A narrative literature review of the impact of conscientious objection by health professionals on women’s access to abortion worldwide 2013–2021

Davis, Jasmine Meredith; Haining, Casey M; Keogh, Louise

doi:10.1080/17441692.2021.2020318

Cited by 7 publications

(3 citation statements)

References 37 publications

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“…These factors also have the potential to undermine patient experience of abortion by delaying access to care, increasing the nancial burden for the consumer, and increasing the risk of experiencing stigma. 12,14,30 In particular, the requirement for referral from a general practitioner to obtain blood tests and ultrasound, and even for abortion itself, means there are multiple instances where consumers are required to put themselves in the vulnerable position of explaining their story without any guarantee that they will be heard, respected, or supported in their request. Negative experiences along the abortion pathway could be conceptualised as moral injuries that accumulate over time.…”

Section: Discussionmentioning

confidence: 99%

Optimising abortion care: Perspectives of care providers and community stakeholders in Melbourne, Australia

Chaouki,

Johnson,

Hui

et al. 2024

Preprint

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Background In Australia, there are a range of barriers that may delay or inhibit a woman/pregnant person from accessing abortion, with these barriers disproportionately affecting marginalised populations. The northern metropolitan region of Melbourne, Australia, is home to a large population of women/gender diverse people of reproductive age, many of whom face significant socio-economic disadvantage. This study aims to understand health care provider and community stakeholder perspectives regarding barriers to, and patient experience of, abortion care in Melbourne’s north.Methods This qualitative study used individual in-depth semi-structured interviews. Twelve key informants were purposively selected based on their professional work and included abortion care providers, and representatives from local reproductive health, multicultural, and Aboriginal and Torres Strait Islander advocacy services. Interviews were conducted via Zoom between June to August 2022. Data were analysed using reflexive thematic analysis.Results Informants identified a range of barriers to abortion across individual, service, and socio-political levels. Informants expressed concern that individual level barriers such as financial disadvantage meant it could be difficult for consumers to access the services they need (e.g. GP appointments and ultrasound). They highlighted that these barriers can be further amplified for consumers from culturally and linguistically diverse backgrounds, who may face language barriers, racism and difficulty navigating the health care system. The concept of patient resourcefulness and resilience emerged as a novel finding. Informants also identified key factors that impact patient experience of abortion care, including service-based factors (eg. ease of locating a service) and the provision of respectful care. Factors that create barriers to access and negatively impact patient experiences of abortion are interlinked, demonstrating the importance of considering both elements for service quality improvement.Conclusion Known barriers to abortion are exacerbated in the region due to the concentration of marginalised populations and lack of affordable abortion services. Quality improvement approaches in this space need to address barriers at the individual, service, and socio-political levels to optimise patient experience and make a meaningful impact. Further research is planned to explore local consumers’ experiences of abortion care and ideas for quality improvement using co-design.

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Section: Discussionmentioning

confidence: 99%

Optimising abortion care: Perspectives of care providers and community stakeholders in Melbourne, Australia

Chaouki,

Johnson,

Hui

et al. 2024

Preprint

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“…While there were few reviews on topics related to the motivations for CO in clinical practice areas such as abortion, organ donation or end of life (24)(25)(26)(27)(28), or to professionals' perspectives on MAiD (29), we decided to conduct a scoping review that particularly addressed motivations for CO to MAiD both from a theoretical and empirical literature in countries with positive legislation when the data of the articles was collected. This scoping review has followed the recommended five-step framework for scoping reviews (30)(31)(32)(33).…”

Section: Methodsmentioning

confidence: 99%

Causes for Conscientious Objection in Medical Aid in Dying: A Scoping Review

Triviño-Caballero,

Parra Jounou,

Roldán Gómez

et al. 2023

bioethics

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In the light of current legislation on Medical Aid in Dying (MAiD; also known as euthanasia and assisted suicide) in different countries worldwide, there have been some arguments devoted to the right to conscientious objection for healthcare professionals in these specific practices. The goals of this scoping review are to provide an overview of the motivations and causes that lie behind conscientious objection identified by previous literature according to professionals’ experiences and to verify if these motives match with theoretical debates on conscientious objection. As the results show, there is a dissonance between the motivations included in the traditional and mainstream definition of conscientious objection used in theoretical and speculative frameworks and the actual factors that empirical studies note as reported motivations to object to MAiD. Hence, either we consider new factors to include as causes of “conscience”, or we accept that there are motivations that are not actually applicable to conscientious objection and should be addressed by other means. As conscientious objection to MAiD is multifaceted, there can be different kinds of motivations acting at the same time. It is thus pertinent to rebalance theoretical and empirical considerations to fully understand the complexity of the phenomenon and so provide insights on how to best deal with conscientious objection.

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“…Del citado conflicto deriva, con todo, una de las principales líneas de crítica a la objeción de conciencia al aborto, que es la de dificultar el acceso a la "prestación sanitaria pública de interrupción voluntaria del embarazo". Se arguye al respecto que, a nivel mundial, la objeción de conciencia afecta al acceso al aborto a los niveles de facultativo, sistema sanitario y entorno sociocultural, y que lo hace tanto directamente (intentos de los profesionales sanitarios de restringir el acceso) como indirectamente (exacerbación de barreras preexistentes) (21). Según algunos análisis, en países como Italia o España la objeción generalizada de los sanitarios no solo estaría causando mayores distancias de viaje, tiempos de espera y costes del aborto, sino que también estaría afectando a la propia circulación del conocimiento sobre su alcance y consecuencias (obstaculización en el acceso a la información, disvalor del testimonio de las mujeres y cegueras y meta-cegueras que se alimentan del silencio cómplice, individual e institucional) (22,23).…”

Section: Objeción De Conciencia Y "Acceso" Al Abortounclassified

Conflictos éticos en un contexto de gestión pública: objeción de conciencia y aborto en la red sanitaria pública española

Vilas-Iglesias,

Caamaño-Alegre

2024

Acta bioeth.

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A narrative literature review of the impact of conscientious objection by health professionals on women’s access to abortion worldwide 2013–2021

Cited by 7 publications

References 37 publications

Optimising abortion care: Perspectives of care providers and community stakeholders in Melbourne, Australia

Optimising abortion care: Perspectives of care providers and community stakeholders in Melbourne, Australia

Causes for Conscientious Objection in Medical Aid in Dying: A Scoping Review

Conflictos éticos en un contexto de gestión pública: objeción de conciencia y aborto en la red sanitaria pública española

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