Contraception Archives - Page 5 of 10 - Protection of Conscience Project Library

Conscience, Contraception, and Catholic Health-Care Professionals

Janet E Smith

Abstract
The Church’s teachings are often very challenging. Those who are involved in the health-care professions and who conduct their practices in accord with Church teaching can expect misunderstanding and even rejection from their colleagues and patients. One of the most difficult teachings of the Church is its condemnation of contraception. In 1968 Pope Paul VI issued the encyclical Humanae vitae, which hit the world like a bomb. In it he affirmed the Church’s long-standing teaching on human sexuality and condemned contraception in particular. Today scientific advances such as in vitro fertilization and embryonic stem-cell research, as well as the challenges in making moral decisions about end-of-life care, make it increasingly difficult for health-care professionals to practice in accord with their deeply held moral convictions. Developing a properly formed conscience, which is the voice of God, is essential in dealing with these contemporary issues and making right choices. This essay outlines the process for properly forming the conscience. It also explains why prescribing contraception is morally wrong.

Smith JE. Conscience, Contraception, and Catholic Health-Care Professionals. Linacre Quarterly. 2010 May;77(2):204-228. Edited transcript of a talk given at the first annual symposium for health-care professionals, “Conscience and Ethical Dilemmas in Catholic Healthcare,” hosted by the Archdiocese of Baltimore Respect Life Office and Baltimore Guild of the Catholic Medical Association, Baltimore, MD, May 9, 2009. The text is more conversational than a written paper and not as closely documented as a professional piece. Much of the material was accompanied by PowerPoint slides.

Physicians’ “right of conscience”- beyond politics

Asgad Gold

Extract
Introduction: Recently, the discussion regarding the physicians’ “Right of Conscience” (ROC) has been on the rise. This issue is often confined to the “reproductive health” arena (abortions, birth control, morning-after pills, fertility treatments, etc.) within the political context. The recent dispute of the Bush-Obama administrations regarding the legal protections of health workers who refuse to provide care that violates their personal beliefs is an example of the political aspects of this dispute.

Gold A. Physicians’ “right of conscience”- beyond politics. J Law Med Ethics. 2010 Spring;38(1):134-42. PubMed PMID: 20446991.

When Two Fundamental Rights Collide at the Pharmacy: The Struggle to Balance the Consumer’s Right to Access Contraception and the Pharmacist’s Right of Conscience

Suzanne Davis, Paul Lansing

Extract
Conclusion
In conclusion, we think that the marketplace of ideas should be allowed to function on this issue. So long as consumers have access to distribution channels for emergency contraception and to information regarding where the drug is available, there is no reason why the market would fail to reconcile this dilemma. However, if Wilson is correct that governments will not be able to fight the urge to take an active role in this dispute, then freedom of conscience should be the paramount fundamental right. This determination is necessary to provide the proper balance of rights because placing an affirmative duty on pharmacists to dispense a drug negates the basic premises on which our nation is built and only avoids a slight inconvenience to consumers who desire emergency contraception. Finally, it is important for governments to recognize that there are sound arguments on both sides of this legal debate and that an in depth analysis of the ethical and public policy ramifications of regulation on this issue is absolutely necessary.

Davis S, Lansing P. When Two Fundamental Rights Collide at the Pharmacy: The Struggle to Balance the Consumer’s Right to Access Contraception and the Pharmacist’s Right of Conscience. 12 Depaul J. Health Care L. 67, 89-91 (2009)

From reproductive choice to reproductive justice

Rebecca J Cook, Bernard M Dickens

International Journal of Gynecology & Obstetrics

Abstract
Since the 1994 Cairo Conference on Population and Development, the human rights movement has embraced the concept of reproductive rights. These are often pursued, however, by means to which objection is taken. Some conservative political and religious forces continue to resist implementation of several means of protecting and advancing reproductive rights. Individuals’ rights to grant and to deny consent to medical procedures affecting their reproductive health and confidentiality have been progressively advanced. However, access to contraceptive services, while not necessarily opposed, is unjustifiably obstructed in some settings. Rights to lawful abortion have been considerably liberalized by legislative and judicial decisions, although resistance remains. Courts are increasingly requiring that lawful services be accommodated under transparent conditions of access and of legal protection. The conflict between rights of resort to lawful reproductive health services and to conscientious objection to participation is resolved by legal duties to refer patients to non-objecting providers.

Cook RJ, Dickens BM. From reproductive choice to reproductive justice. Int J Gyn Ob. 2009 Aug;106(2):106-109.

Plan B and the Doctrine of Double Effect

Rebecca Stangl

Extract
An appeal to the doctrine of double effect supposes that the end aimed at is morally good. I claim that women who use emergency contraception need only intend the contraceptive effect of the medication, and not any possible abortifacient effect it may have. If one denies that even the former is a permissible end, then the doctrine of double effect makes no difference.

Stangl R. Plan B and the Doctrine of Double Effect. Hastings Center Report. 2009 Jul-Aug;39(4):21-5.

(Working Paper) Conscientious Oppression: Conscientious Objection in the Sphere of Sexual and Reproductive Health

Marcelo Alegre

Yale Law School Lillian Goldman Law Library

Abstract
Although for centuries conscientious objection was primarily claimed by those who for religious or ethical reasons refused to join the ranks of the military (whether out of a general principle or in response to a particular violent conflict), in recent decades a significant broadening of the concept can be seen. In Thailand, for example, doctors recently refused medical attention to injured policemen suspected of having violently repressed a demonstration. In Argentina a few public defenders have rejected for conscientious reasons to represent individuals accused of massive human rights violations. In different countries all over the world there are doctors who refuse to perform euthanasia, schoolteachers who reject to teach the theory of evolution, and students who refuse to attend biology classes where frogs are dissected.

Alegre M. (Working Paper) Conscientious Oppression: Conscientious Objection in the Sphere of Sexual and Reproductive Health. 2009;1-34.

Clandestine induced abortion: prevalence, incidence and risk factors among women in a Latin American country

Antonio Bernabé-Ortiz, Peter J White, Cesar P Carcamo, James P Hughes, Marco A Gonzales, Patricia J Garcia, Geoff P Garnett, King K Holmes

Canadian Medical Association Journal, CMAJ — Canadian Medical Association Journal

Abstract
Background: Clandestine induced abortions are a public health problem in many developing countries where access to abortion services is legally restricted. We estimated the prevalence and incidence of, and risk factors for, clandestine induced abortions in a Latin American country. Methods: We conducted a large population-based survey of women aged 18–29 years in 20 cities in Peru. We asked questions about their history of spontaneous and induced abortions, using techniques to encourage disclosure.Interpretation: The incidence of clandestine, potentially unsafe induced abortion in Peru is as high as or higher than the rates in many countries where induced abortion is legal and safe. The provision of contraception and safer- sex education to those who require it needs to be greatly improved and could potentially reduce the rate of induced abortion.

Keywords:

Bernabé-Ortiz A, White PJ, Carcamo CP, Hughes JP, Gonzales MA, Garcia PJ et al. Clandestine induced abortion: prevalence, incidence and risk factors among women in a Latin American country. Can Med Ass J. 2009;180(3):298-304.

Hormonal contraception: recent advances and controversies

(ASRM Practice Committee)

Journal Extract
This Educational Bulletin outlines delivery systems and contraceptive formulations, summarizes advances in emergency contraception and reviews the effects of hormonal contraception on cancer risks, cardiovascular disease, and bone.

ASRM. Hormonal contraception: recent advances and controversies (ASRM Practice Commitee). Fertil Steril. 2008;90(3 SUPPL.):s103-s113.

Moral Courage Through a Collective Voice

(Ethics and Rural Healthcare)

Julie Aultman

Extract
In posing the question of whether it is morally right for the only pharmacist in town to refuse healthcare services based on his or the community’s religious convictions, I could not help but think of “the conscience clause.” While many states across the United States support the conscience clause, which protects healthcare professionals from discrimination when refusing to dispense birth control pills or performing abortions and sterilizations, such clauses have different implications in the rural setting.When a physician or pharmacist refuses to prescribe or dispense birth control pills, the urban patient is able to acquire birth control from another healthcare provider with less difficulty than the rural patient. The rural patient may have to drive a great distance to acquire birth control even if it is needed for a medical condition rather than to prevent pregnancy.

Aultman J. Moral Courage Through a Collective Voice (Ethics and Rural Healthcare). Am J Bioeth. 2008;8(4):67-69.

Conscientious Objectors Behind the Counter: Statutory Defenses to Tort Liability for Failure to Dispense Contraceptives

Jennifer E. Spreng

Extract
Conclusion
Pharmacists are already involved in litigation over conscience clauses; it is probably only a matter of time before a woman sues a pharmacist for wrongful conception. Changes in the pharmacy profession and correlative tort duties mean a common law or statutory duty to dispense or sell emergency or daily oral contraceptives is not outside the realm of possibility. Many religious pharmacists have compelling reasons to refuse to sell, but federal Free Exercise protections are currently uncertain. State statutory conscience clauses offer some protection and do not violate the Establishment Clause. Therefore, more states should not hesitate to provide
this protection to all healthcare providers.

Spreng JE. Conscientious Objectors Behind the Counter: Statutory Defenses to Tort Liability for Failure to Dispense Contraceptives. 1 St. Louis U. J. Health L. & Pol’y 337, 337-40 (2008)