Conscientious Objection, Not Refusal: The Power of a Word

2021 ◽  
pp. 002436392110082
Author(s):  
Cynthia Jones-Nosacek

Conscientious objection (CO) in medicine grew out of the need to protect healthcare providers who objected to performing abortions after the Roe v. Wade decision in the 1970s which has since over time expanded to include sterilization, contraception, in vitro fertilization, stem cell research, and end-of-life issues. Since 2006, there has been a growing amount of published literature arguing for the denial of CO. Over the last three years, there has also been an increase in calling this conscientious refusal. This article will argue that the term conscientious objection is more accurate than conscientious refusal because those who object are not refusing to provide care. CO also emphasizes that there are reasoned arguments behind one’s decision not to perform certain actions because of one’s own principles and values. Summary How something is presented matters. Objection emphasizes the thought behind the action while refusal gives the impression that medical care is not given.

2017 ◽  
Vol 66 (2) ◽  
pp. 177-194
Author(s):  
Guadalupe Grimaux ◽  
Agustín Silberberg

Objetivo: El objetivo del estudio es conocer las respuestas éticas de los médicos residentes en uno de los hospitales de alta complejidad de Buenos Aires (Argentina). Se investigaron los principales dilemas bioéticos de la práctica médica y se estudiaron las cuestiones bioéticas consideradas más relevantes por los médicos residentes. Método: Estudio de tipo descriptivo correlacional de diseño transversal. Se diseñó una encuesta para ser distribuida entre los residentes de un hospital de alta complejidad. La población es de 105 médicos residentes. La encuesta es anónima y estudia dos grandes campos de investigación bioética: inicio y final de la vida. Resultados: Participó el 100% de la población en estudio. En el campo de investigación sobre cuestiones de fin de vida, encontramos que el 61.9% de los residentes es contrario a la eutanasia, el 81.9% distingue entre limitación del esfuerzo terapéutico y eutanasia, y el 76.2% considera adecuada la limitación del esfuerzo terapéutico ante un tratamiento fútil. En el campo de investigación sobre cuestiones de inicio de la vida, los datos de nuestro estudio evidencian que el 61.9% está en desacuerdo con el aborto ante feto discapacitado y el 31.5% en caso de violación de la madre. El 44.8% considera apropiado el aborto ante embarazo ectópico sin previsión de signos próximos de complicación en la madre. Más del 80% está de acuerdo con la ligadura de trompas y con los anticonceptivos. El 86.7% considera apropiada la fecundación in vitro en el caso de un matrimonio estéril. El 81.9% rechaza la investigación con células madre obtenidas de embriones vivos y el porcentaje disminuye a 49.5% cuando la investigación tiene como objetivo la curación de una enfermedad. Los tres temas de bioética considerados más relevantes son: 1) suspensión del tratamiento en fin de vida (60.9%), 2) aborto (58%) y 3) eutanasia (45.7%). Conclusión: El estudio evidencia una valoración desigual de la vida humana en el inicio de la vida entre los médicos residentes de la población encuestada, manifestando en algunos de ellos una deficiencia en la percepción de la dignidad ontológica del embrión. La cuestión bioética considerada más relevante por los residentes es la suspensión del tratamiento y la limitación del esfuerzo terapéutico en el final de la vida. El conocimiento de las opiniones de los residentes abre el camino a una estrategia de formación bioética más eficaz y profunda. ---------- Aim: Ethical conceptions among medical residents at a high complexity hospital in Buenos Aires were investigated. Method: descriptive-correlational study with a transversal design. An anonymous survey was designed to be distributed among residents of one hospital. It analyzed two bioethics research fields: beginning and end of life. Results: All medical residents participated. Regarding end of life issues, 61.9% were against euthanasia, 81.9% were able to distinguish between limiting a therapeutic effort and practicing euthanasia, and 76.2% considered adequate to limit a therapeutic effort in cases of futile treatment. Regarding beginning of life, 61.9% disagree with abortion of a disable fetus, 31.5% in cases of rape of mother. In addition, 44.8% considered adequate to practice abortion in ectopic pregnancy without considering any complication sign in mothers. More than 80% agreed with Fallopian tube ligation and anovulatory contraceptive methods. Regarding sterility in a marriage, 86.7% approved in vitro fertilization. While 81.9% disapproved research with stem cells obtained from living embryos, this score was reduced to 49.5% when the aim is to cure a disease. Bioethics subjects considered more relevant were: 1) suspension of treatment, 2) abortion and 3) euthanasia. Conclusions: there is an unequal consideration of human life value among medical residents, with some of them showing a deficiency in the ontological dignity of the embryo. The bioethics subject considered more relevant was suspension of treatment and limitation of therapeutic efforts. The knowledge of these opinions could help developing new strategies in order to give an efficient bioethical formation.


Author(s):  
Courtney S. Campbell

This chapter considers ecclesiastical teaching and personal experience regarding new reproductive technologies, such as in vitro fertilization, repro-genetic options, such as preimplantation genetic diagnosis, and stem cell research ethics. The principal argument is that the ethics of medical technologies used to treat and provide remedies for infertility turns primarily on questions of moral agency, familial integrity, and medical professionalism, including safety and efficacy. The Church of Jesus Christ of Latter-day Saints (LDS) procreative imperative can make the experience of infertility a wrenching personal ordeal that necessitates re-storying personal and gender identities relative to spiritual entrustment. Repro-genetic technologies find a moral point through disease prevention but are ethically controversial when their intent is for nonmedical purposes, such as sex selection or enhanced capacities. Despite firm convictions about the sanctity of human life, LDS teaching shows surprising acceptance regarding use of embryos for stem cell research.


2019 ◽  
Vol 19 (8) ◽  
pp. 539-546
Author(s):  
Jing Wang ◽  
Chi Liu ◽  
Masayuki Fujino ◽  
Guoqing Tong ◽  
Qinxiu Zhang ◽  
...  

Worldwide, infertility affects 8-12% of couples of reproductive age and has become a common problem. There are many ways to treat infertility, including medication, intrauterine insemination, and in vitro fertilization. In recent years, stem-cell therapy has raised new hope in the field of reproductive disability management. Stem cells are self-renewing, self-replicating undifferentiated cells that are capable of producing specialized cells under appropriate conditions. They exist throughout a human’s embryo, fetal, and adult stages and can proliferate into different cells. While many issues remain to be addressed concerning stem cells, stem cells have undeniably opened up new ways to treat infertility. In this review, we describe past, present, and future strategies for the use of stem cells in reproductive medicine.


2020 ◽  
Vol 19 (2) ◽  
pp. 518-533
Author(s):  
Stephanie K. Boys ◽  
Evan M. Harris

As the anti-abortion movement gains ground in the United States, it is important to explore the potential impact of overturning Roe v. Wade (1973) on the practice of IVF (in vitro fertilization). If the United States Supreme Court abandoned the legal right to early pregnancy terminations, it would open the door for states to enforce laws defining life to begin at conception. In all likelihood, legally establishing life to begin at conception may make IVF far less likely to be successful, significantly more expensive, more likely to result in high risk pregnancies with multiples, and more medically invasive. As the prevalence of IVF grows, this is a practice that should no longer be ignored in the political discourse on abortion. Instead, the unintended consequences of life at conception bills on the cost, availability, safety, and success rates of IVF can provide a strong argument in the toolbox of strategies for social workers lobbying against anti-abortion legislation.


Dialogue ◽  
1991 ◽  
Vol 30 (3) ◽  
pp. 383-398 ◽  
Author(s):  
Christine Overall

What would be a genuinely caring approach to the provision of procedures of so-called artificial reproduction such as in vitro fertilization (IVF)? What are appropriate and justified social policies with respect to attempting to enable infertile persons to have offspring? These urgent questions have provoked significant disagreements among theologians, sociologists, healthcare providers, philosophers and even — or especially — among feminists. In the existing literature and in developing social policy, three different kinds of answers can be discerned. (1) Some have suggested that access to IVF should be provided as a matter of right. (2) Some existing social policies and practices imply that access to IVF is a privilege. (3) Some theorists have argued that, because of its alleged violation of family values and marital security, or because of its risks, costs, and low success rate, IVF should not be available at all. After evaluating each of these views, I shall offer a feminist alternative, describing what I think would constitute the caring provision of in vitro fertilization.


2010 ◽  
Vol 38 (2) ◽  
pp. 204-211 ◽  
Author(s):  
Lawrence Goldstein

Lost at times in the heat of debate about stem cell research, or any controversial advanced technology, is the need for precision in debate and discussion. The details matter a great deal, ranging from the need to use words that have precise definitions, to accurately quote colleagues and adversaries, and to cite scientific and medical results in a way that reflects the quality, rigor, and reliability of the work at issue. Regrettably, considerable inaccuracy has found its way into the debates about stem cells, on all sides, with consequent fogging of the issues.A key detail that is often overlooked in the debates about the uses of human embryonic stem cells in research comes from the nature of in vitro fertilization (IVF) treatment for infertility. Specifically, there are many frozen human embryos (more precisely called blastocysts) that are in excess of reproductive needs of the couple who generated them, and that must be either frozen indefinitely, donated to another couple, or destroyed.


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