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Objection of conscience

Dominic Wilkinson
Decisions about allocation of limited healthcare resources are frequently controversial. These decisions are usually based on careful analysis of medical, scientific and health economic evidence. Yet, decisions are also necessarily based on value judgements. There may be differing views among health professionals about how to allocate resources or how to evaluate existing evidence. In specific cases, professionals may have strong personal views (contrary to professional or societal norms) that treatment should or should not be provided...
October 12, 2016: Journal of Medical Ethics
David S Oderberg
I explore the increasingly important issue of cooperation in immoral actions, particularly in connection with healthcare. Conscientious objection, especially as pertains to religious freedom in healthcare, has become a pressing issue in the light of the US Supreme Court judgement in Hobby Lobby Section 'Moral evaluation using the basic principles of cooperation' outlines a theory of cooperation inspired by Catholic moral theologians such as those cited by the court. The theory has independent plausibility and is at least worthy of serious consideration-in part because it is an instance of double-effect reasoning, which is also independently plausible despite its association with moral theology...
October 3, 2016: Journal of Medical Ethics
Jocelyn Maclure, Isabelle Dumont
In a thought-provoking paper, Schuklenk and Smalling argue that no right to conscientious objection should be granted to medical professionals. First, they hold that it is impossible to assess either the truth of conscience-based claims or the sincerity of the objectors. Second, even a fettered right to conscientious refusal inevitably has adverse effects on the rights of patients. We argue that the main problem with their position is that it is not derived from a broader reflection on the meaning and implications of freedom of conscience and reasonable accommodation...
September 28, 2016: Journal of Medical Ethics
Laura Florence Harris, Jodi Halpern, Ndola Prata, Wendy Chavkin, Caitlin Gerdts
Conscientious objection to abortion - a clinician's refusal to perform abortions because of moral or religious beliefs - is a limited right, intended to protect clinicians' convictions while maintaining abortion access. This paper argues that conscientious objection policies and debates around the world generally do not take into account the social, political, and economic pressures that profoundly influence clinicians who must decide whether to claim objector status. Lack of clarity about abortion policies, high workload, low pay, and stigma towards abortion providers can discourage abortion provision...
September 12, 2016: Global Public Health
Xavier Symons
Schuklenk and Smalling argue that it is practically impossible for civic institutions to meet the conditions necessary to ensure that conscientious objection does not conflict with the core principles of liberal democracies. In this response, I propose an alternative definition of conscience to that offered by Schuklenk and Smalling. I discuss what I call the 'traditional' notion of conscience, and contrast this with the existentialist conception of conscience (which I take to be a close cousin of the view targeted by Schuklenk and Smalling)...
September 9, 2016: Journal of Medical Ethics
Shimon M Glick, Alan Jotkowitz
The recent essay by Schuklenk and Smalling opposing respect for physicians' conscientious objections to providing patients with medical services that are legally permitted in liberal democracies is based on several erroneous assumptions. Acting in this manner would have serious harmful effects on the ethos of medicine and of bioethics. A much more nuanced and balanced position is critical in order to respect physicians' conscience with minimal damage to patients' rights.
September 6, 2016: Journal of Medical Ethics
Stephen W Smith
Conscience and conscientious objections are important issues in medical law and ethics. However, discussions tend to focus on a particular type of conscience-based claim. These types of claims are based upon predictable, generalizable rules in which an individual practitioner objects to what is otherwise standard medical treatment (for example, the objections recognised in the Abortion Act). However, not all conscience based claims are of this type. There are other claims which are based not on an objection to a treatment in general but in individual cases...
August 20, 2016: Health Care Analysis: HCA: Journal of Health Philosophy and Policy
T Trey, A Sharif, A Schwarz, M Fiatarone Singh, J Lavee
Previous publications have described unethical organ procurement procedures in the People's Republic of China. International awareness and condemnation contributed to the announcement abolishing the procurement of organs from executed prisoners starting from January 2015. Eighteen months after the announcement, and aligned with the upcoming International Congress of the Transplantation Society in Hong Kong, this paper revisits the topic and discusses whether the declared reform has indeed been implemented. It is noticeable that China has neither addressed nor included in the reform a pledge to end the procurement of organs from prisoners of conscience, nor have they initiated any legislative amendments...
August 17, 2016: American Journal of Transplantation
Nadia N Sawicki
Stakeholders in law, medicine, and religion are unable to reach consensus about how best to address conflicts between healthcare providers' conscientious objections to treatment and patients' rights to access medical care. Conscience laws that protect objecting providers and institutions from liability are criticized as too broad by patient advocates and as too narrow by defenders of religious freedom. This Article posits that some of the tension between these stakeholders could be mitigated by statutory recognition of a duty on the part of healthcare institutions or providers to disclose conscientiously motivated limitations on practice...
2016: American Journal of Law & Medicine
Nancy Berlinger
No abstract text is available yet for this article.
March 2016: Hastings Center Report
Mara Buchbinder, Dragana Lassiter, Rebecca Mercier, Amy Bryant, Anne Drapkin Lyerly
Much of the debate on conscience has addressed the ethics of refusal: the rights of providers to refuse to perform procedures to which they object and the interests of the patients who might be harmed by their refusals. But conscience can also be a positive force, grounding decision about offering care.
March 2016: Hastings Center Report
Hasan Shanawani
Conscientious objection (CO) is the refusal to perform a legal role or responsibility because of personal beliefs. In health care, conscientious objection involves practitioners not providing certain treatments to their patients, based on reasons of morality or "conscience." The development of conscientious objection among providers is complex and challenging. While there may exist good reasons to accommodate COs of clinical providers, the exercise of rights and beliefs of the provider has an impact on a patient's health and/ or their access to care...
April 2016: Journal of Religion and Health
Christian Fiala, Kristina Gemzell Danielsson, Oskari Heikinheimo, Jens A Guðmundsson, Joyce Arthur
Reproductive health care is the only field in medicine where health care professionals (HCPs) are allowed to limit a patient's access to a legal medical treatment - usually abortion or contraception - by citing their 'freedom of conscience.' However, the authors' position is that 'conscientious objection' ('CO') in reproductive health care should be called dishonourable disobedience because it violates medical ethics and the right to lawful health care, and should therefore be disallowed. Three countries - Sweden, Finland, and Iceland - do not generally permit HCPs in the public health care system to refuse to perform a legal medical service for reasons of 'CO' when the service is part of their professional duties...
June 2016: European Journal of Contraception & Reproductive Health Care
Sandra Paço, Sérgio Deodato
OBJECTIVE: To discuss conscientious objection in nursing, identifying the ethic and legal basis for this decision-making. METHODOLOGY: Qualitative study in which the methodology used was ethical reflection based on a legal analysis of the laws in question, proceeding to a bibliographical and documentary research CONCLUSIONS: Portuguese law and ethical pillars that form the basis of the Code of Ethics of nurses in Portugal defend the freedom of conscience as a professional practice...
December 2015: Revista Gaúcha de Enfermagem
L Syd M Johnson
Since its inception in 1968, the concept of whole-brain death has been contentious, and four decades on, controversy concerning the validity and coherence of whole-brain death continues unabated. Although whole-brain death is legally recognized and medically entrenched in the United States and elsewhere, there is reasonable disagreement among physicians, philosophers, and the public concerning whether brain death is really equivalent to death as it has been traditionally understood. A handful of states have acknowledged this plurality of viewpoints and enacted "conscience clauses" that require "reasonable accommodation" of religious and moral objections to the determination of death by neurological criteria...
March 2016: Journal of Bioethical Inquiry
François Beaufils
Both object of science and conscience, bioethics is concerned about the impact of biomedical research and its applications for the human person. Object of pluralistic and multidisciplinary thought and proposal, bioethics seeks to reconcile respect for fundamental values and progress in life sciences.
December 2015: Soins; la Revue de Référence Infirmière
Peter West-Oram, Alena Buyx
The right to conscientious objection in the provision of healthcare is the subject of a lengthy, heated and controversial debate. Recently, a new dimension was added to this debate by the US Supreme Court's decision in Burwell vs. Hobby Lobby et al. which effectively granted rights to freedom of conscience to private, for-profit corporations. In light of this paradigm shift, we examine one of the most contentious points within this debate, the impact of granting conscience exemptions to healthcare providers on the ability of women to enjoy their rights to reproductive autonomy...
June 2016: Bioethics
Ronli Sifris
This article focuses on Tasmania's Reproductive Health (Access to Terminations) Act 2013, which decriminalises abortion in that State. The article first provides an overview of the Tasmanian legislation, comparing it with Victoria's Abortion Law Reform Act 2008. It then provides a more in-depth analysis of a doctor's right to "conscientious objection" and the requirement in both Acts of an "obligation to refer". The article concludes that ultimately, as a democratic society, it is important that both a woman's right to terminate a pregnancy and a doctor's right to freedom of conscience is respected...
June 2015: Journal of Law and Medicine
Felix Irmiš
A patient has to cope with an illness on a physical, mental and spiritual level. There exists a difference between religiousness and spirituality even though the approach has a common foundation. Nonreligious spirituality relates to an inner experience, transcendent states of consciousness, meaningfulness, responsibility, sympathy, ethics, humanisation, faith. We encounter the spiritual point of view in humanistic psychotherapy, pastoral medicine, work of hospital chaplains, New Age, psychotherapies with religious and alternative aspects, transpersonal psychotherapy, psycho-spiritual crises, unusual states of consciousness, in meditation, Yoga, relaxation, kinesiology, ethicotherapy, reincarnation therapy, positive motivation, holotropic breathing, etc...
2015: Casopís Lékar̆ů C̆eských
Kathleen M Morrell, Wendy Chavkin
PURPOSE OF REVIEW: Conscientious objection to reproductive healthcare (refusal to perform abortion, assisted reproductive technologies, prenatal diagnosis, contraception, including emergency contraception and sterilization, etc.) has become a widespread global phenomenon and constitutes a barrier to these services for many women. Adolescents are a particularly vulnerable group because some providers object to specific aspects of their reproductive healthcare because of their status as minors...
October 2015: Current Opinion in Obstetrics & Gynecology
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