Attempts have been made recently to remove conscience rights from those who do not espouse libertarian approaches in health care. Those who disagree with abortion, surrogacy, sex-change surgery, etcetera, face losing the right to refuse to perform or allow such procedures. After one such threat, Cardinal Rigali (Philadelphia) reminded Congress that numerous laws protecting conscience rights already exist, dating from 1973. Some address specific contexts, such as abortion, AIDS prevention, or sterilization, yet none has been enforced through regulations, therefore few policy makers or health care personnel know of them. In 2007, the Ethics Committee of the American College of Obstetricians and Gynecologists stated that pro-life physicians must do abortion referrals. The committee was reminded by the Secretary of Health and Human Services that such coercion is an abuse of federal conscience laws. These laws will be revisited here. In Canada, Human Rights Commissions have encouraged professional bodies to withdraw conscience rights from those who oppose certain procedures. The College of Physicians and Surgeons of Ontario stated its intention to obligate physicians to refer abortion-seeking patients to more accommodating physicians, and only prompt action by many Christian groups prevented this. Conscience rights in health care in Canada will also be briefly described. Questions for discussion include: is there a theological basis for conscience? Is it essentially a legal right, therefore removable? Is it an ontological capacity, fundamental to human freedom? Since conscience is subjective, might it not err in its judgments? Are there guiding factors that should be considered? Are all conscience decisions equally valid?