How to Allow Conscientious Objection in Medicine While Protecting Patient Rights

2016 ◽  
Vol 26 (1) ◽  
pp. 120-131 ◽  
Author(s):  
AARON ANCELL ◽  
WALTER SINNOTT-ARMSTRONG

Abstract:Paradigmatic cases of conscientious objection in medicine are those in which a physician refuses to provide a medical service or good because doing so would conflict with that physician’s personal moral or religious beliefs. Should such refusals be allowed in medicine? We argue that (1) many conscientious objections to providing certain services must be allowed because they fall within the range of freedom that physicians have to determine which services to offer in their practices; (2) at least some conscientious objections to serving particular groups of patients should be allowed because they are not invidiously discriminatory; and (3) even in cases of invidiously discriminatory conscientious objections, legally prohibiting individual physicians from refusing to serve patients on the basis of such objections is not always the best solution.

2021 ◽  
pp. 168-185
Author(s):  
Maja Čolaković ◽  

The patient's right to available and accessible healthcare is correlated with the physician's obligation to provide the appropriate medical services. More recently, in medical practice in several countries, there have been an increasing number of cases where physicians (and other healthcare providers) refuse to provide a specific medical service, referring to their religious and moral beliefs i.e. the right to conscientious objection. Do physicians violate their professional obligation to act for the benefit of the patient and provide the necessary medical services? Does this interfere with the patient's right to self-determination and his other rights? Does this lead to discrimination against patients and indirect imposition of physicians' moral and religious beliefs? These are just several questions raised in theory and practice due to the conscientious objection in medicine. This paper explores the doctrinal and legislative approaches of the right to conscientious objection in medicine in Europe and worldwide.


2017 ◽  
Vol 26 (4) ◽  
pp. 1027-1038 ◽  
Author(s):  
Rafael Toro-Flores ◽  
Pilar Bravo-Agüi ◽  
María Victoria Catalán-Gómez ◽  
Marisa González-Hernando ◽  
María Jesús Guijarro-Cenisergue ◽  
...  

Background: In the last decades, there have been important developments in the scientific and technological areas of healthcare. On certain occasions this provokes conflict between the patients' rights and the values of healthcare professionals which brings about, within this clinical relationship, the problem of conscientious objection. Aims: To learn the opinions that the Nurses of the Madrid Autonomous Community have regarding conscientious objection. Research design: Cross-cutting descriptive study. Participants and research context: The nurses of 9 hospitals and 12 Health Centers in the Madrid Autonomous Community. The study was done by means of an auto completed anonymous questionnaire. The variables studied were social-demographical and their opinions about conscientious objections. Ethical considerations: The study was approved by the Ethical Community of Clinical Research of the University Hospital Príncipe de Asturias. Participants were assured of maximum confidentiality and anonymity. Findings: A total of 421 nurses answered the questionnaire. In total, 55.6% of the nurses confirmed they were religious believers, and 64.3% declared having poor knowledge regarding conscientious objection. The matters that caused the greatest objections were voluntary abortions, genetic embryo selection, refusal of blood transfusions, and therapy refusal. Discussion: Different authors state that the most significant cases of conscientious objections for health professionals are those regarding carrying out or assisting in abortions, euthanasia, the practice of assisted reproduction and, finally, the prescription and dispensing of the morning-after pill. In our study, the most significant cases in which the nurses would declare conscientious objections would be the refusal to accept treatment, the selection of embryos after genetic diagnosis preimplantation, the patient’s refusal to receive blood transfusions due to religious reasons and pregnant women’s request for voluntary abortions within the first 14 weeks. Conclusion: Nurses’ religious beliefs influence their opinions regarding conscientious objection. The nurses who declare themselves as religious believers object in a higher percentage than those without religious beliefs.


2012 ◽  
Vol 7 (3) ◽  
pp. 157-181 ◽  
Author(s):  
Andrew Hambler

Abstract This article will argue that the term ‘conscientious objection’ can be applied beyond its associations with military service and reproductive healthcare, to explain the situation of a registrar of marriages, who, in carrying out his or her employment, has an objection based on religious beliefs to a specific aspect of his or her job requirements—namely the conduct of civil partnerships. It is argued that this objection is worthy of recognition and potential accommodation because of the weight of the burden which conscience imposes on the registrar, a burden that outweighs the case against recognition. The article then turns to examine critically the options for accommodating such a conscientious objection within United Kingdom law to the extent of considering three broad options, each with attendant advantages and disadvantages. Finally the article comes to the conclusion that re-configuring discrimination law might be the most pragmatic solution.


2021 ◽  
pp. 343-359
Author(s):  
Howard Davis

Without assuming prior legal knowledge, books in the Directions series introduce and guide readers through key points of law and legal debate. It discusses European Convention law and relates it to domestic law under the HRA. Questions, discussion points, and thinking points help readers to engage fully with each subject and check their understanding as they progress and knowledge can be tested by self-test questions and exam questions at the chapter end. This chapter discusses Article 9, which establishes a general right to freedom of ‘thought, conscience, and religion’. The right to ‘manifest’ belief is ‘qualified’ in the sense that justified interferences are allowed. The duty of a court addressing an Article 9 issue is to decide whether there has been an interference, for which the state is responsible, that either restricts a person in holding religious beliefs or restricts the manifestation of belief. Manifestations of belief can be restricted if the restriction can be justified under the terms of Article 9(2). Important issues involving conscientious objection and the wearing of religious dress both in the context of employment and generally are considered in relation to justification. Article 9 can often be invoked in tandem with other Convention rights that also help to secure freedom of religion and belief.


2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Casey Michelle Haining ◽  
Louise Anne Keogh

Abstract Background Dealing with end of life is challenging for patients and health professionals alike. The situation becomes even more challenging when a patient requests a legally permitted medical service that a health professional is unable to provide due to a conflict of conscience. Such a scenario arises when Victorian health professionals, with a conscientious objection (CO) to voluntary assisted dying (VAD), are presented with patients who request VAD or merely ask about VAD. The Voluntary Assisted Dying Act 2017 (Vic) recognizes the inherent conflict of conscience that may arise for some health professionals when asked to provide VAD and responds by affording broad protection to conscientious objectors who wish to refuse to take part in the VAD process. Methods Seventeen semi-structured qualitative interviews were conducted with Victorian health professionals with a self-identified CO to VAD in the lead-up to the implementation of VAD in Victoria. Interviews explored how participants anticipated they would manage their CO in practice. Interviews were transcribed verbatim and analyzed thematically. Results Our results reveal that the way in which health professionals claimed they would approach CO conversations is variable and was dependant on the strength of their opposition to VAD. We categorized conscientious objectors according to their approach as either dissuasive non-referrers, passive non-referrers, facilitators or negotiators. Our study also explores the perceived difficulties of exercising one’s CO as identified by our participants. Conclusion The broad protection offered by the Voluntary Assisted Dying Act 2017 (Vic) encourages a range of behaviors from conscientious objectors, due to the minimal obligations imposed. In order to assist conscientious objectors, more policy, institutional guidance, and education needs to be available to conscientious objectors explicitly addressing how to effectively manage one’s CO. Such guidance is imperative to ensuring that their moral integrity is preserved and that they are exercising their CO appropriately.


2007 ◽  
Vol 2 (3) ◽  
pp. 136
Author(s):  
Harvensica Gunnara

Banyaknya kasus “kelalaian atau kesalahan medis” dan pasien yang belum memperoleh haknya dalam pelayanan medis merupakan masalah yang sangat krusial dewasa ini Untuk mengatasi masalah tersebut telah ditetapkan berbagai kebijakan dibidang pelayanan medis dalam rangka memberikan perlindungan pada hak pasien yang antara lain adalah UU Kesehatan dan UU Praktik Kedokteran, dan agar tujuan kebijakan tersebut dapat dicapai perlu adanya peran aktif seluruh pihak. Namun, berbagai kebijakan pelayanan medis dalam rangka perlindungan hak pasien belum sepenuhnya mencapai tujuan yang diharapkan. Tujuan penelitian ini adalah menganalisis kebijakan pelayanan medis dalam rangka perlindungan hak pasien di Rumah Sakit Kanker Dharmais Jakarta. Penelitian ini menggunakan pendekatan kualitatif dengan metode studi kasus. Data diperoleh dari wawancara mendalam dengan 5 orang informan dan telaah dokumen kebijakan. Teknik analisis data yang digunakan dalam penelitian ini adalah analisis isi. Hasil penelitian menunjukkan bahwa: 1) kebijakan pelayanan medis telah mengatur perlindungan hak pasien, 2) kebijakan pelayanan medis sudah mengatur “kelalaian atau kesalahan medis”, tetapi belum secara menyeluruh, 3) tenaga medis belum sepenuhnya melaksanakan kebijakan pelayanan medis, 4) upaya perlindungan hak pasien di rumah sakit sudah dilaksanakan sesuai dengan kebijakan, 5) kebijakan pelayanan medis yang belum dilaksanakan sepenuhnya sehingga tujuan kebijakan belum tercapai. “Kelalaian atau Kesalahan medis” dan pasien belum memperoleh hak pelayanan medis disebabkan. Oleh sebab itu perlu: 1) melakukan audit medis terhadap pelaksanaan kebijakan dan upaya rumah sakit melindungi hak pasien, 2) menyusun kebijakan mikro yang mengatur mengenai “kelalaian atau kesalahanmedis” secara menyeluruh.Kata kunci : Hak pasien, kebijakan pelayanan medis, kelalaian, kesalahan medisAbstractThere are many medical negligence or error charges which patients did not accept their rights in medical service. This is a crucial matter which has a large impact. To solve the problem, many policies have been decided many to give protection for patient rights, for example Health Act and Medical Practice Act. In order to achieve the policy goal, all stakeholders should totally participate. However, many polices have not fully achieved the expected goals, and thus the necessity to analyze content, implementation, and result of those policies. This study objective is to analyze medical service policy for patient rights protection in Cancer Hospital of Dharmais Jakarta. This research applies qualitative approach with case study method. Those collected data are sourced from in-depth interview with 5 informants and policy document study. To analyze data in this research using content analyze. These results of study show that: 1) medical service policy has regulated patient rights safety, 2) medical service policy has regulated concerning medical negligence or error, however it has not been completed, 3) medical professional has not been totally implemented medical service policy, 4) hospital efforts in patient rights safety has been implemented following policy, 5) medical service policy which has not been totally implemented and policy content which has not been totally regulated for problem settlement will affect policy goal that have not been achieved. The problems of medical negligence or error and situations where patients have not accepted their rights are caused by medical service policy which is not regulating medical negligence or error in a comprehensive way and medical professional has not been totally implemented medical service policy. There is a necessity to do medical audit for implementation of policy and hospital efforts in protecting patient rights and to formulate micro policy regulating medical negligence or error comprehensively.Keywords : Patient right, medical service policy, negligence, error charges


Author(s):  
Mark R. Wicclair

This chapter examines conscientious objection in health care, with a specific focus on end-of-life care. It begins with a brief historical overview and identifies distinguishing characteristics of refusals to provide a medical service that are instances of conscientious objection (conscience-based refusals). Several reasons are presented for accommodating conscience-based refusals, and it is maintained that the primary reason is to enable health professionals to maintain their moral integrity. Two extreme approaches to managing conscience-based refusals are critically analyzed, and a middle-ground approach (reasonable accommodation) is explained and defended. Conscience clauses (i.e., legal rules and regulations that protect the exercise of conscience) are discussed, and it is argued that typical conscience clauses do not provide an appropriate model for public policy in relation to conscientious objection in end-of-life care.


Author(s):  
Safarova Hulkar Norbek Qizi ◽  

In the article, the issues of regulation of medical service and the concept of patient rights are analyzed. The quality and directions of the system of qualified medical services are discussed. The activities of entities providing medical service in ensuring the rights of patients were studied. In addition, proposals were put forward to amend norms related to the introduction of telemedicine and to improve the existing legislation in the Law of the Republic of Uzbekistan “On Public Health”.


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