Amid historic restrictions on abortion, puberty blockers, and assisted suicide, a health-law expert exposes America’s broken system of medical conscience, which shields clinicians who refuse evidence-based care yet offers no protections to those who provide prohibited treatment.

Pitched battles over abortion, puberty blockers, and assisted suicide have turned American healthcare into a legal minefield. Faced with mounting restrictions on medical practice, doctors and nurses who follow their conscience to provide standard treatments risk being fined, fired, or even imprisoned, while clinicians who conscientiously deny evidence-based care are shielded without condition from any such consequences. Dov Fox argues that by ceding the moral vocabulary of conscience to refusers alone, the lopsided law of medical conscience selectively burdens providers, drives vulnerable patients underground, and impoverishes the dynamic pluralism of medicine.

The Conscience of Care lays bare the broken system of medical conscience and sets out to fix it. Fox canvases a landscape of contested services that include IVF, IUDs, opioids, psychedelics, organ transplants, and advance directives. He develops practical reforms that rebalance conscience protection by introducing measured safeguards for providers and scaling back the categorical refuge afforded to refusers. The Conscience of Care articulates a bold vision of medicine that reclaims the lost promise of conscience to bridge social divides on matters of life and death, impairment and identity.

About the Author

Dov Fox is Herzog Research Professor of Law at the University of San Diego, where he founded and directs the Center for Health Law Policy & Bioethics. He is the author of Birth Rights and Wrongs: How Medicine and Technology Are Remaking Reproduction and the Law, and his research has been featured in the New York Times, the Wall Street Journal, The Atlantic, The Economist, CBS This Morning, and NBC’s Today Show. He is the recipient of a Guggenheim Fellowship.

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