Abstract The legal approach to abortion is evolving from criminal prohibition towards accommodation as a life-preserving and health-preserving option, particularly in light of data on maternal mortality and morbidity. Modern momentum for liberalization comes from international adoption of the concept of reproductive health, and wider recognition that the resort to safe and dignified healthcare is a major human right. Respect for women’s reproductive self-determination legitimizes abortion as a choice when family planning services have failed, been inaccessible, or been denied by rape. Recognition of women’s rights of equal citizenship with men requires that their choices for self-determination be legally respected, not criminalized.
Extract This article focuses on . . . the locus and extent of legal decision-making power as regards the disabled fetus. It does this by exploring how the relationship between the law of abortion and that of wrongful birth affects the scope of a pregnant woman’s decision-making abilities in this context. . . .In order to reflect on how the law shapes and controls a woman’s (or couple’s) autonomy in this context, the article considers both the non- rights-based English legal position on abortion and its rights-based US counterpart, in addition to exploring aspects of the law of wrongful birth in both jurisdictions. It also makes some suggestions as to the value of autonomy in this context and how extensive it should be at law, although the opportunity to do so here is limited. The discussion entails reflection on the role of the medical profession, the relationship between autonomy and reasons and the interests of people with disabilities or impairments.
Abstract In this essay I shall describe and analyse the current debate on physician assisted suicide in contemporary German Protestant church and theology. It will be shown that the Protestant (mainly Lutheran) Church in Germany together with her Roman Catholic sister church has a specific and influential position in the public discussion: The two churches counting the majority of the population in Germany among their members tend to ‘‘organize” a social and political consensus on end-of-life questions. This cooperation is until now very successful: Speaking with one voice on end-of-life questions, the two churches function as the guardians of a moral consensus which is appreciated even by many non-believers. . .I shall argue that it will be necessary to go beyond this actual controversy to the works of Gerhard Ebeling and Karl Barth for a clear and instructive account of conscience and a theological analysis of the concepts of life and suicide. On the basis of their considerations, a conscience-related approach to physician assisted suicide is developed.
Abstract The South African Choice on Termination of Pregnancy Act 92 of 1996 gives women the right to voluntary abortion on request. The reality factor, however, is that five years later there are still more ‘technically illegal’ abortions than legal ones. Amongst other factors, one of the main obstacles to access to this constitutionally enshrined human right is the right to conscientious objection/refusal. Although the right to conscientious objection is also a basic human right, the case of refusal to provide abortion services on conscientious objection grounds should not be seen as absolute and inalienable, at least in the developing world. In the developed world, where referral to another service provider is for the most part accessible, a conscientious objector to abortion does not really put the abortion seeker’s life at risk. The same cannot be said in developing countries even when abortion is decriminalised. This is because referral procedures are fraught with major obstacles. Therefore, it is argued that the right to conscientious objection to abortion should be limited by the circumstances in which the request for abortion arises.
Extract Patient autonomy certainly deserves both moral respect and legal protection, but to demand of a physician that she act in a manner she deems to be morally unpalatable not only compromises the physician’s ethical integrity, but is also likely to have a corrosive effect upon the dedication and zeal with which she ministers to patients.
Extract Currently, fetal tissue research is integral for potential cures, and there is no convincing evidence that it can be deemed an abortion lure. Therefore, let research continue on the road of revolutionary, scientific discovery, hopefully picking up along the way the technology to end the pain of so many suffering beyond that path of medical enlightenment. At present, it is their most promising hope for a healthy life.
(Conscience and freedom of conscience: An analysis of conflicts of conscience in Swedish society and of the concepts of conscience)
Mats Alden
Thesis
Abstract This thesis has several aims which are related in various ways. The first task is to study conflicts of conscience in Swedish society. In this type of conflict, the terms conscience and freedom of conscience are central terms. Thus it is vital that they are understood and related to when analyzing the conflicts themselves. The second task is therefore to study and come to grips with the term conscience, suggest a definition, and then apply the various ways of understanding conscience to the conflicts of conscience in order to answer the question of whether or not an individual should follow his or her conscience. The third task is to study the term freedom of conscience and provide a definition. In addition, a typology is provided and applied to the conflicts of conscience studied in order to answer the question of whether or not there is ample freedom to follow one’s conscience. Finally, I take a stand for one of the types in the typology. The first task is undertaken in Chapter 2, the second task comprises Chapter 3 and the third task, Chapter 4.
Extract In this article, I will first describe the argumentative way in which the major Christian churches in the Netherlands and Belgium have dealt with what they considered the challenge of the demand to legalize euthanasia in their respective countries. Given the important differences between the courses of events in both countries, the part on the interventions in the Netherlands will be considerably longer than the one on Belgium. No doubt, the most important reason for this difference is the fact that the public discussion on euthanasia together with efforts to change the penal law prohibiting it, took shape in the Netherlands already from 1968 on. Next to this, the fact that the major Christian churches in the Netherlands were not in agreement on the proper approach also contributes to a more differentiated picture. In the third part of this article, I will present some comments and a moral theological evaluation of the core of the argumentation forwarded by the Christian churches.
Abstract This paper presents an overview of the dimensions of unsafe motherhood, contrasting data from economically developed countries with some from developing countries. It addresses many common factors that shape unsafe motherhood, identifying medical, health system and societal causes, including women’s powerlessness over their reproductive lives in particular as a feature of their dependent status in general. Drawing on perceptions of Jonathan Mann, it focuses on public health dimensions of maternity risks, and equates the role of bioethics in conscientious medical care to that of human rights in public health care. The microethics of medical care translate into the macroethics of public health, but the transition compels some compromise of personal autonomy, a key feature of Western bioethics, in favour of societal analysis. Religiously-based morality is seen to have shaped laws that contribute to unsafe motherhood. Now reformed in former colonizing countries of Europe, many such laws remain in effect in countries that emerged from colonial domination. UN conferences have defined the concept of ‘reproductive health’ as one that supports women’s reproductive self-determination, but restrictive abortion laws and practices epitomize the unjust constraints to which many women remain subject, resulting in their unsafe motherhood. Pregnant women can be legally compelled to give the resources of their bodies to the support of others, while fathers are not legally compellable to provide, for instance, bone-marrow or blood donations for their children’s survival. Women’s unjust legal, political, economic and social powerlessness explains much unsafe motherhood and maternal mortality and morbidity.
Extract This case concerns the justification of moral constraints that a physician group decides to apply to itself in the provision of patient services. Family physicians confront this issue with regard to reproductive medical services and state laws such as those in Oregon regarding physician-assisted suicide. Whether such constraints are ethically justified depends on the distinction between professional medical ethics and individual conscience.
