Global Doctors for Choice, a trans-national network of physician advocates for reproductive health and rights, began exploring the phenomenon of conscience-based refusal of reproductive health care as a result of increasing reports of harms worldwide. A white paper by Dr. Wendy Chavkin, special lecturer and professor emerita of population and family health at Columbia University Mailman School of Public Health, examines the prevalence and impact of such refusal and reviews policy efforts to balance individual conscience, autonomy in reproductive decision-making, safeguards for health, and professional medical integrity.