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Fidelity to Patients

The central claims of Chapter 5 are that health care professionals who serve a gatekeeping role are fiduciaries for their patients (normatively speaking), they therefore have a fiduciary duty of loyalty to them, and this duty prohibits them from making typical conscientious refusals because doing so jeopardizes health interests of their patients. This chapter explains why this argument works even though typical objectors tend to view the fetus or embryo whose life is at risk as their second patient. At the same time, the author agrees that making a referral to a colleague who is willing and able to provide the offending service, rather than providing it oneself, can be a morally appropriate option for a conscientious objector. The chapter as a whole defends the approach to typical refusals of prioritizing patient interests, specifically for cases where the objector and patient have an existing fiduciary relationship. The author also extends her analysis to atypical refusals in reproductive health care.