The Impact of ‘conscientious objection’ on abortion-related outcomes: A synthesis of legal and health evidence

Londras, Fiona de; Cleeve, Amanda; Rodríguez, María I.; Farrell, Alana; Furgalska, Magdalena; Lavelanet, Antonella

doi:10.1016/j.healthpol.2023.104716

Cited by 6 publications

(2 citation statements)

References 34 publications

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“…In reality, however, legislators often remain silent on this issue or merely formulate unspecific or unclear guidelines. It would be particularly important to provide answers to questions such as who may refuse, what must be done despite refusal and when a refusal on grounds of conscience can be granted at all [ 39 ].…”

Section: Discussionmentioning

confidence: 99%

Conscientious objection and barriers to abortion within a specific regional context - an expert interview study

Krawutschke,

Pastrana,

Schmitz

2024

BMC Med Ethics

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Background While most countries that allow abortion on women’s request also grant physicians a right to conscientious objection (CO), this has proven to constitute a potential barrier to abortion access. Conscientious objection is regarded as an understudied phenomenon the effects of which have not yet been examined in Germany. Based on expert interviews, this study aims to exemplarily reconstruct the processes of abortion in a mid-sized city in Germany, and to identify potential effects of conscientious objection. Methods Five semi-structured interviews with experts from all instances involved have been conducted in April 2020. The experts gave an insight into the medical care structures with regard to abortion procedures, the application and manifestations of conscientious objection in medical practice, and its impact on the care of pregnant women. A content analysis of the transcribed interviews was performed. Results Both the procedural processes and the effects of conscientious objection are reported to differ significantly between early abortions performed before the 12th week of pregnancy and late abortions performed at the second and third trimester. Conscientious objection shows structural consequences as it is experienced to further reduce the number of possible providers, especially for early abortions. On the individual level of the doctor-patient relationship, the experts confirmed the neutrality and patient-orientation of the vast majority of doctors. Still, it is especially late abortions that seem to be vulnerable to barriers imposed by conscientious objection in individual medical encounters. Conclusion Our findings indicate that conscientious objection possibly imposes barriers to both early and late abortion provision and especially in the last procedural steps, which from an ethical point of view is especially problematic. To oblige hospitals to partake in abortion provision in Germany has the potential to prevent negative impacts of conscientious objection on women’s rights on an individual as well as on a structural level.

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Section: Discussionmentioning

confidence: 99%

Conscientious objection and barriers to abortion within a specific regional context - an expert interview study

Krawutschke,

Pastrana,

Schmitz

2024

BMC Med Ethics

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“…19.2). The reviewed evidence for Recommendation 22, unfortunately, did not focus on these protective interventions, but on the impact of conscientious objection on abortion care 30 …”

Section: The Recommendationsmentioning

confidence: 99%

The WHO abortion care guideline: Law and policy—Past, present, and future

Erdman

2023

Intl J Gynecology & Obste

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In the 2022 Abortion Care Guideline, the World Health Organization (WHO) undertook systematic evidence reviews of seven law and policy interventions to assess their health and social impacts. Distinct recommendations were formulated for each. The present article highlights how the Guideline reconceptualizes abortion regulation as a complex structural intervention that shapes clinical care and service delivery and distributes risks and resources within these systems and in the care relations that define them. It then presents the Guideline recommendations and summarizes their evidence base, drawing on recent legal and policy developments to emphasize their real‐world significance. The article concludes by anticipating the future of abortion law and policy, focusing on service delivery innovations and diverse care models, drug regulation and the supply of abortion pills, and protective interventions crafted in the context of political crisis and immediate need that serve policy objectives and take regulatory forms different from the past.

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