Claims of conscience are a substantial area of concern in relation to healthcare decisions but are often only considered in a limited context. Broadening our understanding of claims of conscience, however, might lead to claims that we are moving back towards a doctor-centred understanding of medical care. This article argues that we can allow claims of conscience without unduly penalising patients by focusing on the responsibilities that ought to attach to conscience claims. This article sets out three responsibilities – humility, universality and reciprocal respect – which ought to be part of any claim of conscience. The Charlie Gard case is then used as an example to explore the use of responsibilities. The article then moves to consider possible issues that arise from this view.