In preparation for the imminent end of the world, converts to new evangelical forms of Christianity among the Lelet of New Ireland must practise constant self-scrutiny and self-discipline. Previously wrongdoing was unproblematic if concealed; now signs of sin are keenly sought in self and others. Illness, as God's punishment, is a significant sign of sin. To be cured, the ill must be scrupulously virtuous - thus doubly introspective. This accent on moral agency makes illness a source of public and internalized shame, intensifying an impetus towards a new form of conscience. Illnesses and deaths undergo a tortuous process of evaluation, in the light of competing traditional, biomedical, and new religious views. The new has not swept away the old; rather, change is incorporated in ways that are difficult to predict. The development of an internalized conscience in Lelet converts, though theoretically likely, cannot be taken for granted.