱发病态，实际上是忠于医学的内在道德。我的第二个回应是，即使这样的拒绝最好被认为是出于良心的反对，仍然没有个人劫持药物。拒绝诱发病态的医生不必以基督徒的身份拒绝，但可以以医生的身份拒绝。以病态为中心的医学解释提供了一种区分良心反对与宗教、异质和偏执的拒绝的原则方法。患者拒绝的病理诱导程序不会受到医学伤害。