Physicians, not conscripts — conscientious objection in health care
by Ronit Y Stahl, Ezekiel J Emanuel
New England Journal of Medicine 2017; 376:1380-1385 April 6, 2017 doi: 10.1056/NEJMsb1612472
Objection to providing patients interventions that are at the core of medical practice – interventions that the profession deems to be effective, ethical and standard treatments – is unjustifiable (AMA Code of Medical Ethics [Opinion 11.2.2]10).28*31
Making the patient paramount means offering and providing accepted medical interventions in accordance with patients’ reasoned decisions. Thus, a health care professional cannot deny patients access to medications for mental health conditions, sexual dysfunction, or contraception on the basis of their conscience, since these drugs are professionally accepted as appropriate medical interventions.
…[A]bortion is politically and culturally contested, it is not medically controversial. It is a standard obstetrical practice. Health care professionals who are unwilling to accept these limits have two choices: select an area of medicine, such as radiology, that will not put them in situations that conflict with their personal morality or, if there is no such area, leave the profession.
Response to: ‘Why medical professionals have no moral claim to conscientious objection accommodation in liberal democracies’ by Schuklenk and Smalling
by Richard J Lyus
Journal of Medical Ethics 2017 Apr;43(4):250-252. doi: 10.1136/medethics-2015-103643.
Bioethicists commenting on conscientious objection and abortion should consider the empirical data on abortion providers. Abortion providers do not fall neatly into groups of providers and objectors, and ambivalence is a key theme in their experience. Practical details of abortion services further upset the dichotomy. These empirical facts are important because they demonstrate that the way the issue is described in analytical bioethics does not reflect reality. Addressing conscientious objection as a barrier to patient access requires engaging with those who provide the service and those who are able to but do not. The experiences of doctors facing these decisions potentially challenge and expand our understanding of the issue as an ethical concern.
The Journal of Medical Ethics, a BMJ journal, published a long list of articles on abortion in April 2017, most of which are on the subject of conscientious objection to abortion and whether or not it is ethically supportable. The above abstract is from one of them. The full list of papers can be found here: Abortion: Journal of Medical Ethics. The first two pages contain 36 articles published in 2017 and 2016, and the list goes back further than that too.