Conscientious objection is a legally protected right of medical professionals to recuse themselves from patient care activities that conflict with their personal values. Anesthesiology is different from most specialties with respect to conscientious objection in that the focus is to facilitate safe, efficient, and successful performance of procedures by others, rather than to perform the treatment in question. This could give rise to a unique, somewhat indirect ethical tension between the application of conscientious objection and potential infringement upon patient autonomy and well-being. While some situations have clear grounds and precedent for conscientious objection (e.g., abortion, or futile procedures), newer procedures, such as gender-affirming surgery and xenotransplantation, may trigger conscientious objection for complex reasons. This review discusses ethical, legal, and practical aspects of conscientious objection; challenges to anesthesia groups, departments, and healthcare organizations when conscientious objection is invoked by anesthesiologists; and strategies to help mitigate the ethical dilemmas.
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November 2024
Conscientious Objection and the Anesthesiologist: An Ethical Dilemma
Raghuram Koganti, B.A.;
Raghuram Koganti, B.A.
1Department of Anesthesiology, University of Illinois College of Medicine, Chicago, Illinois.
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Moshe M. Cohn, M.D., H.E.C.-C.;
Moshe M. Cohn, M.D., H.E.C.-C.
2Department of Population Health, Division of Medical Ethics, New York University Grossman School of Medicine, New York, New York; Pediatric Critical Care, Valley Health System, Paramus, New Jersey; Palliative Medicine and Ethics Consulting, Teaneck, New Jersey.
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Steven H. Resnicoff, J.D.;
Steven H. Resnicoff, J.D.
3Center for Jewish Law & Judaic Studies, DePaul University College of Law, Chicago, Illinois.
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Steven Roth, M.D.
Steven Roth, M.D.
4Department of Anesthesiology, College of Medicine, University of Illinois at Chicago, Chicago, Illinois.
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This article is accompanied by an editorial on p. 822.
Submitted for publication May 6, 2024. Accepted for publication July 19, 2024.
Address correspondence to Dr. Roth: Department of Anesthesiology, College of Medicine, University of Illinois at Chicago, 835 South Wolcott Avenue, Room E714, Chicago, Illinois 60612. rothgas@uic.edu.
Anesthesiology November 2024, Vol. 141, 849–858.
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Raghuram Koganti, Moshe M. Cohn, Steven H. Resnicoff, Steven Roth; Conscientious Objection and the Anesthesiologist: An Ethical Dilemma. Anesthesiology 2024; 141:849–858 doi: https://doi.org/10.1097/ALN.0000000000005173
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