Giubilini and Savulescu in their recent Journal of Bioethical Inquiry symposium article presented an account of conscientious objection that argues for its recognition as a non-financial conflict of interest. In this short commentary, I highlight some problems with their account. First, I discuss their solicitor analogy. Second, I discuss some problems surrounding their objectivity claim about standards of medical care. Next, I discuss some issues arising from consistently applying their approach. Finally, I highlight that conscientious objection should be viewed not (...) as a conflict of interest but as something that society has an interest in preserving. I conclude by arguing that clinicians who have a conscientious objection can be treated in the same way as those who decide to subspecialize and do not need to give up work in their specialty. While Giubilini and Savulescu present an interesting argument about conscientious objection, theirs is not a compelling view. Indeed, the way we approach conscientious objection has more to teach us about conflicts of interest than the other way around. (shrink)

IntroductionAfter three decades of the absolute prohibition of abortion, Chile enacted Law 21,030, which decriminalizes voluntary pregnancy termination when the person is at vital risk, when the embryo or fetus suffers from a congenital or genetic lethal pathology, and in pregnancy due to rape. The law incorporates conscientious objection as a broad right at the individual and institutional levels.ObjectivesThe aim of the study was to explore the exercise of conscientious objection in public health institutions, describing and analyzing its consequences and (...) proposals to prevent it from operating as structural violence.Materials and methodsThis study uses a qualitative, post-positivist design. At the national level, according to the chain technique, people who were identified as key actors due to their direct participation in implementing the law were included. Grounded theory was used to analyze the information obtained through a semi-structured interview. The methodological rigor criteria of transferability or applicability, dependability, credibility, auditability, and theoretical-methodological adequacy were met.ResultsData from 17 physicians, 5 midwives, 6 psychologists, 8 social workers, 2 nursing technicians, and 1 lawyer are included. From an inductive process through open coding, conscientious objection as structural violence and strategies to minimize the impact of objection emerge as meta-categories. The first meta-category emerges from the barriers linked to the implementation of the law, the infringement of the rights of the pregnant person, and pseudo conscientious objection, affecting timely and effective access to pregnancy termination. The second meta-category emerges as a response from the participants, proposing strategies to prevent conscientious objection from operating as structural violence.ConclusionConscientious objection acts as structural violence by infringing the exercise of sexual and reproductive rights. The State must fulfill its role as guarantor in implementing public policies, preventing conscientious objection from becoming hegemonic and institutionalized violence. (shrink)

Background Conscientious objection is a person’s refusal to fulfill a legal duty due to their ethical values, religious beliefs, or ideological affiliations. In nursing, it refers to a nurse’s refusal to perform an action or participate in a particular situation based on their conscience. Conscientious objection has become a highly contested topic in recent years. Research objectives This study had four objectives: (1) eliciting information on how Turkish nurses perceive conscientious objection, (2) revealing whether their moral beliefs affect the care (...) they provide, (3) determining their experiences with conscientious objection, and (4) identifying existing or potential issues of conscientious objection. Research design This qualitative study collected data through semi-structured interviews. The data were analyzed using thematic content analysis. Participants The sample consisted of 21 nurses. Ethical considerations The study was approved by an ethics committee. Confidentiality and anonymity were guaranteed. Participation was voluntary. Findings The analysis revealed four themes: (1) universal values of nursing (professional values), (2) experiences with conscientious objection (refusing to provide care/not providing care), (3) possible effects of conscientious objection (positive and negative), and (4) scope of conscientious objection (grounded and groundless). Conclusion Participants did not want to provide care due to (1) patient characteristics or (2) their own religious and moral beliefs. Participants stated that conscientious objection should be limited in the case of moral dilemmas and accepted only if the healthcare team agreed on it. Further research is warranted to define conscientious objection and determine its possible effects, feasibility, and scope in Turkey. (shrink)

In this response paper, we respond to the criticisms that Michal Pruski raised against our article “Beyond Money: Conscientious Objection in Medicine as a Conflict of Interests.” We defend our original position against conscientious objection in healthcare by suggesting that the analogies Pruski uses to criticize our paper miss the relevant point and that some of the analogies he uses and the implications he draws are misplaced.