Lidia Casas Archives - Protection of Conscience Project Library

Chilean medical and midwifery faculty’s views on conscientious objection for abortion services

Lidia Casas, Lori Freedman, Alejandra Ramm, Sara Correa, C Finley Baba, M Antonia Biggs

International Perspectives on Sexual and Reproductive Health

Abstract
CONTEXT: In 2017, Chile reformed its abortion law to allow the procedure under limited circumstances. Exploring the views of Chilean medical and midwifery faculty regarding abortion and the use of conscientious objection (CO) at the time of reform can inform how these topics are being taught to the country’s future health care providers.

METHODS: Between March and September 2017, 30 medical and midwifery school faculty from universities in Santiago, Chile were interviewed; 20 of the faculty taught at secular universities and 10 taught at religiously affiliated universities. Faculty perspectives on CO and abortion, the scope of CO, and teaching about CO and abortion were analyzed using a grounded theory approach.

RESULTS: Most faculty at secular and religiously affiliated universities supported the rights of clinicians to refuse to provide abortion care. Secular-university faculty generally thought that CO should be limited to specific providers and rejected the idea of institutional CO, whereas religious-university faculty strongly supported the use of CO by a broad range of providers and at the institutional level. Only secular-university faculty endorsed the idea that CO should be regulated so that it does not hinder access to abortion care.

CONCLUSIONS: The broader support for CO in abortion among religious-university faculty raises concerns about whether students are being taught their ethical responsibility to put the needs of their patients above their own. Future research should monitor whether Chile’s CO regulations and practices are guaranteeing people’s access to abortion care..

Casas L, Freedman L, Ramm A, Correa S, Baba CF, Biggs MA. Chilean medical and midwifery faculty’s views on conscientious objection for abortion services. Int Persp Sex Repro Health. 2020;46:25-34.

Abortion in Chile: The practice under a restrictive regime

Lidia Casas, Lieta Vivaldi

Abstract
This article examines, from a human rights perspective, the experience of women, and the practices of health care providers regarding abortion in Chile. Most abortions, as high as 100,000 a year, are obtained surreptitiously and clandestinely, and income and connections play a key role. The illegality of abortion correlates strongly with vulnerability, feelings of guilt and loneliness, fear of prosecution, physical and psychological harm, and social ostracism. Moreover, the absolute legal ban on abortion has a chilling effect on health care providers and endangers women’s lives and health. Although misoprostol use has significantly helped to prevent greater harm and enhance women’s agency, a ban on sales created a black market. Against this backdrop, feminists have taken action in aid of women. For instance, a feminist collective opened a telephone hotline, Linea Aborto Libre (Free Abortion Line), which has been crucial in informing women of the correct and safe use of misoprostol. Chile is at a crossroads. For the first time in 24 years, abortion law reform seems plausible, at least when the woman’s life or health is at risk and in cases of rape and fetal anomalies incompatible with life. The political scenario is unfolding as we write. Congressional approval does not mean automatic enactment of a new law; a constitutional challenge is highly likely and will have to be overcome.

Casas L, Vivaldi L. Abortion in Chile: The practice under a restrictive regime. Reprod Health Matters. 2014 Nov;22(44):70-81.

Invoking conscientious objection in reproductive health care: evolving issues in Peru, Mexico and Chile

Lidia Casas

Abstract
As Latin American countries seek to guarantee sexual and reproductive health and rights, opponents of women’s rights and reproductive choice have become more strident in their opposition, and are increasingly claiming conscientious objection to providing these services. Conscientious objection must be seen in the context of the rights and interests at stake, including women’s health needs and right to self-determination. An analysis of law and policy on conscientious objection in Peru, Mexico and Chile shows that it is being used to erode women’s rights, especially where it is construed to have no limits, as in Peru. Conscientious objection must be distinguished from politically-motivated attempts to undermine the law; otherwise, the still fragile re-democratisation processes underway in Latin America may be placed at risk. True conscientious objection requires that a balance be struck between the rights of the objector and the health rights of patients, in this case women. Health care providers are entitled to their beliefs and to have those beliefs accommodated, but it is neither viable nor ethically acceptable for conscientious objectors to exercise this right without regard for the right to health care of others, or for policy and services to be rendered ineffectual because of individual objectors.

Keywords:

Casas L. Invoking conscientious objection in reproductive health care: evolving issues in Peru, Mexico and Chile. Reprod Health Matter. 2009 Nov;17(34):78-87.