In people, a conscience is a built-in mechanism that assists in determining what is the right way to behave in given situations and circumstances. With a conscience, you are prompted to evaluate the actions you've taken or could take. Considering not only how they benefit you and how convenient they are for you, but also what impact they have on others - directly or indirectly.
Because of this, something as seemingly harmless as leaving a piece of trash on a park bench instead of dropping it in the nearest trash can may leave you feeling displeased with yourself. Accidentally being rude to an innocent stranger may nag you for hours. For worse, more severe and serious offenses, you may be robbed of sleep. Or at least, that would be the case if you're a conscientious person.
A conscience could be suppressed and repressed to the point where it is barely hearable, but it could still be affecting your state. You may not be as much in the mood for things or even begin hating yourself and not knowing why. Having voices in your head that you do not recognize as your own is a possibility, too. And if you're the kind who dreams as a way to access and process what's in your subconscious, what you've been denying might come up there.
Lacking conscience, on the other hand, denotes a brain disability. Although, ironically, those that do often take pride in it, mistaking their inability to weigh matters in terms of impact, consequences, and balance, as a sort of 'slickness' that allows them to take shortcuts in life and go through it unbothered. It can be enviable, but the reality is that it is self-centered and relatively short-sighted. And in extreme cases, leads to sociopathy and psychopathy - if not just narcissism.
Ideally, your conscience would work for you and your greatest good. Not as something that hinders your potential, crippling and paralyzing you, but that helps develop and reveal your best version. So that you can live an exemplary life with few to no regrets.
For this, engaging in self-reflection when you run into a moral or ethical issue is important. This is how to fine-tune the systems that program and inform your conscience. And it is life-long work. Along with keeping it clear.