Extract an egalitarian justice argument, he mentions only briefly as more promising than the former: refusing to provide reproductive assistance to homosexual parents while making it available to heterosexual parents constitutes unjust discrimination against the former. Appel does not develop this suggestion at all, but I want to say a word about an issue on which it hinges, namely, the moral standing that reproductive assistance has in a just health care system.
Abstract Conclusion Ultimately, this Article proposes a new model for such “conscientious objections,” one that presumes the general obligation ‘of health care professionals, who hold monopolistic state licenses, to participate in requested medical care that is not contraindicated or illegal, notwithstanding their personal moral objections. This model is based on “the· premise that it “is the patient’s best interest (as determined by -the patient, but mediated by the health care professional’s medical judgment), not the health care professional’s personal interests, that should govern the professional relationship. This should be the standard taught in professional schools and promoted by professional associations. “Conscientious objections” should be permissible based on prevailing medical ethics; however, to the extent that they are based on the personal morals of the· health care professional, they should be actively discouraged.
Abstract This article argues that practitioners have a professional ethical obligation to dispense emergency contraception, even given conscientious objection to this treatment. This recent controversy affects all medical professionals, including physicians as well as pharmacists. This article begins by analyzing the option of referring the patient to another willing provider. Objecting professionals may conscientiously refuse because they consider emergency contraception to be equivalent to abortion or because they believe contraception itself is immoral. This article critically evaluates these reasons and concludes that they do not successfully support conscientious objection in this context. Contrary to the views of other thinkers, it is not possible to easily strike a respectful balance between the interests of objecting providers and patients in this case. As medical professionals, providers have an ethical duty to inform women of this option and provide emergency contraception when this treatment is requested.
Extract If a pharmacist’s beliefs or personal convictions prevent him or her from providing a particular service, the pharmacist must disclose this fact before accepting employment to allow procedures to be put in place to enable patients to access the services they require. In such circumstances the Code of Ethics and Standards requires that a pharmacist must not condemn or criticise the patient and that either the pharmacist or a member of staff must advise the patient of an alternative source for the service requested.
Best Practice and Research Clinical Obstetrics & Gynaecology
Abstract Women’s sexual and reproductive rights are an integral part of daily practice for obstetricians/gynaecologists and the key to the survival and health of women around the world. Women’s sexual and reproductive health is often compromised because of infringements of their basic human rights, not the lack of medical knowledge. Understanding the relevance of respecting and promoting sexual and reproductive rights is critical for providing current standards of care, and includes access to information and care, confidentiality, informed consent and evidence-based practice. The violation of women’s rights in their daily lives through common problems such as gender-based violence and discrimination results in serious consequences for their health. Obstetricians/gynaecologists are natural advocates for women’s health, yet may be lacking in their understanding of relevant laws or the limits of conscientious objection. This chapter outlines the framework for sexual and reproductive rights, and explores its relevance to the practising clinician.
Abstract Despite serious challenges to the identity of Catholic health institutions in the United States, both Church and society should continue to see them as privileged places of moral discernment. This discernment occurs in “institutional conscience,” namely, a dialogue among all those authorized to act on the institution’s behalf about institutional actions, for example, medical interventions. The institutional conscience of Catholic health institutions should be respected by society at large, leaving them free to practice Christian healing and to show the problems with certain practices that they reject, such as abortion, and to seek alternatives.
Extract Religious initiatives to propose, legislate, and enforce laws that protect denial of care or assistance to patients, (almost invariably women in need), and bar their right of access to lawful health services, are abuses of conscientious objection clauses that aggravate public divisiveness and bring unjustified criticism toward more mainstream religious beliefs. Physicians who abuse the right to conscientious objection and fail to refer patients to nonobjecting colleagues are not fulfilling their profession’s covenant with society.
Journal Extract The dilemma of conscientious objection by US pharmacists has yet to be resolved. The issue was thrust into the mass-media spotlight when a pharmacist in Texas rejected a rape victim’s prescription for emergency contraception (the morning-after pill). The pharmacist argued that dispensing the drug was a “violation of morals”.
Further cases have since been reported and include such acts as intimidation and confiscation of the prescription by the pharmacist. Pharmacists argue that they are a health-care provider and, like doctors, should have the right to refuse to participate in services they morally object to. Pharmacists argue that they are a health-care provider and, like doctors, should have the right to refuse to participate in services they morally object to. In fact, the policy of the American Pharmacists Association permits pharmacists to object to dispensing drugs but requires them to ensure another pharmacist is available to dispense or transfer the prescription to another pharmacy. Further, the Association argues that this approach is “seamless” and the patient is “not aware that the pharmacist is stepping away from the situation”.
Extract I have, however, a question about the implication that the pharmacy assistant was being unprofessional because he let his personal conviction affect the provision of care. I would like to assume for the sake of argument that his personal conviction was that Plan B is unethical because it induces abortion and he is of the opinion that abortion ends a person’s life. By providing Plan B he would be doing something that he genuinely believes is in the best interest of neither his adult client nor her embryo. Wouldn’t it be unprofessional to ignore this conviction and provide the drug anyway? What should a professional do when he is asked to do something by a client that he genuinely believes is not in the client’s best interest? What would a lawyer do?
Abstract Conclusion . . . The pharmaceutical industry will continue to create drugs to which some pharmacists object on religious grounds. Employers must anticipate that some pharmacists will object not only to birth control, but also to Ritalin, 226 Viagra for unmarried men, or drugs to treat AIDS; some pharmacists may even object on religious grounds to serving particular customers. The religious discrimination provisions of the Civil Rights Act allow most employers to dispense with the majority of possible religious accommodations for pharmacists who refuse to fill prescriptions on religious grounds. Those provisions are meaningless, however, if employers are reluctant to assert Title VII’s protections against accommodations imposing an undue hardship on the pharmacy’s business operations. As pharmacies negotiate the tensions between consumers demanding prompt access to prescription drugs, a tight labor market for pharmacists, pressure from certain religious groups to discourage the use of birth control, vocal national groups advocating expanded access to contraception, and their own economic bottom line, Title VII can serve either as an answer or as an excuse. Employers may use Title VII as a pretense to justify unnecessary accommodations for objecting pharmacists; pharmacies may attempt to use federal law to shield themselves from customer and activist criticism by asserting that they have no choice but to accommodate. On the other hand, pharmacies can utilize Title VII as a tool to define the outer limits of their pharmacist accommodation policies. A clear understanding of the parameters of Title VII’s religious accommodation requirements will help guide and monitor the behavior and legal justifications presented by employers, employees, and customers when pharmacists refuse to dispense certain drugs on religious grounds.
