Law Archives - Page 16 of 39 - Protection of Conscience Project Library

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.

Federal provider conscience regulation: Unconscionable

Robert F Card

Abstract
This paper argues that the provider conscience regulation recently put into place in the USA is misguided. The rule is too broad in the scope of protection it affords, and its conception of what constitutes assistance in the performance of an objectionable procedure reveals that it is unworkable in practice. Furthermore, the regulation wrongly treats refusal of other reproductive services as on a par with conscientious objection to participation in abortion. Finally, the rule allows providers to refuse even to discuss “objectionable” options with patients and serves to protect discriminatory refusals of medical care. For all of these reasons, this regulation is unwise.

Card RF. Federal provider conscience regulation: Unconscionable. J Med Ethics. 2009;35(8):471-472.

Conscience in the Workplace

C W Von Bergen

Abstract
Most definitions of conscience in the US legal context are broadly defined as including religious, moral, or ethical principles. The wave of state and federal laws and bills supporting conscience protection for medical personnel are increasingly covering all health care services, and this has created counterclaims challenging the idea that health-related professionals may deny legally and medically permitted therapeutic interventions, particularly if their objections are personal and religious. The question is whether Americans deem it proper to put a person in the position of leaving his or her job or violating his or her conscience. Although such laws make reference to “conscience,” most define that term in a virtually boundless fashion to include religion, moral, or ethical principles and convictions. Such a broad definition may bring the freedom of conscience debate clearly within the protection of Title VII and its prohibition of religious discrimination.

Von Bergen CW. Conscience in the Workplace. Employee Relat Law J. 2009;35(1):3-24.

Belgian euthanasia law: a critical analysis

Raphael Cohen-Almagor

Abstract
Some background information about the context of euthanasia in Belgium is presented, and Belgian law on euthanasia and concerns about the law are discussed. Suggestions as to how to improve the Belgian law and practice of euthanasia are made, and Belgian legislators and medical establishment are urged to reflect and ponder so as to prevent potential abuse.

Cohen-Almagor R. Belgian euthanasia law: a critical analysis. J Med Ethics. 2009;35(7):436-439.

Rights to emergency contraception

Edith Weisberg, Ian S Fraser

Abstract
Emergency contraception (EC) provides women with a safe means of preventing pregnancy following unprotected sexual intercourse or potential contraceptive failure, and is accepted as a legitimate method of fertility control. The right of women to access EC, along with other contraceptive methods, needs to be affirmed. The consequences of unintended pregnancy are serious, imposing appreciable burdens on children, women, men, and families. Every child has the right to be a wanted child and not enter this world because its mother was denied access to EC. For maximum effectiveness, barriers to access must be removed. It is essential that EC pills are available over-the-counter with no minimum age for access. There is a tension between the rights of women to access EC without medical or legal intervention and the rights of providers who have a conscientious objection to provision on religious or moral grounds. The principles of autonomy, non-maleficence, and beneficence all weigh in favor of the rights of a woman faced with the possibility of an unintended pregnancy to unrestricted access to EC against providers whose religious views are opposed to this.

Weisberg E, Fraser IS. Rights to emergency contraception. Int J Gynec Obstet. 2009 Jun 18;106(2):160-163.

What Physicians Need to Know About the Legal Status of Abortion in the United States

Tracy A Weitz

Abstract
Abortion is the most politically contested social issue in the United States, a debate that manifests itself in extensive regulation of abortion as a health care service. This study provides a brief history of the judicial acceptance of abortion regulation and an overview of the most common forms of abortion regulation affecting physicians in the United States. The article concludes with a discussion of pending threats to the legal right to abortion in the United States and recommended resources where physicians can find assistance to comply with existing laws.

Weitz TA. What Physicians Need to Know About the Legal Status of Abortion in the United States. Clin Obstet Gynecol. 2009 Jun;52(2):130-139.

(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.

(Book Review) Conflicts of conscience in health care an institutional compromise

Dhrubajyoti Bhattacharya

Holly Fernandez Lynch. Conflicts of Conscience in Health Care: An Institutional Compromise. Boston: The MIT Press; 2008, 368 pp. ISBN: 9780262123051

Extract
Lynch demystifies the practice of medicine as a value-neutral panacea to remedy social ills with physicians as unwavering obligors to provide service on demand. . . . As far as the provision of services goes, protecting patient and physician interests are, as Lynch argues, not mutually exclusive propositions. In practice, physicians who check their moral apprehensions at the hospital doors may even compromise patient safety. An enlightened approach, as proposed here, encourages health professionals to embrace moral plurality to inform, rather than stymie, the provision of services in the best interests of patients—while respecting physician individuality.

Conflicts of Conscience in Health Care: An Institutional Compromise will serve as an excellent resource for educators and policymakers eager to parse the complex issues of patient wants, physician duties, and institutional prerogatives to secure individual and population health and well-being.

Bhattacharya D. (Book Review) Conflicts of conscience in health care an institutional compromise. J Leg Med. 2009;30(2):289-298.

Emergency Contraception and Physicians’ Rights of Conscience: A Review of Current Legal Standards in Wisconsin

Ciaran T Bradley

Abstract
Recent legislation in Wisconsin mandating provision of emergency contraception to victims of sexual assault may create a conflict of conscience for some health care professionals. Although disputes exist over the exact mechanism of action of emergency contraception, those professionals who espouse a particularly strict stance may be reluctant to dispense the medication for fear that it could prevent a fertilized embryo from implanting in the uterus. While no objection of conscience clause was written into the new law, Wisconsin law has a long tradition of recognizing rights of conscience in matters of religious conflict. This legal tradition both at statutory and common law levels is summarized with application to the recent emergency contraception mandate. A case is made for a potential legal defense should a health care professional abstain from dispensing emergency contraception.

Bradley CT. Emergency Contraception and Physicians’ Rights of Conscience: A Review of Current Legal Standards in Wisconsin. Wis Med J. 2009 May; 108(3):156-160

Legal Protection and Limits of Conscientious Objection: When Conscientious Objection is Unethical

Bernard M Dickens

Abstract
The right to conscientious objection is founded on human rights to act according to individuals’ religious and other conscience. Domestic and international human rights laws recognize such entitlements. Healthcare providers cannot be discriminated against, for instance in employment, on the basis of their beliefs. They are required, however, to be equally respectful of rights to conscience of patients and potential patients. They cannot invoke their human rights to violate the human rights of others. There are legal limits to conscientious objection. Laws in some jurisdictions unethically abuse religious conscience by granting excessive rights to refuse care. In general, healthcare providers owe duties of care to patients that may conflict with their refusal of care on grounds of conscience. The reconciliation of patients’ rights to care and providers’ rights of conscientious objection is in the duty of objectors in good faith to refer their patients to reasonably accessible providers who are known not to object. Conscientious objection is unethical when healthcare practitioners treat patients only as means to their own spiritual ends. Practitioners who would place their own spiritual or other interests above their patients’ healthcare interests have a conflict of interest, which is unethical if not appropriately declared.

Dickens BM. Legal Protection and Limits of Conscientious Objection: When Conscientious Objection is Unethical. Med Law. 2009;28(2)337-347.