This is a "preprint", the athours' own submitted manuscript pre refereeing and editorial processing of an article published in the Cambridge Quarterly of Healthcare Ethics, 26 (1): 59-68. Citations should refer to the final, published version, available: https://www.cambridge.org/core/journals/cambridge-quarterly-of-healthcare- ethics/article/div-classtitlethe-legal-ethical-backbone-of-conscientious- refusaldiv/45A305D4DD8E293869FC6A5F69DF0A02 The Legal Ethical Backbone of Conscientious Refusal Christian Munthe, Department of Philosophy, Linguistics and Theory of Science and Centre for Ethics, Law and Mental Health, University of Gothenburg Email: christian.munthe@gu.se Morten Ebbe Juul Nielsen, Philosophy, Department of Media, Cognition and Communication, and Institute of Food and Resource Economics, University of Copenhagen. Email: mejn@hum.ku.dk Abstract: This paper analyses the idea of a legal right to conscientious refusal for health care professionals from a basic legal ethical standpoint, using refusal to perform tasks related to legal abortion (in cases of voluntary employment) as a case in point. The idea of a legal right to conscientious refusal is distinguished from ideas regarding moral rights or reasons related to conscientious refusal, and none of the latter are found to support the notion of a legal right. Reasons for allowing some sort of room for conscientious refusal for health care professionals based on the importance of cultural identity and the fostering of a critical atmosphere might provide some support, if no countervailing factors apply. One such factor is that a legal right to health care professionals conscientious refusal must comply with basic legal ethical tenets regarding the rule of law and equal treatment, and this requirement is found to create serious problems for those wishing to defend the idea under consideration. We conclude that the