WITH A CLEAR CONSCIENCE; What Do You Do When Personal Beliefs Collide with Aspects of Your Professional Life? Here Are Some Stories on Resolving (or Avoiding) Work-Related Moral and Ethical Conflicts

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One of the worst things about work-related ethical conflicts is that they sneak up on you, ethicist Kathy Kinlaw says.

"A lot of us don't think about these dilemmas until they hit," says Kinlaw, associate director for the Center for Ethics at Emory University in Atlanta. "People often walk into settings where neither they nor the corporation are ready to deal with them."

Health care workers, for instance, have had to deal with an inordinate share of moral dilemmas in the past two or three decades, Kinlaw said. As increasingly complex medications and procedures have been developed, they have brought moral and religious concerns for some of those expected to carry them out.

And opting out of dispensing certain drugs or carrying out certain procedures in turn places patients in quandaries they feel violate their rights, she said.

That debate is coming to a head in Washington, where the federal Department of Health and Human Services is considering a Bush administration proposal to protect health care workers who refuse to dispense drugs or conduct procedures that violate their personal values.

The measure, if enacted, would deny federal funding to any organization that does not accommodate such employees.

It's not just health industry professionals who deal with this, either. Law enforcement and military environments are among those often rife with potential moral conflicts. A number of First Coast residents have wrestled with such conflicts and had to find a variety of ways through - or around - them.

Pharmacist Anita Thompson's job at an institution whose values line up with hers - both she and St. Vincent's Medical Center are Catholic - means she never has to worry about having to dispense birth control and the even more-controversial "morning-after" medications.

"It's been a lot more comfortable here," she said of the two decades or so she's worked at St. Vincent's.


In his 25 years as a pharmacist, Jim Koivisto said he's found a way for his employees and him to avoid filling orders that violate their consciences while making sure customers get the medications their doctors have prescribed.

Unlike doctors, who can specialize in their practices, pharmacists are required to dispense all medications they have in stock. Koivisto, co-owner of Halliday's and Koivisto's Pharmacy in Jacksonville, wouldn't say what medications he does or doesn't keep in stock. But if he or one of his pharmacists had a problem with filling a given order, they would either pass it to a colleague who didn't or send the patient to another store.

"If I'm a Cadillac dealer, I'm not going to stock Ford parts," said Koivisto, a Christian. "But I'll tell you where to get Ford parts if that's what you're after."

He added: "The bottom line is, I would make sure the patient's health was protected."

And that's generally how it's done in pharmacies across Jacksonville, said Thompson, who is secretary of the Duval County Pharmacy Association.

"I haven't spoken to any pharmacist who's said you have to fill everything that comes through the door," Thompson said.


Avoiding the potential moral dilemma is another approach, said Northside resident Alfred Geiger.

He dealt with his conflict - being a pacifist during the Korean War - by seeking and achieving conscientious objector status during the 1950s.

Geiger said he was raised in a Christian home where the Bible was considered the source of moral ideals and Jesus Christ a pacifist example to be followed. So was Mahatma Gandhi, the Indian leader whose non-violent revolution freed India from British colonial rule.

"I was simply convinced that wars seldom settled anything at all," Geiger said. "Wherever pacifism has really been tried, it has accomplished things war couldn't accomplish. …


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