The ethical justifiability of accommodating conscientious refusals in health care has become a hotly contested issue. This debate has been fueled recently by expanded legalization of physician-assisted death, public health crises that impact reproduction (e.g., Zika), and greater recognition of the rights of LGBT patients. This debate has become particularly acute in the developing world, where access to abortion services may be severely limited and thus conscientious refusals on the part of a few providers may have a tremendous impact. Between absolutist defenses of a right to conscientious refusal in any case in which a healthcare provider (whether individual or institution) considers their conscience/mission to be implicated, and calls to abolish any legal protection of conscientious refusals, lie various “compromise” proposals that seek to safeguard healthcare providers’ exercise of conscience as well as patients’ access to legal, but morally contentious, medical services. This presentation will explicate and defend a compromise view in which respect for conscientious refusal claims is based on the adjudication of publicly defensible reasons articulated by providers, or a general consensus that such services are morally contestable on reasonable grounds. This defense will include response to critiques of similar proposals by Robert Card and others, particularly involving conscience claims that are premised upon defensible, if defeasible, metaphysical premises. Typically, compromise views require healthcare professionals to be transparent in their refusals, offer unbiased information regarding available healthcare services, and provide referrals or transfers of care when necessary to ensure access. Such compromises raise the specter of moral complicity and potential moral scandal by virtue of seemingly approving of such services. This presentation will thus elucidate various criteria by which degrees of moral complicity may be assessed, as well as operative distinctions within the concept of scandal, which subserve a nuanced analysis of complicity and scandal with respect to transparency, information, and referral/transfer.