Abortion Archives - Page 13 of 49 - Protection of Conscience Project Library

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.

(Correspondence) Access to abortion

Janet Epp Buckingham

Extract
Given that abortion and its regulation and restriction continue to be hotly debated in Canada, it is not simply “like any other medical procedure.” It is also inaccurate to portray a physician who exercises a right of conscientious objection to participating in abortion as violating CMA policy. The 1988 CMA Policy on Induced Abortion specifically allows for such a right of conscientious objection.

Buckingham JE. (Correspondence) Access to abortion. Can Med Assoc J. 2007;176(4):492.

Emergency Contraception for Women Who Have Been Raped: Must Catholics Test for Ovulation, or Is Testing for Pregnancy Morally Sufficient?

Daniel P Sulmasy

Abstract
On the grounds that rape is an act of violence, not a natural act of intercourse, Roman Catholic teaching traditionally has permitted women who have been raped to take steps to prevent pregnancy, while consistently prohibiting abortion even in the case of rape. Recent scientific evidence that emergency contraception (EC) works primarily by preventing ovulation, not by preventing implantation or by aborting implanted embryos, has led Church authorities to permit the use of EC drugs in the setting of rape. Doubts about whether an abortifacient effect of EC drugs has been completely disproven have led to controversy within the Church about whether it is sufficient to determine that a woman is not pregnant before using EC drugs or whether one must establish that she has not recently ovulated. This article presents clinical, epidemiological, and ethical arguments why testing for pregnancy should be morally sufficient for a faith community that is strongly opposed to abortion.

Sulmasy DP. Emergency Contraception for Women Who Have Been Raped: Must Catholics Test for Ovulation, or Is Testing for Pregnancy Morally Sufficient? Kennedy Inst Ethics J. 2006;16(4):305-331.