Stories about conflicts between the rights of conscience of healthcare professionals and their employers are frequently publicized in the media. In May 2004, for example, Stephanie Adamson, an emergency medical technician (EMT), filed a federal lawsuit against Superior Ambulance Service of Elmhurst, Illinois, who fired her when she followed her religious beliefs and refused to take part in an abortion. Adamson was responding to a non-emergency call in August 2003 to transport a patient from Mt. Sinai Hospital in Chicago to an abortion clinic. According to the complaint, once Adamson confirmed that her assignment was to transport the patient for an elective abortion, she told her employer that transporting the patient to an abortion clinic violated her religious beliefs. After a second crew was sent to transport the patient, Adamson’s supervisor fired her. What are rights of conscience and how far do they extend? Do they extend to any religious or ethical objection and do they protect any health care professional? What law protects rights of conscience? State law, federal law, constitutional law? Do institutions or associations also have a right of conscience protected by law? The U.S. Constitution may protect rights of conscience but only partially. The Constitution protects liberty only against state or governmental action. Even when the Constitution applies, judges may apply an analysis that “balances” the individual’s interest against the government’s interest. Given the political context of abortion and the sanctity of life, judges may weight the governmental interest over the ethical individual’s interest. Most conscience conflicts involving health care, however, arise in the context of private employer-employee relations because so much is provided by private organizations, hospitals, HMOs, corporations, clinics. However broad liberty of conscience may be against government under the constitution (state or federal), private corporations and employers aren’t compelled to respect it. What protection exists in the context of private, corporate action? This is governed in federal law by Title VII and in state law by some narrow conscience laws. The upshot of all this is that there isn’t much legal protection. The challenge is to create a broader right of conscience in the private marketplace. New law must be made through state or federal legislation. In a sense, we are renewing a debate in American history on the breadth of the right of conscience that has not been settled since 1650. New legal protection is needed to protect the right of conscience with the growth of the health care industry and the increase in new technological challenges.