There is a growing trend worldwide of health care professionals conscientiously refusing to provide abortions and similar reproductive health services in countries where these services are legal and professionally accepted. Carolyn McLeod responds to this problem by arguing that conscientious objectors in health care should have to prioritize the interests of patients in receiving care over their own interest in acting on their conscience. She defends this “prioritizing approach” to conscientious objection over the more popular “compromise approach” in bioethics. All the while, she is careful not to downplay the importance of health care professionals having a conscience or the moral complexity of their conscientious refusals. McLeod first describes what is at stake for the main parties to the conflicts generated by conscientious refusals in reproductive health care: the objector and the patient. She then defends the prioritizing approach to these refusals. Her central argument is that health care professionals who are charged with gatekeeping access to services like abortions are normatively fiduciaries for both their patients and the public they are licensed to serve. As such, they have a duty of loyalty to these beneficiaries and must give primacy to their interests in gaining access to care. The insights contained in the book extend beyond the ethics of conscientious refusals to other topics in ethics including the value of conscience and the fundamental moral nature of the relationships health care professionals have with current and prospective patients.