Opponents of conscientious objection in healthcare, such as Savulescu, argue that healthcare professionals cannot have a right to conscientiously object to provide professional services, because such a right would be incompatible with their professional obligations. Defenders of conscientious objection in healthcare typically respond to this line of argument by describing the professional obligations of healthcare professionals in a ‘top-down’ manner – making generalizations about the healthcare professions and the ways in which these are organized, and deriving claims about individual professional obligations from these generalizations which are compatible with a right to conscientiously object. I argue that such approaches don’t succeed in grounding individual professional obligations. What we need to do instead is to approach this issue ‘bottom up’. The best way to determine what exactly the professional obligations of healthcare professionals are, and to determine whether or not these are compatible with a right to conscientiously object is to focus our attention on the issue of how individual professional obligations are acquired in the healthcare professions. When we do this we arrive at some surprising results, which I outline.