Volume 34, Issue 2, Summer 2015
Kimberly S. Engels
A Sartrean Analysis of Conscience-based Refusals in Healthcare
Workplace Decisions in Light of Group Praxis
This paper provides an analysis of conscience-based refusals in healthcare from a Sartrean view, with an emphasis on the tension between individual responsibility and professional role morality. Conscience-based refusals in healthcare involve healthcare workers refusing to perform actions based on core moral beliefs. Initially this appears in line with Sartrean authenticity, which requires acknowledgment that one is not identical with professional role. However, by appealing to Sartre’s later social thought, I show that professional role morality is authentic when one considers common group practices, which Sartre refers to as pledged group praxis. I demonstrate that for healthcare providers, authenticity mandates putting the goals and generally accepted praxis of healthcare front and center in the workplace decision process. I conclude by strengthening Andrew West’s existentialist decision-making model with Sartre’s later social thought. With the updated model, I show that for healthcare workers most often the authentic decision is to perform generally accepted healthcare procedures in spite of individual moral qualms. This is because working in healthcare necessitates viewing one’s professional tasks in their broader social context—as unified, communal group praxis.