Christian medical practitioners carry their conscience with them into their medical practice, though some would argue that they ought not to be allowed to. On the matter of whether physicians ought to be permitted the ability to conscientiously refuse to provide medical services, to what system ought individuals direct their arguments? What values govern that system, and what policies or practices ought those values to produce? I argue that law is the proper system for resolving debates about a practitioner’s ability to conscientiously refuse. The fundamental values of the U.S. political and legal systems are liberty, pluralism, and justice, and laws about conscientious refusals in medicine ought to conform to these values. I make a public reason argument that everyone ought to support broad legal protections of individual conscience and recognize such protections as to their benefit. I argue that medical practitioners ought to have an assumed right of conscientious refusal available for use in all but the most narrowly restricted circumstances, and that the burden of accommodating patient rights falls not on the practitioner but on government. I consider reasonable requirements that may be expected of refusers, the narrow limits to such broad rights, and I consider some practical matters of the application of such a policy. In the conclusion, I consider what integrity requires when one supports broad legal protections of individual conscience for everyone, including those whose conscience seems seem ill-formed.