Abortion Archives - Page 13 of 51 - Protection of Conscience Project Library

The Proper Place of Values in the Delivery of Medicine (Conscience in Medicine)

Julian Savulescu

Extract
Physicians who fail to act in their patient’s interests breach the fundamental duty of care of a physician. It is negligent to deny a person who would benefit a blood transfusion, a vaccination, an abortion, intensive care or sedation at the end of their life. Physicians should not play God. If they morally disagree with some medical treatment, they can give their reasons to their patients and they can take that debate to the level of law and professional bodies. But in a liberal society they should not inflict their judgments on their patients. Physicians can disagree, but they should not dictate.

Savulescu J. The Proper Place of Values in the Delivery of Medicine (Conscience in Medicine). Am J Bioeth. 2007 Dec 19;21-22.

Conscience is the means by which we engage the moral dimension of medicine

Raymond Barfield

Extract
This discussion leaves us with a very practical question: what do I do if my informed conscience says not to participate in, say, an abortion or some other intervention, while the patient, law, and hospital policy allow it? The only answer I have is the answer common to other human encounters — speak truthfully, quickly and transparently. But do not abandon conscience, which, though certainly fallible, is far better than the alternative of having a person with immense power such as a physician acting without it. Conscience is the imperfect means by which we tether medicine and morality.

Barfield R. Conscience is the means by which we engage the moral dimension of medicine. American Journal Of Bioethics. 2007 Dec;7(12):26-7; discussion W1-2.

Opinion no. 385: The Limits of Conscientious Refusal in Reproductive Medicine

American College of Obstetricians and Gynecologists

American College of Obstetricians & Gynecologists

Abstract
Health care providers occasionally may find that providing indicated, even standard, care would present for them a personal moral problem-a conflict of conscience particularly in the field of reproductive medicine. Although respect for conscience is important, conscientious refusals should be limited if they constitute an imposition of religious or moral beliefs on patients, negatively affect a patient’s health, are based on scientific misinformation, or create or reinforce racial or socioeconomic inequalities. Conscientious refusals that conflict with patient well-being should be accommodated only if the primary duty to the patient can be fulfilled. All health care providers must provide accurate and unbiased information so that patients can make informed decisions. Where conscience implores physicians to deviate from standard practices, they must provide potential patients with accurate and prior notice of their personal moral commitments. Physicians and other health care providers have the duty to refer patients in a timely manner to other providers if they do not feel that they can in conscience provide the standard reproductive services that patients request. In resource-poor areas, access to safe and legal reproductive services should be maintained. Providers with moral or religious objections should either practice in proximity to individuals who do not share their views or ensure that referral processes are in place. In an emergency in which referral is not possible or might negatively have an impact on a patient’s physical or mental health, providers have an obligation to provide medically indicated and requested care.

ACOG. The Limits of Conscientious Refusal in Reproductive Medicine. ACOG Committee on Ethics. 2007;385):1-6.

Achieving Transparency In Implementing Abortion Laws

Rebecca J Cook, JN Erdman, Bernard M Dickens

International Journal of Gynecology & Obstetrics

Abstract
National and international courts and tribunals are increasingly ruling that although states may aim to deter unlawful abortion by criminal penalties, they bear a parallel duty to inform physicians and patients of when abortion is lawful. The fear is that women are unjustly denied safe medical procedures to which they are legally entitled, because without such information physicians are deterred from involvement. With particular attention to the European Court of Human Rights, the UN Human Rights Committee, the Constitutional Court of Colombia, the Northern Ireland Court of Appeal, and the US Supreme Court, decisions are explained that show the responsibility of states to make rights to legal abortion transparent. Litigants are persuading judges to apply rights to reproductive health and human rights to require states’ explanations of when abortion is lawful, and governments are increasingly inspired to publicize regulations or guidelines on when abortion will attract neither police nor prosecutors’ scrutiny.

Cook RJ, Erdman J, Dickens BM. Achieving Transparency In Implementing Abortion Laws. Int J Gyn Ob. 2007 Nov;99(2):157-161.

Abortion is more than a debate about conscientious objection

Jenny Talia

Extract
Too much effort is expended on debating the rights and wrongs about abortion and not enough is done to prevent it. What proportion of conscientious objectors makes a conscientious effort to ensure men and women use contraception? Conversely, is the pro-choice contingent too lax about initiating discussions on contraception to men and women opportunistically? Of course, there is responsibility for everyone along the chain. What I have a problem with are health professionals who not only deny the rights of women for abortion, but also refuse to offer contraception on religious and moral grounds and insist on abstention.

Talia J. Abortion is more than a debate about conscientious objection. BMJ Sex Repro Health. 2007;33(4):243.

Conscience in America: the slippery slope of mixing morality with medicine

Georgia Chudoba

Extract

Extract
Conscience clauses in this country are becoming dangerously broad and over-inclusive. What was once a protection for physicians who objected to performing abortions is now a tool for religious activists to obstruct a patient’s right to contraceptives, sterilization, and any other medical procedure that they feel is “morally” wrong. The Legislature must place limits on these clauses to protect patients’ rights. At the onset of new medical research on stem cells and infertility treatments, it is crucial that Congress enact legislation that will protect patients’ rights to these treatments. There needs to be a balance between the doctor’s right of conscience and the patient’s right to treatment.

Chudoba G. Conscience in America: the slippery slope of mixing morality with medicine. Southwestern University Law Review. 2007;36(1):85-106.

(Correspondence) Clarification of the CMA’s position concerning induced abortion

Jeff Blackmer

Canadian Medical Association Journal, CMAJ — Canadian Medical Association Journal

Extract
Discussion:
CMA policy states that “a physician should not be compelled to participate in the termination of a pregnancy.” In addition, “a physician whose moral or religious beliefs prevent him or her from recommending or performing an abortion should inform the patient of this so that she may consult another physician.” You should therefore advise the patient that you do not provide abortion services. You should also indicate that because of your moral beliefs, you will not initiate a referral to another physician who is willing to provide this service (unless there is an emergency). However, you should not interfere in any way with this patient’s right to obtain the abortion. At the patient’s request, you should also indicate alternative sources where she might obtain a referral. This is in keeping with the obligation spelled out in the CMA policy: “There should be no delay in the provision of abortion services.”.

Blackmer J. (Correspondence) Clarification of the CMA’s position concerning induced abortion. Can Med Assoc J. 2007;176(9):1310.

Achieving transparency in implementing abortion laws

Rebecca J. Cook, Joanna N. Erdman, Bernard M. Dickens

Cook RJ Erdman JN, Dickens BM. Achieving transparency in implementing abortion laws. Int J Gynaecol Obstet. (2007) 99, 157-161

Health care provider refusals to treat, prescribe, refer or inform: Professionalism and conscience

R Alta Charo

Advance: Journal of the ACS Issue Groups

Extract
Conscience is a tricky business. Some interpret its personal beacon as the guide to universal truth and undoubtedly many of the health care providers who refuse to treat or refer or inform their patients do so in the sincere belief that it is in the patients’ own interests, regardless of how those patients might view the matter themselves. But the assumption that one’s own conscience is the conscience of the world is fraught with dangers. As C.S. Lewis wrote, “of all tyrannies, a tyranny sincerely exercised for the good of its victims may be the most oppressive. It would be better to live under robber barons than under omnipotent moral busybodies. The robber baron’s cruelty may sometimes sleep, his cupidity may at some point be satiated; but those who torment us for our own good will torment us without end for they do so with the approval of their own conscience.”

Charo RA. Health care provider refusals to treat, prescribe, refer or inform: Professionalism and conscience. Advance J ACS Issue Groups. 2007 Spring 1:119-135.

(Correspondence) Access to abortion

Andrée Côté

Extract
I am deeply disturbed by the negative responses (posted as e-letters) to the guest editorial by Sanda Rogers and Jocelyn Downie. Most of the authors articulate an uncompromising ideological position in favour of the right to life of a fetus, while ignoring the basic human rights of women who, presumably, are their patients. . . . Why should an individual doctor’s personal beliefs trump the legal definition of “person” and of “human being,” violate the constitutionally entrenched rights of women to sexual and reproductive autonomy, and violate international human rights?

Côté A. (Correspondence) Access to abortion. Can Med Assoc J. 2007 Feb 13;176(4):493-494.