© Business & Professional Ethics Journal. ISSN 0277-2027.
Correspondence may be sent to Kimberly Engels, kimberly.engels@marquette.edu.
Business & Professional Ethics Journal
doi: 10.5840/bpej2015111133
Online First: November 19, 2015
A Sartrean Analysis of Conscience-based
Refusals in Healthcare: Workplace Decisions
in Light of Group Praxis
Kimberly S. Engels
Marquette University
Abstract: This paper provides an analysis of conscience-based refusals in healthcare
from a Sartrean view, with an emphasis on the tension between individual respon-
sibility 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 acknowl-
edgment 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 work-
place 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.
Key Words: Sartre, role morality, bad faith, group praxis, medical ethics
Introduction
There are many important concerns for employees when balancing their profes-
sional obligations with misgivings about certain practices that they intuitively see
as wrong. Professional role morality, in which one is pressured to abide by a set