Conscientious Objection Research Articles

Definitions, perspectives, and reasons for conscientious objection among healthcare workers, facility managers, and staff in South Africa: a qualitative study

Conscientious objection (CO) on the part of healthcare providers is a growing threat to safe abortion access. In South Africa, evidence suggests that this legal clause may be manipulated as a justification for public-sector healthcare providers to exempt themselves from their duties to provide essential reproductive health services as required by national laws and protocols. This qualitative study improves our understanding of the definitions, perspectives, and use of CO among providers, staff, and facility managers in South Africa, and CO’s effect on public-sector abortion availability. Using 18 focus group discussions and 23 in-depth interviews, we examined CO attitudes and behaviours of staff from health facilities that provide abortion care in Gauteng, Limpopo, KwaZulu-Natal, and Eastern Cape Provinces. We find that CO is invoked for a variety of reasons, some unrelated to the legal basis for objection. There have been progressive shifts in attitudes towards abortion over time, but stigma against women and girls who seek abortion remains substantial among staff at facilities providing abortion. Providers who offer abortion services also report high levels of discrimination and isolation from colleagues. Such factors, combined with operational barriers to offering quality abortion care (such as lack of training support or financial incentives) and lack of clarity on CO definitions and procedures, may incentivise some providers to invoke CO inappropriately. Dissemination of national guidelines on CO should be prioritised to reduce ambiguity, and interventions addressing abortion stigma should be considered for all facility staff to safeguard abortion availability in South Africa.

The impact on patients of objections by institutions to assisted dying: a qualitative study of family caregivers’ perceptions

BackgroundVoluntary assisted dying became lawful in Victoria, the first Australian state to permit this practice, in 2019 via the Voluntary Assisted Dying Act 2017 (Vic). While conscientious objection by individual health professionals is protected by the Victorian legislation, objections by institutions are governed by policy. No research has been conducted in Victoria, and very little research conducted internationally, on how institutional objection is experienced by patients seeking assisted dying.Methods28 semi-structured interviews were conducted with 32 family caregivers and one patient about the experience of 28 patients who sought assisted dying. Participants were interviewed during August-November 2021. Data from the 17 interviews (all with family caregivers) which reported institutional objection were analysed thematically.ResultsParticipants reported institutional objection affecting eligibility assessments, medication access, and taking the medication or having it administered. Institutional objection occurred across health settings and was sometimes communicated obliquely. These objections resulted in delays, transfers, and choices between progressing an assisted dying application and receiving palliative or other care. Participants also reported objections causing adverse emotional experiences and distrust of objecting institutions. Six mediating influences on institutional objections were identified: staff views within objecting institutions; support of external medical practitioners and pharmacists providing assisted dying services; nature of a patient’s illness; progression or state of a patient’s illness; patient’s geographical location; and the capability and assertiveness of a patient and/or caregiver.ConclusionsInstitutional objection to assisted dying is much-debated yet empirically understudied. This research found that in Victoria, objections were regularly reported by participants and adversely affected access to assisted dying and the wider end-of-life experience for patients and caregivers. This barrier arises in an assisted dying system that is already procedurally challenging, particularly given the limited window patients have to apply. Better regulation may be needed as Victoria’s existing policy approach appears to preference institutional positions over patient’s choice given existing power dynamics.

Christian Anarchist: Ammon Hennacy, A Life on the Catholic Left by William Marling

Reviewed by: Christian Anarchist: Ammon Hennacy, A Life on the Catholic Left by William Marling Benjamin Peters Christian Anarchist: Ammon Hennacy, A Life on the Catholic Left. By William Marling. New York: New York University Press, 2022. 319pp. $45.00. In The Long Loneliness, Dorothy Day recalled the divisions that emerged within the Old Left in the 1920s and 1930s. There were those who were sympathetic to the American Federation of Labor (AFL) and those who opposed it, favoring instead the Industrial Workers of the World or “Wobblies.” The Wobblies, with their call for “One Big Union,” regarded the skilled workers of the AFL as “the aristocrats of labor.” Impatient with the dialectic of “the orthodox Marxists,” they believed in direct action—even through violence. But Day also identified small anarchist groups. While anarchism in the United States was associated with secular figures such as Emma Goldman and Alexander Berkman, Day pointed to Ammon Hennacy as a “Christian anarchist” in the mold of Tolstoy and the Sermon on the Mount. Borrowing this characterization, William Marling’s Christian Anarchist: Ammon Hennacy, A Life on the Catholic Left offers the first critical biography of Hennacy, an important figure on the Left (Catholic or otherwise) and, in particular, for the Catholic Worker. Hennacy had been involved with the Wobblies, but rejected violent class-warfare and became a pacifist who was imprisoned as a conscientious objector during World War I, where he met Berkman. Marling paints a vivid portrait of Hennacy starting with his childhood in Ohio raised by Quaker parents, his education at Hiram College, and his various attempts to live out his anarchist commitments, which Marling describes as “individualistic, anti-authoritarian, Christian pacifism.” Hennacy simply called it his “one-man revolution” (or as he supposedly once declared: “An anarchist is someone who doesn’t need a [End Page 81] cop to make him behave.”) The picture that clearly emerges is of a very disciplined and dedicated form of life and focus on personal responsibility. It was this pacifist anarchism that Hennacy brought to the Catholic Worker in the 1950s, though not without controversy. Indeed, Michael Baxter has even suggested that there are two poles within the Catholic Worker: the Father John Hugo-traditionalist pole and the Hennacy-anarchist pole, with most Workers falling somewhere in between. Marling also provides insights into Hennacy’s friendship with Scott Nearing, whose Living the Good Life became a classic in the back to the land movement in the 1960s, and the influence of the Hopi people, who Hennacy saw as providing a template for a more social form of pacifist anarchism. Marling does not limit his scope to an intellectual study of Hennacy’s life and thought. He spends considerable time on Hennacy’s personal life, recounting Hennacy’s first marriage to Selma Melms with whom he had two daughters. Melms eventually left Hennacy and took their daughters to join a religious cult in California. Marling gives a heartbreaking account of Hennacy’s often futile attempts to be part of his daughters’ lives. Marling also ventures into Hennacy’s relationship with Day, who influenced Hennacy’s decision to enter the Catholic Church in 1952. Marling strongly implies that this relationship was more than (as William Miller described it) “sophomoric.” Marling holds up correspondence that suggests they shared a real romantic intensity—which Day certainly exhibited when Hennacy began to pursue other (often younger) women in the Catholic Worker. If nothing else, this confirms the suspicion that Dorothy Day—in contrast to the more saintly manner she is often portrayed today—was attractive to many men and she did not always brush such attention away. Christian Anarchist is well-written and much needed—though more interviews with folks who knew Hennacy such as Karl Meyer or the late Tom Cornell could have given it a little more familiarity. That said, Marling has provided a great service to scholars or anyone else interested in the U.S. Left, Catholic radicalism, or the Catholic Worker. Accessible to both undergraduate and graduate students, Christian Anarchist will certainly become the definitive biography of Ammon Hennacy for years to come. And as the current political and economic climate (eerily mirroring that of...

William Cowper's Wokeness

Infatuated as he was with his news subscriptions, William Cowper would find in the morning papers all the evidence he needed to build a case against the Empire. Cowper's personal and public-facing writing returns continuously to matters of imperialism taken from the news yet, for all his furious denunciation of the Empire, there remains in Cowper's writing a sense of spiritual doubt that complicates a straight reading of the poet as conscientious objector. Referring to Frantz Fanon's and Paulo Freire's model of white double consciousness, this paper argues that Cowper's spiritual conflict is inherently a racial one, with the poet disassociated from self and country by sympathy for the colonized. The 18th-century newspaper, with its disparate array of anonymously penned articles written for and about the Empire, served as the quintessential voyeur to instigate the sort of culpability and shame that characterizes William Cowper's work.

Spiritualizing Politics Without Politicizing Religion: The Example of Sargent Shriver by James R. Price and Kenneth R. Melchin

Reviewed by: Spiritualizing Politics Without Politicizing Religion: The Example of Sargent Shriver by James R. Price and Kenneth R. Melchin David O’Brien Spiritualizing Politics Without Politicizing Religion: The Example of Sargent Shriver. By James R. Price and Kenneth R. Melchin. Toronto: University of Toronto Press, 2022. 200 pp. $45.00. This is an important book. James R. Price and Kenneth R. Melchin have a fresh address to the very old question of “religion and politics” as it once again explodes across the world and even upsets long settled arrangements here in the United States. The authors want to help clarify the situation which they think has been made difficult by the “fog of the culture wars,” the “proliferation of doctrinaire religious convictions,” and the “growing secularism the academy and the public square.” Price and Melchin are determined not to contribute to these endless debates but instead to “think responsibly about politics and religion” and offer constructive proposals designed to enable communities of faith to help their members carry out their shared responsibilities for public life. Their goal is contained in the title: to “spiritualize politics without politicizing religion.” To do this they intend to “affirm the religion-politics distinction that guards freedom of conscience and diversity of belief” while, with equal conviction, “affirming the religion–politics relations that ensure religious involvement in nurturing values essential for public life.” They understand that balancing religious [End Page 95] integrity and shared responsibility will always be a challenge, perhaps requiring in some cases conscientious objection to agreed-upon policies. The authors believe that religion and politics need to be distinguished from each other, but that politics needs religion to achieve its objectives while Christians need politics to carry out Gospel-based obligations. Faced with religious diversity, religion must avoid the twin temptations of disengagement and withdrawal at one end and theocratic power at the other. Politics on the other hand—and here they usually mean liberal democratic politics—requires the spiritual and moral energy of religion if its citizens are to bear their shared responsibility for self-government. Rather than lament divisions, Price and Melchin look for ways to address these challenges with full respect for religious claims and civic responsibilities. They begin with an extended analysis of the speeches of Sargent Shriver, founding leader of the Peace Corps. Shriver’s life and work illustrates how this worked out with one “exemplary figure.” They find him first as a Catholic layman familiar with church teaching, influenced by the scholastic philosophy of natural law updated by Jacques Maritain, and engaged with lively movements of Catholic Action inspiring women and men of his generation to take on new responsibilities at the centers of American life now open to them. Shriver found leadership roles in public education, race relations, and civic dialogue, first in Chicago, then in Washington in the administration of his brother-in-law John F. Kennedy and his successor Lyndon B. Johnson. Like so many of his generation, Shriver was formed in the remarkable families, parishes, schools, and ideas of the American Catholic community, then took full advantage of new opportunities opened by family aspirations and post-World War II prosperity. Making that move into centers of shared public responsibility while remaining faithful to Christianity and his American Catholic subculture required aspiring middle class Catholics like Shriver to adopt a bilingualism, speaking among themselves of Christian faith, Catholic practice, and the shared values found in church teaching, then using broader terms to embrace others in shared work for common purposes. When, in their professional and public work, they needed to find common ground with non-Catholics, Shriver and others continued to speak of service, respect for the other, and democratic aspirations for liberty and justice, all informed by what Shriver thought of as Christian charity. Some thought this move watered down the claims of faith, but the authors argue that, in the case of Shriver, he in fact expanded and deepened Christian ideals of justice and charity. At one point in his inter-racial work Shriver stated the goal that informed all his work: “to direct the [End Page 96] immense power of religion to shaping the conduct and thoughts of men...

Contemplating the Impacts of Canadian Healthcare Institutions That Refuse to Provide Medical Assistance in Dying: A Framework-Based Discussion of Potential Health Access Implications.

Following the historic Canadian legislation on medical assistance in dying (MAiD) in 2016, many implementation challenges and ethical quandaries have formed the focus of further scholarly investigation and policy revisions. Of these, conscientious objections held by some healthcare institutions have involved relatively less scrutiny, despite indicating possible hurdles to the universal availability of MAiD services in Canada. In this paper, we contemplate potential accessibility concerns that pertain specifically to service access, with the hope to trigger further systematic research and policy analysis on this frequently overlooked aspect of MAiD implementation. We organize our discussion using two important health access frameworks: Levesque and colleagues' Conceptual Framework for Access to Health and the Provisional Framework for MAiD System Information Needs (Canadian Institute for Health Information). Our discussion is organized along five framework dimensions through which institutional non-participation may generate or exacerbate inequities in MAiD utilization. Considerable overlaps are revealed across framework domains, indicating the complexity of the problem and the need for further investigation. Conscientious dissensions on the part of healthcare institutions form a likely barrier to ethical, equitable, and patient-oriented MAiD service provision. Comprehensive, systematic evidence is urgently needed to understand the nature and scope of resulting impacts. We urge Canadian healthcare professionals, policymakers, ethicists, and legislators to attend to this crucial issue in future research and in policy discussions.

Below the Surface of Clinical Ethics

AbstractOften lurking below the surface of many clinical ethical issues are questions regarding background metaphysical, epistemological, meta-ethical, and political beliefs. In this issue, authors critically examine the effects of background beliefs on conscientious objection, explore ethical issues through the lenses of particular theoretical approaches like pragmatism and intersectional theory, rigorously explore the basic concepts at play within the patient safety movement, offer new theoretical approaches to old problems involving decision making for patients with dementia, explicate and explore the problems and promises of machine learning in medicine, and offer us a non-rights-based argument for the just distribution of healthcare resources.

Barriers and facilitators for engaging in the practice of medical assistance in dying among providers in Canada: a scoping review protocol.

This review will explore the perceived barriers and facilitators for engaging in the practice of medical assistance in dying (MAiD) from the perspective of physicians, nurse practitioners, and medical residents in Canada. The number of MAiD requests in Canada is growing steadily and is predicted to continue to grow with the passing of Bill C-7 in 2021, which expands access to individuals whose deaths are not reasonably foreseeable. Under federal law, physicians and nurse practitioners are the only health care professionals permitted to assess for and administer MAiD. Providers are not obligated to engage in the practice of MAiD; therefore, patient access relies on providers' readiness to engage in the practice. More information is needed to understand the barriers and facilitators for engaging in MAiD care from the perspective of providers. This review will consider studies that identify physicians, nurse practitioners, and medical residents' perceived barriers and facilitators for engaging in the practice of MAiD in Canada. Physicians, nurse practitioners, and medical residents who do not directly administer MAiD, including those who identify as conscientious objectors or non-participants, will be included. Studies looking at barriers and facilitators for providing MAiD care to individuals with dementia, mental illness, or for individuals under the age of 18 years will be excluded. MEDLINE, Embase, CINAHL with Full-text, and APA PsycINFO will be searched. Studies will be screened and data extracted by 2 independent reviewers using a tool created for this review. The scoping review findings will be presented in a narrative format and mapped in tables to address the review aims.

Conscience, Doubt, and the Militarized Body in Pain

The Military Service Acts of 1916–18, passed under the more general Defense of the Realm Act (1914), implemented conscription throughout England, Scotland, and Wales. Opposition to conscription led to the imprisonment and abuse of thousands of conscientious objectors, who were in an ambiguous legal position, subject to punishment from both military and civil law, but protected

Conscientious Objection to Gender-Affirming Surgery: Institutional Experience and Recommendations.

As more academic institutions with surgical residency training programs begin to offer gender-affirming surgery, issues of trainee conscientious objection related to participation in these patient encounters may arise. In this article, the authors discuss their institutional experience with residents' conscientious objection to involvement in gender-affirming surgery. Although there are ethical arguments for and against conscientious objection, current U.S. federal policy grants all health care workers conscientious objector status upon their request. Recommendations are offered for other institutions that may experience similar situations regarding conscientious objection to gender-affirming care or to other aspects of plastic and reconstructive surgery.

The Management of Voluntary Abortion in Family Counselling Services. A Qualitative Study on the Role of Social Workers in Italy

Introduction. Elective abortion has always been considered taboo. The event can sometimes be experienced as traumatic, as the woman finds herself struggling against a range of emotions: fear, shame, ambivalence, and a sense of guilt. Multidisciplinary support is therefore fundamental to guide women during this complex phase, and social workers usually play a key role in the process. The present study aimed therefore to explore the experiences and perspectives of social workers who worked with women who decided to have abortions, focusing on the strongest and weakest aspects of their support process. Methodology. The study involved 10 social workers working in family counselling services in Italy. All of them were female, with a mean age of 47 years, and a mean of 16.7 years of experience in the field. The study followed a qualitative approach, based on semi-structured interviews that were studied following the principles of thematic analysis. Results. Three fundamental themes emerged from the data analysis: “Limits of the family counselling procedures and organization”; “The emotional dimension of elective abortion”; and “The issue of conscientious objectors”. Discussion. The study highlighted how family counselling services are facing a crisis due to the lack of resources, personnel, and projects allowing for women’s proper sexual education and support. It also showed how the social worker’s role, which is fundamental, has instead been reduced, especially regarding elective abortions. Moreover, there was a lack of social and sanitary contexts integration and professional training that would provide the operators with specific skills and make them feel prepared to address such delicate situations. Conclusions. The need has emerged for a new, multidisciplinary perspective on the issue of voluntary interruption of pregnancy and social workers play a major role. However, the support system still presents many shortcomings for the women in need of assistance. The present study offers innovative and practical suggestions to properly fill these gaps.

A Balance of Rights: The Italian Way to the Abortion Controversy.

The U.S. Supreme Court's Dobbs ruling triggered a global debate about access to abortion and the legislative models governing it. In the United States, there was a sudden reversal of federal guidance about pregnancy termination that is unprecedented in Western and high-income countries. The strong polarization on the issue of abortion and the difficulty of finding a point of compromise lead one to consider the experiences of countries that have had different paths. Italy stands as a candidate for being a partially alternative model because it allows abortion up to 12weeks, but without considering it a subjective right. The legislation in place since 1978 aims to balance the interests of the fetus and those of the woman. An issue often raised concerning Italian law is that of conscientious objection granted to doctors. Many gynecologists declare themselves objectors, and this makes access to abortion more difficult in some regions of Italy. After discussing this issue and envisaging different ways to deal with it, the article concludes by highlighting new dilemmas about a possible divorce between the law and medical ethics in different directions and offers some avenues to begin setting up a response.

Improving measures of access to legal abortion: A validation study triangulating multiple data sources to assess a global indicator.

Global mechanisms have been established to monitor and facilitate state accountability regarding the legal status of abortion. However, there is little evidence describing whether these mechanisms capture accurate data. Moreover, it is uncertain whether the "legal status of abortion" is a valid proxy measure for access to safe abortion, pursuant to the global goals of reducing preventable maternal mortality and advancing reproductive rights. Therefore, this study sought to assess the accuracy of reported monitoring data, and to determine whether evidence supports the consistent application of domestic law by health care professionals such that legality of abortion functions as a valid indicator of access. We conducted a validation study using three countries as illustrative case examples: Argentina, Ghana, and India. We compared data reported by two global monitoring mechanisms (Countdown to 2030 and the Global Abortion Policies Database) against domestic source documents collected through in-depth policy review. We then surveyed health care professionals authorized to perform abortions about their knowledge of abortion law in their countries and their personal attitudes and practices regarding provision of legal abortion. We compared professionals' responses to the domestic legal frameworks described in the source documents to establish whether professionals consistently applied the law as written. This analysis revealed weaknesses in the criterion validity and construct validity of the "legal status of abortion" indicator. We detected discrepancies between data reported by the global monitoring and accountability mechanisms and the domestic policy reviews, even though all referenced the same source documents. Further, provider surveys unearthed important context-specific barriers to legal abortion not captured by the indicator, including conscientious objection and imposition of restrictions at the provider's discretion. Taken together, these findings denote weaknesses in the indicator "legal status of abortion" as a proxy for access to safe abortion, as well as inaccuracies in data reported to global monitoring mechanisms. This information provides important groundwork for strengthening indicators for monitoring access to abortion and for renewed advocacy to assure abortion rights worldwide.

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

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.

Institutional objection to abortion: A mixed-methods narrative review.

Institutional objection (IO) occurs when institutions providing health care claim objector status and refuse to provide legally permissible health services such as abortion. IO may be regulated by sources including law, ethical codes and policies (including State and local/institutional policies). We conducted a mixed-methods narrative review of the empirical evidence exploring IO to abortion provision globally, to inform areas for further research. MEDLINE (Ovid), Embase (Ovid), CINAHL (EBSCO), Global Health (CAB Abstracts), ScienceDirect and Scopus were searched in August 2021 using keywords including 'conscientious objection', 'faith-based organizations', 'religious hospitals' and 'abortion'. Eligible research focused on clinicians' attitudes and experiences of IO to abortion. The 28 studies included in the review were from nine countries: United States (19), Chile (2), Turkey (1), Argentina (1), Australia (1), Colombia (1), Ghana (1), Poland (1) and South Africa (1). The analysis demonstrated that IO was claimed in a range of countries, despite different legislative and policy frameworks. There was strong evidence from the United States that clinicians in religious healthcare institutions were less likely to provide abortions and abortion referrals, and that training of future abortion providers was negatively affected by IO. Qualitative evidence from other countries showed that IO was claimed by secular as well as religious institutions, and individual conscientious objection could be used as a mechanism for imposing IO. Further research is needed to explore whether IO is morally justified, how decisions are made to claim IO, and on what grounds. Finally, appropriate models for regulating IO are needed to ensure the protection of women's access to abortion. Such models could be informed by those used to regulate IO in other contexts, such as voluntary assisted dying.

Institutional Conscientious Objection to Medical Assistance in Dying in Canada: A Critical Analysis of the Personnel-Based Arguments

Debate rages over whether Canadian provincial and territorial governments should allow healthcare institutions to conscientiously object to providing medical assistance in dying (MAiD). This issue is likely to end up in court soon through challenges from patients, clinicians, or advocacy groups such as Dying With Dignity Canada. When it does, one key question for the courts will be whether allowing institutional conscientious objection (ICO) to MAiD respects (i.e., shows due regard for) the consciences of the objecting healthcare institutions, understood as unitary entities. This question has been thoroughly explored elsewhere in the academic literature. However, another key question has been underexplored. Specifically, precedent set by the Supreme Court of Canada’s decision in Loyola High School v. Quebec (Attorney General) suggests that the courts will consider whether allowing ICO to MAiD respects the consciences of the personnel within objecting healthcare institutions. My answer to this question is no, by which I mean that allowing ICO to MAiD shows undue disregard for some consciences and undue regard for others. To justify this answer, I analyze the arguments that hold that allowing ICO in healthcare respects the consciences of the personnel within objecting healthcare institutions. My conclusion is that none of these personnel-based arguments succeed in the case of ICO to MAiD. Some fail because they are wrong about the nature of conscience and complicity. Others fail because they contradict the arguments’ proponents’ positions on conscientious objection by individual healthcare providers. Still others fail because they are internally inconsistent.

Służba zastępcza jako element ochrony wolności sumienia jednostki. Refleksje na tle art. 85 Konstytucji

This article examines the conscience clause, which is also known as conscientious objection, and its purpose in protecting an individual’s beliefs when they come into conflict with positive law. Specifically, the author discusses how the conscience clause applies to the constitutional duty to perform military service. In the case of mandatory military service, the legislator recognizes the possibility of a conflict of conscience for an individual when the duty to perform military service would be in conflict with the moral principles upheld by that individual. To address this issue, the legislator has introduced the institution of alternative service. Alternative service, which includes, among other things, work in the fields of environmental protection, fire protection, healthcare, social assistance, and care for people with disabilities or the homeless, has become a constitutional guarantee for the freedom of conscience and religion expressed in Article 53 of the Constitution.

Jeretici i disidenti - vernici prigovarači savesti i jugoslovensko vojno krivično pravo od 1945. do 1991

The paper presents results of a research focusing on a four decades' struggle for legal recognition of the right to conscientious objection in Socialist Yugoslavia. Without a pretense to evaluate it, the paper aspires to describe and explain the evolution of Yugoslav Military Criminal Law by examining its distinctive historical causes and inner logic. Methodologically, the study relies on normative analysis of relevant legal sources that have been either understudied or simply disregarded. It analyzes especially the 1989 Amendment to the Military Service Obligation Act that introduced the right to conscientious objection into the Yugoslav socialist legal system , as well as related archival materials, newspaper reports and other written accounts depicting the political background of the 1989 legal reform. The study sheds light on socialist secularism and questions the common perception of the Yugoslav People's Army as a conservative institution unwilling to compromise. It also contributes to a broader theoretical discussion on the ambiguous nature of conscientious objection as a right and/or a privilege.

The use of animals in veterinary medicine education in Brazil: students’ perspectives and the right to conscientious objection

Resumo: Esta pesquisa teve como objetivo avaliar o uso de animais no ensino da Medicina Veterinária no Brasil, do ponto de vista de discentes e egressos. Por meio de questionário online, foram abordados tópicos sobre desconforto frente aulas e pesquisas, direito de objeção de consciência e uso de métodos alternativos de ensino, respondido por 523 discentes e 414 egressos, de instituições públicas e particulares. Verificou-se que atualmente há maior oferta de disciplinas sobre direitos dos animais, bem-estar animal e/ou bioética, porém, há maior vivência de desconforto, com influência direta sobre o aprendizado. O conhecimento da objeção de consciência é baixo. Dos indivíduos objetores, apenas a minoria enfrentou dificuldades, mas foi significativo o receio de prejuízos decorrentes de suas manifestações. Diversos métodos alternativos de ensino são utilizados e o aprendizado com eles tem aprovação por discentes, apesar de ainda haver professores que se opõem a seu uso.

Medical Assistance in Dying: A Review of Canadian Health Authority Policy Documents

The purpose of this study was to describe policies developed by English-speaking Canadian health authorities to guide multi-disciplinary healthcare practice in the context of MAID. Seventeen policies from 9 provinces and 3 territories were identified and analyzed thematically. Themes developed from these documents related to ensuring a team approach to care, supporting informed patient choice, creating region-specific guidance on eligibility criteria and safeguards, accommodating conscientious objection, and making explicit organizational responsibilities. Ethical language concerned vulnerability, non-judgmental care, dignity, non-abandonment, confidentiality, moral conscience, and diverse cultural values. Overall, these policies addressed important risk mitigation strategies, acknowledged important social contracts, and supported ethical practice. Collectively, these policies outline important considerations in the evolving Canadian context for other jurisdictions seeking to create policy around assisted death.