Conscience and Moral Tyranny

Moral claims based on conscience are increasingly prominent among both health professionals and the general public. These claims are typically treated with deference, and moral examination of them is confined to their impact on others. Such deference is rooted in religious tolerance and an embrace of personal liberties, reinforced by the idea that conscience plays a special role in assuring moral integrity and preserving personal identity. The result is a regard for conscience that allows it to become tyrannical, both over others and over one’s own moral sensibility. Two recent books, Lauris Kaldjian’s Practicing Medicine and Ethics (2014) and Judith Andre’s Worldly Virtue (2015), illuminate how we can reintegrate conscience within our moral sensibility rather than give it sovereignty over moral life. Andre’s interpretation of the virtues of hope and humility is especially helpful in assigning a more modest role to conscience within a dynamic and functional moral framework.