Out of Bounds: When professional medical groups call to violate provider conscience 

Disclaimer: Opinions expressed in this guest post are solely those of the author.

The intersection of professional medical societies' clinical guidance and individual healthcare providers' personal moral objections presents a complex ethical and professional dilemma.

While the primary goal of clinical guidelines is to ensure high-quality, evidence-based patient care, compelling providers to perform or participate in procedures that violate deeply held personal convictions can be seen as a significant overreach, potentially crossing the line into an infringement on individual conscience.

Ignoring provider conscience?

The American College of Obstetricians and Gynecologists (ACOG) has recently released (Nov. 2025) a committee opinion that addresses access to contraception. This ACOG committee opinion states that "Religious doctrines of hospital systems or health care professionals should not affect patients' access to the full range of contraceptive methods." 

In other words, the opinion portrays the patient as unilaterally important in the physician-patient relationship, even if it minimizes or eliminates the personal, and often deep moral, convictions of the physician.

This is problematic yet not surprising, as the ACOG has previously released similar opinions in the past minimizing a provider’s moral objections. In its 2007 committee opinion, the ACOG states, ironically, that “Such challenges to [personal] integrity can result in considerable moral distress for providers.” Nonetheless, their demonization of moral objections persists. 

Federal Protections

It is crucial to recognize that neither ACOG's guidance, nor any other medical groups' policies, should supersede a physician's moral objections to any intervention or procedure.

Moral objection is a deeply held personal conviction and is protected by federal law under the Church Amendments and the Coats-Snowe Amendment for religious liberty. These legislative protections acknowledge the fundamental right of healthcare professionals to decline participation in procedures that violate their conscience. 

Respect for a healthcare provider's personal convictions is a cornerstone of ethical medical practice.

The American Medical Association (AMA) Code of Medical Ethics, for instance, acknowledges that physicians have a right to decline to participate in care that conflicts with their personal values, provided that the patient's care is not jeopardized and that the physician facilitates or recommends the transfer of care to another willing provider. 

Specifically, the AMA Code of Medical Ethics states:

Physicians are not defined solely by their profession. They are moral agents in their own right and, like their patients, are informed by and committed to diverse cultural, religious, and philosophical traditions and beliefs… Physicians are expected to provide care in emergencies, honor patients’ informed decisions to refuse life-sustaining treatment, and respect basic civil liberties and not discriminate against individuals [based on race, gender, sexual orientation, or disability status].

We Can Respect Both

Ethical frameworks in healthcare should emphasize a nuanced approach that respects both patient autonomy and physician conscience, without one inherently outweighing the other.

This balance is crucial for supporting trust in the medical profession and ensuring equitable access to care while upholding the moral agency of healthcare providers. Rather than diminishing a provider’s moral conscience and/or objections, organizational policies should foster open dialogue and mutual respect between patients and providers.

The goal should be not to diminish the value of either party but to find a practical and ethical solution that upholds the principles of justice, beneficence, and non-maleficence in healthcare. Professional medical societies have fiduciary responsibility to all their members and should advocate for care policies without coercing individual providers.

Professional obligations, while significant, are finite; they will eventually cease for all individuals, whether by choice for retirement or due to unforeseen circumstances like physical limitations or illness. However, a person's moral convictions are enduring and will continue irrespective of their professional status.

ACOG's guidance is and will always be secondary to the moral convictions of any healthcare provider.