Building Moral Community in an Age of Polarization: A Model for Reconciling Rights of Conscience in Healthcare Organizations.

Responding to conscientious objection and participation declarations to various morally contentious medical services requires a careful, inclusive, and comprehensive approach in reconciling the right of conscience of involved parties. In this paper, we make a case that the traditional discourse of whether or not to accommodate conscience-based requests does not adequately support complex, team-based healthcare systems in addressing emerging areas of moral controversy in medicine, particularly in this era of polarization. We describe how key parties in our organization developed an inclusive and comprehensive approach to reconciling rights of conscience in the context of the introduction of a morally contentious and divisive medical practice. This approach prioritized the building of a moral community, a recognition of moral diversity, a values-based approach, and the development of resources and infrastructure in managing conscience-based requests, to enable healthcare professionals uphold their fiduciary duties and promote positive patient experiences. This model of managing conscientious based situations may be applicable to other healthcare organizations that provide various morally controversial services.