Conscientious objection and refusal to provide reproductive healthcare: A White Paper examining prevalence, health consequences, and policy responses

Abstract

Empirical evidence is essential for varied political actors as they respond with policies or regulations to the competing concerns at stake. Further research and training in diverse geopolitical settings are required. With dual commitments toward their own conscience and their obligations to patients' health and rights, providers and professional medical/public health societies must lead attempts to respond to conscience-based refusal and to safeguard reproductive health, medical integrity, and women's lives.

Proposal to inform European institutions regarding the regulation of conscientious objection to abortion

“…Finally, the heterogeneous practice of conscientious objection among the different European countries contributes to the undermining of the right to voluntary abortion [3].…”

“…On the other hand are those who are opposed to the legalisation of abortion or who accept a culture of conscientious objection. Consequently they advocate for the regulation of conscientious objection so that it may be used as a barrier to women's access to abortion, as is already the case in almost all countries, even within Europe [3]. The reality is that most European countries share common legislation on abortion that includes a clause on professional 'conscientious objection' exclusively for abortion and not for any other activity or action within or outside the field of medicine.…”

The Council on Anthropology and Reproduction (CAR) Opposes Legislation that Creates Barriers to Safe Abortion Care

“…Currently, abortion opponents in many nations promote conscientious objection as a way to circumvent the legalization of abortion. Since women seeking abortion services may not always be offered referrals to other health providers, these conscientious refusals can impinge upon women's right to receive needed care (Chavkin et al 2013). In the United States, mergers between Catholic and nonsectarian hospitals mean not only the prohibition of abortion services in the merged facility, but also prohibitions on the provision of emergency contraception for rape victims who are brought to the facility's emergency room (MergerWatch and ACLU 2013).…”

How health services can improve access to abortion

“…[3] Unregulated conscientious objection results in high conscientious objection prevalence areas where abortions are hard to access. [14] The system operated in Norway is the best example of how conscientious objection can be overseen to ensure proper service delivery in all regions of the country. Regulations on conscientious objection ensure that all conscientious objectors are known about and that local providers have enough non-objectors to ensure the availability of adequate services.…”

“…Regulations on conscientious objection ensure that all conscientious objectors are known about and that local providers have enough non-objectors to ensure the availability of adequate services. [14] Availability of abortion depends on adequate equipment; adequate availability of theatre time for surgical procedures; [15] necessary drugs being licensed for use; and trained, experienced health personnel. Furthermore, for surgical abortion in the second trimester, access to abortion depends on doctors having the necessary skills, which can become a problem unless younger doctors have the motivation and training to acquire these skills.…”