Conscientious Objection in Reproductive Health Care: Analysis of Pichon and Sajous v. France

2008 ◽  
Vol 15 (1) ◽  
pp. 7-43 ◽  
Author(s):  
Adriana Lamačková

AbstractThis article explores the issue of conscientious objection invoked by health professionals in the reproductive and sexual health care context and its impact on women's ability to access health services. The right to exercise conscientious objection has been recognized by many international and European scholars as being derived from the right to freedom of thought, conscience and religion. It is not, however, an absolute right. When the exercise of conscientious objection conflicts with other human rights and fundamental freedoms, a balance must be struck between the right to conscientious objection and other affected rights such as the right to respect for private life, the right to equality and non-discrimination, and the right to receive and impart information. Particularly in the reproductive health care context, states that allow health professionals to exercise conscientious objection must accommodate this in such a way that its exercise does not compromise women's access to health services. This article analyses the European Court of Human Rights' decision on admissibility in Pichon and Sajous v. France (2001) and argues that a balancing approach should be applied in cases of conscientious objection in the sexual and reproductive health care context.

2012 ◽  
Vol 19 (3) ◽  
pp. 231-256 ◽  
Author(s):  
Christina Zampas ◽  
Ximena Andión-Ibañez

Abstract The practice of conscientious objection often arises in the area of individuals refusing to fulfil compulsory military service requirements and is based on the right to freedom of thought, conscience and religion as protected by national, international and regional human rights law. The practice of conscientious objection also arises in the field of health care, when individual health care providers or institutions refuse to provide certain health services based on religious, moral or philosophical objections. The use of conscientious objection by health care providers to reproductive health care services, including abortion, contraceptive prescriptions, and prenatal tests, among other services is a growing phenomena throughout Europe. However, despite recent progress from the European Court of Human Rights on this issue (RR v. Poland, 2011), countries and international and regional bodies generally have failed to comprehensively and effectively regulate this practice, denying many women reproductive health care services they are legally entitled to receive. The Italian Ministry of Health reported that in 2008 nearly 70% of gynaecologists in Italy refuse to perform abortions on moral grounds. It found that between 2003 and 2007 the number of gynaecologists invoking conscientious objection in their refusal to perform an abortion rose from 58.7 percent to 69.2 percent. Italy is not alone in Europe, for example, the practice is prevalent in Poland, Slovakia, and is growing in the United Kingdom. This article outlines the international and regional human rights obligations and medical standards on this issue, and highlights some of the main gaps in these standards. It illustrates how European countries regulate or fail to regulate conscientious objection and how these regulations are working in practice, including examples of jurisprudence from national level courts and cases before the European Court of Human Rights. Finally, the article will provide recommendations to national governments as well as to international and regional bodies on how to regulate conscientious objection so as to both respect the practice of conscientious objection while protecting individual’s right to reproductive health care.


2018 ◽  
Vol 14 (6) ◽  
pp. 466
Author(s):  
Oluremi A. Savage-Oyekunle

The positive obligations on states parties to ensure covenant rights will only be fully discharged if individuals are protected by the state, not just against violations of covenant rights by its agents, but also against acts committed by private persons or entities that would impair the enjoyment of covenant rights…. (Paragraph 8 General Comment 31 Human Rights Committee) This article explores the responsibility of the Nigerian state towards ensuring female adolescents’ access to sexual and reproductive health (SRH) care information and services especially contraceptive information and services. It thereafter, considers the stance of the treaty monitoring bodies to state parties’ obligations on the right to access SRH care information and services. The article concludes by declaring the need for judicial activism and stricter monitoring of the government’s activities in other to ensure that adolescents enjoy actual access to SRH care information and services.


2020 ◽  
Vol 4 (1) ◽  
pp. 41-62
Author(s):  
D. N. Parajuli

 Reproductive rights are fundamental rights and freedoms relating to reproduction and reproductive health that vary amongst countries around the world, but have a commonality about the protection, preservation and promotion of a woman‘s reproductive health rights. Reproductive rights include the right to autonomy and self-determination , the right of everyone to make free and informed decisions and have full control over their body, sexuality, health, relationships, and if, when and with whom to partner, marry and have children , without any form of discrimination, stigma, coercion or violence. The access and availability of reproductive health services are limited due to geography and other issues, non-availability and refusal of reproductive health services may lead to serious consequences. The State need to ensure accessibility, availability, safe and quality reproductive health services and address the lifecycle needs of women and girls and provide access of every young women and girls to comprehensive sexuality education based on their evolving capacity as their human rights, through its inclusion and proper implementation in school curriculum, community-based awareness program and youth led mass media. It is necessary for strengthening compliance, in a time-bound manner, with international human rights standards that Nepal has ratified that protect, promote, and fulfill the basic human rights and reproductive health rights in Nepal and also need to review standards and conventions that Nepal has had reservations about or those that have been poorly implemented in the country.


Author(s):  
Fatemeh Rahmanian ◽  
Soheila Nazarpour ◽  
Masoumeh Simbar ◽  
Ali Ramezankhani ◽  
Farid Zayeri

AbstractBackgroundA dimension of reproductive health services that should be gender sensitive is reproductive health services for adolescents.ObjectiveThis study aims to assess needs for gender sensitive reproductive health care services for adolescents.MethodsThis was a descriptive cross-sectional study on 341 of health care providers for adolescents in health centers and hospitals affiliated to Shiraz University of Medical Sciences in Iran in 2016. The subjects of the study were recruited using a convenience sampling method. The tools for data collection were: (1) a demographic information questionnaire and; (2) a valid and reliable questionnaire to Assess the Needs of Gender-Sensitive Adolescents Reproductive Health Care Services (ANQ-GSARHS) including three sections; process, structure and policy making for the services. Data were analyzed using SPSS 21.ResultsThree hundred and forty-one health providers with an average working experience of 8.77 ± 5.39 [mean ± standard deviation (SD)] years participated in the study. The results demonstrated the highest scores for educational needs (92.96% ± 11.49%), supportive policies (92.71% ± 11.70%) and then care needs (92.37% ± 14.34%) of the services.ConclusionsProviding gender sensitive reproductive health care services for adolescents needs to be reformed as regards processes, structure and policies of the services. However, the gender appropriate educational and care needs as well as supportive policies are the priorities for reform of the services.


2011 ◽  
Vol 11 (4) ◽  
pp. 284-304 ◽  
Author(s):  
Mark Campbell

Article 9 of the European Convention on Human Rights provides protection for freedom of thought, conscience and religion. From one perspective, it may be said that Article 9 guarantees a right to conscientious objection in health care, whereas from another perspective, a Strasbourg case, such as Pichon and Sajous v France, effectively means that Article 9 provides little or no protection in that context. In this article it is argued that the matter is more complex than either of these two positions would suggest. Moreover, given the nature of the subject matter, national authorities should be afforded a significant margin of appreciation in the way that they protect and regulate conscientious objection. By way of illustration, there is a discussion of the ways in which Article 9 might affect conscientious objection in health care under English law. The final part of the article considers the conceptual limitations of Article 9 in thinking about conscientious objection in health care; in particular, the claim that the extent to which Article 9 of the Convention provides protection for a conscientious objection in the health care context is a different question from whether conscientious objection by doctors and other health care practitioners is justified in principle.


2014 ◽  
Vol 58 (2) ◽  
pp. 183-209 ◽  
Author(s):  
Charles G Ngwena

AbstractIf applied in isolation from the fundamental rights of women seeking abortion services, the right to conscientious objection can render any given rights to abortion illusory, including the rights to health, life, equality and dignity that are attendant to abortion. A transformative understanding of human rights requires that the right to conscientious objection to abortion be construed in a manner that is subject to the correlative duties which are imposed on the conscientious objector, as well as the state, in order to accommodate women's reproductive health rights. In recent years, the Colombian Constitutional Court has been giving a judicial lead on the development of a right to conscientious objection that accommodates women's fundamental rights. This article reflects on one of the court's decisions and draws lessons for the African region.


2011 ◽  
Vol 5 (4) ◽  
pp. 358-366 ◽  
Author(s):  
Marina J. Chabot ◽  
Carrie Lewis ◽  
Heike Thiel de Bocanegra ◽  
Philip Darney

Men have a significant role in reproductive health decision making and behavior, including family planning and prevention of sexually transmitted diseases (STDs).Yet studies on reproductive health care of men are scarce. The National Survey of Family Growth 2006-2008 provided data that allowed assessment of the predisposing, enabling, and need factors associated with men’s receipt of reproductive health services in the United States. Although more than half (54%) of U.S. men received at least one health care service in the 12 months prior to the survey, far fewer had received birth control counseling/methods, including condoms (12%) and STD/HIV testing/STD treatment (12%). Men with publicly funded health insurance and men who received physical exam were more likely to receive reproductive health services when compared with men with private health insurance and men who did not receive a physical exam. Men who reported religion was somewhat important were significantly more likely to receive birth control counseling/ methods than men who stated religion was very important. The pseudo- R2 (54%), a measure of model fit improvement, suggested that enabling factors accounted for the strongest association with receiving either birth control counseling/ methods or STD/HIV testing/STD treatment.


Author(s):  
Rickie Solinger

The reproductive experiences of women and girls in the 20th-century United States followed historical patterns shaped by the politics of race and class. Laws and policies governing reproduction generally regarded white women as legitimate reproducers and potentially fit mothers and defined women of color as unfit for reproduction and motherhood; regulations provided for rewards and punishments accordingly. In addition, public policy and public rhetoric defined “population control” as the solution to a variety of social and political problems in the United States, including poverty, immigration, the “quality” of the population, environmental degradation, and “overpopulation.” Throughout the century, nonetheless, women, communities of color, and impoverished persons challenged official efforts, at times reducing or even eliminating barriers to reproductive freedom and community survival. Between 1900 and 1930, decades marked by increasing urbanization, industrialization, and immigration, eugenic fears of “race suicide” (concerns that white women were not having enough babies) fueled a reproductive control regime that pressured middle-class white women to reproduce robustly. At the same time, the state enacted anti-immigrant laws, undermined the integrity of Native families, and protected various forms of racial segregation and white supremacy, all of which attacked the reproductive dignity of millions of women. Also in these decades, many African American women escaped the brutal and sexually predatory Jim Crow culture of the South, and middle-class white women gained greater sexual freedom and access to reproductive health care, including contraceptive services. During the Great Depression, the government devised the Aid to Dependent Children program to provide destitute “worthy” white mothers with government aid while often denying such supports to women of color forced to subordinate their motherhood to agricultural and domestic labor. Following World War II, as the Civil Rights movement gathered form, focus, and adherents, and as African American and other women of color claimed their rights to motherhood and social provision, white policymakers railed against “welfare queens” and defined motherhood as a class privilege, suitable only for those who could afford to give their children “advantages.” The state, invoking the “population bomb,” fought to reduce the birth rates of poor women and women of color through sterilization and mandatory contraception, among other strategies. Between 1960 and 1980, white feminists employed the consumerist language of “choice” as part of the campaign for legalized abortion, even as Native, black, Latina, immigrant, and poor women struggled to secure the right to give birth to and raise their children with dignity and safety. The last decades of the 20th century saw severe cuts in social programs designed to aid low-income mothers and their children, cuts to funding for public education and housing, court decisions that dramatically reduced poor women’s access to reproductive health care including abortion, and the emergence of a powerful, often violent, anti-abortion movement. In response, in 1994 a group of women of color activists articulated the theory of reproductive justice, splicing together “social justice” and “reproductive rights.” The resulting Reproductive Justice movement, which would become increasingly influential in the 21st century, defined reproductive health, rights, and justice as human rights due to all persons and articulated what each individual requires to achieve these rights: the right not to have children, the right to have children, and the right to the social, economic, and environmental conditions necessary to raise children in healthy, peaceful, and sustainable households and communities.


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