Conscientious Objection Research Articles

Conscientious objection: will doctors be able to opt out of assisted dying?

Conscientious objection: will doctors be able to opt out of assisted dying?

“Weak characters” easily shaped, or strong‐minded conscientious objectors impervious to change?

AbstractCommentaries on the World War I history of the International Bible Students Association in their USA homeland usually feature decisions made by the movement's leadership and their subsequent arrest and prosecution, supposedly for conspiring to violate the Espionage Act and attempting to cause refusal of duty in the armed forces of the United States. In so doing, these neglect to consider the enthusiastic support and voices of their adherents. In contrast, and in response to Zoe Knox's April 2019 Peace & Change article, this study unmutes the voices of their conscientious objectors and proposes that their experiences were profoundly significant in shaping the movement over the following century.

‘We Must Find a Way to Remember Them Too’: British Second World War Conscientious Objectors in Post-War Culture

This article examines the ways in which British Second World War conscientious objectors (COs) have been commemorated, memorialized, and represented since 1945. Despite comprising nearly 60 000 men, the CO is strikingly absent in both the popular narrative of the Second World War and official, institutional commemorations of the conflict. This is not true of their First World War counterpart. This is unsurprising: the Second World War CO is largely at odds with popular British conceptions of the war as a ‘just’ conflict. Nevertheless, a broad and diverse set of initiatives have been established to commemorate the CO. The CO also features in numerous forms of post-war popular culture, including fiction, films, television programmes, and plays. It is these disparate remembrance practices and representations that this article brings together to help us explore both the memory of wartime conscientious objection and the broader cultural legacies of the Second World War.

Law 194/1978 four years later Conscientious objection and the possibility of preventing the voluntary termination of pregnancy

Not available.

Conscientious Objection and the Anesthesiologist: An Ethical Dilemma.

Conscientious objection is a legally protected right of medical professionals to recuse themselves from patient care activities that conflict with their personal values. Anesthesiology is different from most specialties with respect to conscientious objection in that the focus is to facilitate safe, efficient, and successful performance of procedures by others, rather than to perform the treatment in question. This could give rise to a unique, somewhat indirect ethical tension between the application of conscientious objection and potential infringement upon patient autonomy and well-being. While some situations have clear grounds and precedent for conscientious objection (e.g., abortion, or futile procedures), newer procedures, such as gender-affirming surgery and xenotransplantation, may trigger conscientious objection for complex reasons. This review discusses ethical, legal, and practical aspects of conscientious objection; challenges to anesthesia groups, departments, and healthcare organizations when conscientious objection is invoked by anesthesiologists; and strategies to help mitigate the ethical dilemmas.

Keeping the Patient at the Center of Conscientious Objection while Respecting Our Colleagues.

Keeping the Patient at the Center of Conscientious Objection while Respecting Our Colleagues.

The role of conscience and virtue: contrasting two models of medicine.

Today's medical ethics involve two different viewpoints based on how we understand the role of conscience in medicine and the purpose of healthcare. The first view, called the health-directed model, sees medicine as a way to improve health and promote healing, while also respecting the values of both patients and doctors. In this model, doctors need some discretionary space to decide how to achieve the best health outcomes in their practice. On the other hand, the service-provider model sees the main goal of medicine as providing a service, especially healthcare, with a strong focus on protecting patient autonomy. In this view, doctors are required to provide care even when it goes against their personal beliefs.The goal of this article is to explore the foundations and arguments of these two medical models. Understanding the key ideas behind these models is important for deciding whether to support or oppose conscientious objection in medical ethics. Additionally, the article aims to figure out which model makes a stronger case and to offer advice on how to engage with the opposing view from a virtue ethics perspective.

Do Healthcare Institutions Have Consciences and a Resultant Ethical Right to Institutional Conscientious Objection?

In healthcare, Institutional Conscientious Objection (ICO) occurs when a healthcare institution (e.g., a hospital) refuses to provide a healthcare service (e.g., abortion) on the grounds that this service contradicts its conscience. Debate rages over whether governments should allow ICO in healthcare. Currently, some do, and some don’t. Among other reasons, the debate matters because ICO can have dramatic effects on patients’ ability to access healthcare services. The debate encompasses many topics, but this paper focuses on the arguments regarding institutional conscience. This topic matters because it is legally important in many countries, and because it is central to the ICO debate; both pro-ICO arguments and anti-ICO arguments are often built on claims about the existence or nonexistence of institutional conscience, respectively. This paper’s overarching question is as follows: do healthcare institutions have consciences and a resultant ethical right to ICO? I answer this question by separating it into two sub-questions. The first is as follows: do healthcare institutions have consciences? I argue no. What I add to the literature here is in-depth critical analysis of the debates over what is necessary to satisfy the criteria for conscience, and I bring in lessons from the philosophy of group agency. Unlike the vast majority of ICO opponents, I charitably engage with the best and most recent arguments for institutional conscience (in particular, work by Xavier Symons and Reginald Mary Chua). The second question is as follows: if healthcare institutions do have consciences, does it follow that they thereby have an ethical right to ICO? Again, I argue no. I answer this question via a highly novel and highly systematic approach, which involves precisely conceptually dissecting healthcare institutions, and I bring in lessons from the philosophy of group rights.

The South Korean Conscientious Objection Movement: Lessons in Nonviolence

Abstract There have been many studies on the principles and methods of nonviolent movements, especially in the West, but this area has received little attention in South Korea, which has a rich history of nonviolent movements. Since the recent South Korean conscientious objection movement has achieved significant results in introducing alternative service in a highly militarised society, I decided to conduct a study to apply the advice of Western research to the movement. The nonviolent principles, methods of organisation and strategies proposed by Western researchers have largely been applied to the South Korean movement. However, there were also differences in organisational methods and strategies. Recent Western organising conventions of mass mobilisation rather than structure-based organising were largely unavailable to the South Korean conscientious objection movement due to the radical nature of the issue. The nonviolent winning strategy of disruption-sacrifice-escalation was also not possible in the South Korean movement, which went for disruption-sacrifice-continuation, but escalation.

Data discrepancies: Italian ministry reports on abortion, contextualised

The Italian Ministry of Health reports annually on activities related to abortion and fertility, providing quantitative data that looks ripe for analysis. Actors ranging from activists to medical providers to...

국방의 의무의 형평성과 대체복무제 - 관련 헌법재판소 판례에 대한 분석을 중심으로

The alternative service system is a system proposed as a way to solve the problem of conscientious objection to military service, which is considered to conflict between military service obligations and freedom of conscience. The core value of this system is to realize a balance between the two by “guaranteeing freedom of conscience” without violating the “universality of defense obligations.” It is necessary to discuss the validity of the specific content of the alternative service system by reviewing the decision of the Constitutional Court on specific content under the current Alternative Service Act. The basic obligation can be said to be an obligation that all members of the national community bear together and equally. Therefore, it would be said that the principle of responsiveness burden applies to the duty of national defense. It can be said that this principle is applied to the alternative service system for conscientious objectors. The content of alternative service should be heavier than military service obligations, but not punitive. In accordance with these criteria for judgment, efforts should be made to improve the system by reviewing the individual contents, such as the screening method, service institution, service period, and camp.

Positive and Negative Rights of Conscience: Balancing When Rights Conflict.

Conscientious objection (CO) in medicine has been seen as a negative right, the right to be free from the intervention of others, so as not to be coerced into doing a medical intervention that the objector thinks is immoral. Arguments are now becoming more common calling for protection for the positive right of conscience, the right to perform interventions by the healthcare provider (HCP) even when it goes against the policy of the healthcare institution (HCI) or the law. Rights create obligations. While negative rights only obligate that others not interfere, positive rights create the obligation of others to support the activity. Positive rights of conscience of the HCP impinge on the negative rights of the HCI. They require that the HCI implicitly support the activity of the HCP, which is formal cooperation and can never be justified without the loss of integrity on the part of the HCI. This article will argue, outside of the limitations of CO such as providing care in an emergency when there is no other option, that respect for the negative right of conscience of the HCI outweighs the positive right of the HCP.

Conscientious objection in medicine. A critical approach from the perspective of personalist bioethics

Conscientious objection in medicine. A critical approach from the perspective of personalist bioethics

Between the Church and the State

Abstract Supranational cultural institutions and communities play an interesting role in the development of abortion policy both historically and today. In this article we consider two such institutions: the Catholic Church and the European community. The church is famously antiabortion, and we describe the ways in which the Catholic position manifests itself in different countries. Conversely, almost all European countries have liberal laws that allow abortion on demand for twelve weeks of pregnancy. Italy sits at the intersection of European and Catholic identities. Italy adopted European-style liberal abortion laws early, but Italians continue to identify with the church in surveys, which is one of the causes of high levels of conscientious objection by medical professionals. Italy’s abortion policy pleases neither Catholics nor secularists. We explain this by understanding Italy’s abortion law as liberal de jure, but its culture is still heavily influenced by Catholicism, resulting in limited abortion access de facto.

Principled Conscientious Provision: Referral Symmetry and Its Implications for Protecting Secular Conscience.

"Conscientious provision" refers to situations in which clinicians wish to provide legal and professionally accepted treatments prohibited within their (usually Catholic) health care institutions. It mirrors "conscientious objection," which refers to situations in which clinicians refuse to provide legal and professionally accepted treatments offered within their (usually secular) health care institutions. Conscientious provision is not protected by law, but conscientious objection is. In practice, this asymmetry privileges conservative religious or moral values (usually associated with objection) over secular moral values (usually associated with provision). In this article, we first argue for a legal right to one kind of conscientious provision: referral for procedures prohibited at Catholic hospitals. We then argue that a premise in that argument-the principle of comparably trivial institutional burdens-justifies legal protections for some additional forms of conscientious provision that include, for example, writing prescriptions for contraception or medical abortions. However, this principle cannot justify legal protections for other forms of conscientious provision, for instance, the right to perform surgical abortions or gender-affirming hysterectomies at Catholic hospitals.

Conscience, Disobedience, and Standard of Care.

In the article "Principled Conscientious Provision: Referral Symmetry and Its Implications for Protecting Secular Conscience," Abram L. Brummett, Tanner Hafen, and Mark C. Navin reject what they call the "referral asymmetry" in U.S. conscientious objection law in medicine, which recognizes rights of conscientiously objecting physicians to withhold referrals for medical interventions but does not (yet) recognize rights of physicians to make referrals for medical interventions to which they are morally committed but to which their health care institutions are morally opposed. This commentary concentrates on a second asymmetry, namely, the relationship of a health care provider's referral or nonreferral to the medical standard of care. The commentary argues that this second asymmetry seems to require action more appropriately recognized as civil disobedience than conscientious provision of referral.

Medical oncologist perceptions and willingness to participate in voluntary assisted dying in South Australia.

This study surveyed South Australian medical oncologists to capture their perceptions, willingness to participate and perceived barriers and motivations to participation in voluntary assisted dying (VAD) activities. Approximately 70% of surveyed medical oncologists reported familiarity with VAD legislation. Less than half of physicians (39.1%) reported willingness to participate in any VAD activities, and the rate of conscientious objection was 22%. The top barriers to participation were lack of time and uncertainty given no prior experience. These results demonstrate both a low rate of conscientious objection and a low rate of willingness to participate at the point of VAD implementation in South Australia, and identify barriers to participation that are largely logistical.

대체복무제의 개선방향에 관한 소고

It is meaningful to look back on the current alternative service system at the present time, three years after the alternative service system was implemented. In particular, considering that there is still controversy over the punishment of the alternative service system, it is necessary to reconsider what direction the alternative service system should have in the future. Currently, alternative service personnel in Korea are serving in correctional facilities for 36 months, twice the length of active military service, which is longer than the maximum difference between the general military service period and the alternative service period in Armenia, which the European Court of Human Rights called punitive. In addition, in Armenia, it was controversial that the place of service should be at the workplace 24 hours a day, even though the place of service was various private institutions such as orphanages, nursing homes, mental health institutions, and facilities for the disabled. In Korea, the form of having to serve in a single place called correctional facilities and camp service can be even more problematic. In fact, although there are no uniformly established standards under international law regarding the period of alternative service, according to the recommendations of the Ministerial Committee within the European Council and the decisions of the UN Human Rights Commission, it is mentioned that the period of alternative service should be within a reasonable range that is non-punitive. In addition, among the countries implementing alternative service, the largest difference in period of less than 1.5 times was found. And the European countries have alternative service institutions in various fields, such as social welfare, health, culture, religion, peace, education, the environment, and emergency rescue, and Korea also needs to prepare a variety of service institutions as possible in addition to correctional facilities. In addition, in terms of diversifying service types, it is necessary to consider a method of distinguishing between the types of service that can be served as non-combatants within the military and the types of alternative service of civilians outside the military. Lastly, considering that there are countries that have abolished the interview survey in the process of applying for alternative service, and this was a measure of respect for the freedom of conscience of conscientious objectors, I think Korea needs to consider discussing it in the long run.

“How to navigate this new area”: Intensive care clinicians’ perceptions of voluntary assisted dying in the intensive care unit: A multisite exploratory study

BackgroundThere is growing momentum worldwide for assisted dying. In Australia, voluntary assisted dying may occur in any setting, including an intensive care unit (ICU). As the subject of much debate worldwide, exploring ICU clinicians’ perceptions of assisted dying is essential. AimThe aim of this study was to explore clinicians’ perceptions of and preparedness for voluntary assisted dying in the ICU. MethodAn exploratory qualitative descriptive design using individual interviews was used. Medical, nursing, and allied health clinicians from three ICUs were recruited. Interviews were conducted between Nov 2022 and Jan 2023, with a hypothetical scenario about voluntary assisted dying used to prompt discussion. Interviews were recorded, professionally transcribed, and analysed using inductive content analysis. FindingsICU registered nurses (n = 20), physicians (n = 2), and allied health clinicians (n = 4) participated with interviews lasting 18–45 min (mean: 28 min). Analysis revealed four themes: (i) purpose of ICU reflected that ICU care was not all about saving lives, yet recognising dying and changing priorities was challenging; (ii) dying in the ICU is complex due to difficulties in talking about dying, accepting death as the outcome and evaluating care efficacy; (iii) voluntary assisted dying is a lot of grey because of perceived clinical and ethicolegal challenges; and finally, (iv) respecting choice was about respecting patients' values, beliefs, and autonomy, as well as clinicians’ beliefs and right to exercise autonomy through conscientious objection. ConclusionDying and death are inevitable, and views and perspectives about assisted dying will continue to evolve. Respecting patient choice is at the core of assisted dying, but respecting clinicians’ perspectives and choice is equally important. With voluntary assisted dying now legal in all Australian states, ensuring ICU team and individual clinician preparedness through access to education, resources, and specialist support services is key to raising awareness and easing uncertainty about deaths through voluntary assisted dying.

To participate or not to participate: The troublesome question of nurses' conscientious objection to abortion: A qualitative study.

To report a study investigating the implementation of the "conscience clause" by practising nurses in two National Health Service Hospital Trusts in the UK. A qualitative study. Data were collected from 2018 to 2020 through qualitative face-to-face interviews with 20 nurses, transcribed verbatim and analyzed by thematic analysis. Major themes were developing conscience, negotiating conscience and parameters of participation. Participants had varied views on conscientious objection, reflecting a continuum from unwillingness to be near anything related to abortion to being willing to participate in the whole process. Most participants framed involvement as fulfilling their "duty of care" to their patient. Direct experience of witnessing abortion overrode faith-based foundations to shape participants' beliefs as objectors or non-objectors. Non-objectors were supportive of objecting colleagues. The complex nature of conscience as a fundamental human right is inherently related to the cultural and social context of nursing. "Employability" raised important questions over the real world of a nurse's legal right to invoke conscientious objection without consequences. Problem addressed Conscientious objection to abortion continues to affect nursing. Main findings There was little knowledge of the law and a reluctance to make formal objections. Where and on whom will the research have an impact It highlights the need for delineated and implemented guidelines on conscientious objection in practice for nurses. Its findings, while local, may be applicable to other abortion services. Representatives of each were key in our advisory group. COREQ checklist for qualitative research.