The Supreme Court and the future of Medicaid.

983 guishing claims of conscience from other types of claims. Certainly, if abortion providers’ conscience-based claims require scrutiny, so do conscience-based refusals, to ensure that refusals are indeed motivated by conscience and not by political beliefs, stigma, habit, erroneous understanding of medical evidence, or other factors. Despite nearly four decades of debate about conscientious refusals, we have no clear path for operationalizing them — no standard curriculum to teach health care professionals how to humanely conscientiously object, and no clinical standard of care for conscientious refusals — although there are presumably good and bad, skillful and haphazard, safe and unsafe ways of carrying them out. Since we need both a standard curriculum and a standard of care, it is perhaps premature to introduce a whole new set of conscience claims. The terms used in the current debate, however, are inadequate and inaccurate. Recognizing only negative claims of conscience with respect to abortion — or any care — is a kind of hemineglect. Health care workers with conflicting views about contested medical procedures might all be “conscientious,” even though their core beliefs vary. Failure to recognize that conscience compels abortion provision, just as it compels refusals to offer abortion care, renders “conscience” an empty concept and leaves us all with no moral ground (high or low) on which to stand.