Conscience, Abortion and Jurisdiction

Sheelagh McGuinness; Michael Thomson

doi:10.1093/ojls/gqaa034

Conscience, Abortion and Jurisdiction

Oxford Journal of Legal Studies ◽

10.1093/ojls/gqaa034 ◽

2020 ◽

Vol 40 (4) ◽

pp. 819-845

Author(s):

Sheelagh McGuinness ◽

Michael Thomson

Keyword(s):

Health Professionals ◽

Theoretical Work ◽

Conscientious Objection ◽

Market Control ◽

Professional Obligations ◽

Abortion Care ◽

Private Beliefs

Abstract Conscientious objection has achieved a particular place in contemporary law and culture. Lawyers, political theorists, ethicists, health professionals and others have debated how we best negotiate the tensions that can exist between professional obligations and private beliefs. Conscientious objection to abortion care has been a particular focus of these discussions. In this article, we draw on theoretical work on ‘jurisdiction’ to provide an account of what is embedded in claims to conscience and what the effects of such claims are. We focus specifically on refusals of abortion care enabled by section 4 of the Abortion Act 1967. We argue that legitimating narratives on conscience seek to achieve seemingly contradictory goals: entrenching abortion as morally ambiguous while securing it as part of medicine’s monopolistic practice. While section 4 provides the focus, our concerns extend to the wider landscape and impact of claims to conscience. Through our jurisdictional analysis, we seek to better understand such claims and dramatically reorient thinking by grounding the conscience clause squarely in the politics of ‘task areas’, professional domains, market control and claims of epistemological authority.

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Difficulties and Rights of Women in Pregnancy of Anencephalic Fetuses

Amadeus International Multidisciplinary Journal ◽

10.14295/aimj.v4i7.72 ◽

2019 ◽

Vol 4 (7) ◽

pp. 23-36

Author(s):

Eveline Oliveira Girão Castro ◽

Cláudio Couto Lóssio Neto ◽

Antonio Marlos Duarte de Melo ◽

Jucier Gonçalves Júnior ◽

Athena De Albuquerque Farias

Keyword(s):

Health Professionals ◽

Conscientious Objection ◽

Medical Professional ◽

Women’S Rights ◽

Legal Abortion ◽

Risk Of Death ◽

Abortion Care ◽

Specialized Services ◽

The Right ◽

In Pregnancy

Abstract: Despite a series of advances in the establishment of specialized services for women in all regions of the country, many still face great difficulties in accessing abortion services. Even in relation to anencephaly, there are still challenges for the proper structuring of legal abortion services, as it is difficult to identify health professionals available for abortion care permitted by law. This article discusses the issues involved in these cases. It was concluded that, due to the moral and religious stigma, there is a refusal of doctors related to the practice of abortion, despite the existence of Brazilian technical norms that regulate this practice. However, the right to conscientious objection is not necessarily recognized in the absence of another medical professional to assist women when there is a risk of death. Keywords: Anencephaly, Abortion, Women's Rights.

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Conscientious Objection in Healthcare and Moral Integrity

Cambridge Quarterly of Healthcare Ethics ◽

10.1017/s096318011600061x ◽

2016 ◽

Vol 26 (1) ◽

pp. 7-17 ◽

Cited By ~ 7

Author(s):

MARK WICCLAIR

Keyword(s):

Health Professionals ◽

Conscientious Objection ◽

Alternative Conceptions ◽

Moral Integrity ◽

Specific Context ◽

Moral Space ◽

Social Component ◽

Intellectual Integrity ◽

Moral Convictions

Abstract:There are several reasons for accommodating health professionals’ conscientious objections. However, several authors have argued that among the most important and compelling reasons is to enable health professionals to maintain their moral integrity. Accommodation is said to provide “moral space” in which health professionals can practice without compromising their moral integrity. There are, however, alternative conceptions of moral integrity and corresponding different criteria for moral-integrity-based claims. It is argued that one conception of moral integrity, the identity conception, is sound and suitable in the specific context of responding to health professionals’ conscientious objections and their requests for accommodation. According to the identity conception, one maintains one’s moral integrity if and only if one’s actions are consistent with one’s core moral convictions. The identity conception has been subject to a number of criticisms that might call into question its suitability as a standard for determining whether health professionals have genuine moral-integrity-based accommodation claims. The following five objections to the identity conception are critically examined: (1) it does not include a social component, (2) it is a conception of subjective rather than objective integrity, (3) it does not include a reasonableness condition, (4) it does not include any substantive moral constraints, and (5) it does not include any intellectual integrity requirement. In response to these objections, it is argued that none establishes the unsuitability of the identity conception in the specific context of responding to health professionals’ conscientious objections and their requests for accommodation.

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Junior doctors and conscientious objection to voluntary assisted dying: ethical complexity in practice

Journal of Medical Ethics ◽

10.1136/medethics-2020-107125 ◽

2021 ◽

pp. medethics-2020-107125

Author(s):

Rosalind J McDougall ◽

Ben P White ◽

Danielle Ko ◽

Louise Keogh ◽

Lindy Willmott

Keyword(s):

Health Professionals ◽

Conscientious Objection ◽

Career Progression ◽

Junior Doctors ◽

Assisted Dying ◽

Moral Integrity ◽

Institutional Policies ◽

Australian State ◽

Specific Support ◽

Ethical Complexity

In jurisdictions where voluntary assisted dying (VAD) is legal, eligibility assessments, prescription and administration of a VAD substance are commonly performed by senior doctors. Junior doctors’ involvement is limited to a range of more peripheral aspects of patient care relating to VAD. In the Australian state of Victoria, where VAD has been legal since June 2019, all health professionals have a right under the legislation to conscientiously object to involvement in the VAD process, including provision of information about VAD. While this protection appears categorical and straightforward, conscientious objection to VAD-related care is ethically complex for junior doctors for reasons that are specific to this group of clinicians. For junior doctors wishing to exercise a conscientious objection to VAD, their dependence on their senior colleagues for career progression creates unique risks and burdens. In a context where senior colleagues are supportive of VAD, the junior doctor’s subordinate position in the medical hierarchy exposes them to potential significant harms: compromising their moral integrity by participating, or compromising their career progression by objecting. In jurisdictions intending to provide all health professionals with meaningful conscientious objection protection in relation to VAD, strong specific support for junior doctors is needed through local institutional policies and culture.

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Freedom of conscience in Europe? An analysis of three cases of midwives with conscientious objection to abortion

Journal of Medical Ethics ◽

10.1136/medethics-2016-103529 ◽

2017 ◽

Vol 44 (2) ◽

pp. 104-108 ◽

Cited By ~ 2

Author(s):

Valerie Fleming ◽

Beate Ramsayer ◽

Teja Škodič Zakšek

Keyword(s):

European Union ◽

Health Professionals ◽

Developed Countries ◽

Conscientious Objection ◽

The European Union ◽

European Level ◽

Major Area ◽

Documentary Analysis ◽

Opt Out ◽

Church Law

While abortion has been legal in most developed countries for many years, the topic remains controversial. A major area of controversy concerns women’s rights vis-a-vis the rights of health professionals to opt out of providing the service on conscience grounds. Although scholars from various disciplines have addressed this issue in the literature, there is a lack of empirical research on the topic. This paper provides a documentary analysis of three examples of conscientious objection on religious grounds to performing abortion-related care by midwives in different Member States of the European Union, two of which have resulted in legal action. These examples show that as well as the laws of the respective countries and the European Union, professional and church law each played a part in the decisions made. However, support from both professional and religious sources was inconsistent both within and between the examples. The authors conclude that there is a need for clear guidelines at both local and pan-European level for health professionals and recommend a European-wide forum to develop and test them.

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Legal Protection for Conscientious Objection by Health Professionals

The AMA Journal of Ethic ◽

10.1001/virtualmentor.2006.8.5.hlaw1-0605 ◽

2006 ◽

Vol 8 (5) ◽

pp. 327-331 ◽

Cited By ~ 1

Keyword(s):

Health Professionals ◽

Legal Protection ◽

Conscientious Objection

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Conscientious Objection in Reproductive Health Care: Analysis of Pichon and Sajous v. France

European Journal of Health Law ◽

10.1163/092902708x300172 ◽

2008 ◽

Vol 15 (1) ◽

pp. 7-43 ◽

Cited By ~ 8

Author(s):

Adriana Lamačková

Keyword(s):

Health Care ◽

Human Rights ◽

Reproductive Health ◽

Health Services ◽

Health Professionals ◽

Conscientious Objection ◽

Private Life ◽

Reproductive Health Care ◽

Health Care Context ◽

The Right

AbstractThis article explores the issue of conscientious objection invoked by health professionals in the reproductive and sexual health care context and its impact on women's ability to access health services. The right to exercise conscientious objection has been recognized by many international and European scholars as being derived from the right to freedom of thought, conscience and religion. It is not, however, an absolute right. When the exercise of conscientious objection conflicts with other human rights and fundamental freedoms, a balance must be struck between the right to conscientious objection and other affected rights such as the right to respect for private life, the right to equality and non-discrimination, and the right to receive and impart information. Particularly in the reproductive health care context, states that allow health professionals to exercise conscientious objection must accommodate this in such a way that its exercise does not compromise women's access to health services. This article analyses the European Court of Human Rights' decision on admissibility in Pichon and Sajous v. France (2001) and argues that a balancing approach should be applied in cases of conscientious objection in the sexual and reproductive health care context.

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