Conscientious objection and voluntary interruption of pregnancy
How to balance it with users rights?
Keywords:
LEGAL ABORTION, PATIENT RIGHTS, CONSCIENCE, PHYSICIANS, MEDICAL ETHICS, BIOETHICSAbstract
Introduction: Act 18.987 for the voluntary interruption of pregnancy specifically provided for conscientious objection, in spite of its constitutional origin being recognized. The scope of the objection has resulted in doctrinal debates, both from the legal and the bioethical perspectives. Reconciling the right to being a conscientious objector in the interruption of pregnancy process, with the rights of users who request such interruption, to obtain the service within a context of respect for her confidentiality constitutes an important aspect in this controversy.
Objective: without prejudice of analysing conscientious objection both in terms of its material scope (what may be objected), and its personal scope (who may object), the article will particularly refer to the search for reconciling the right to objection and the right of users to receive the service. As a matter of fact, national and international provisions state objectors are obliged to refer patients to a nonobjecting colleague in order to ensure the provision of the health service. However, many times such referral is not possible in case there are no nonobjecting colleagues in a certain healthcare institution, or the number of nonobjecting colleagues may not cover the demand. The thesis upheld implies that the individual right of physicians to refer the patient when they are conscientious objectors may not be satisfactory exercised unless there is institutional support. In other words, the ultimate responsibility for those users to have access to the service lies in the institutions, which need to organize the service ensuring their demand is satisfied. We will try to prove that this responsibility to organize the service obliges the institution to refrain from referring users to other institutions, and to hire health professionals who are not objectors, so they can cover health services women have a right to, according to the legal provisions in force.
Conclusions: upon analysing the role played by the authorities in the healthcare institutions in terms of the organization of services and the scope and limitations to conscientious objection, we conclude that: a) institutions are responsible for having professionals who do not object to rendering the voluntary interruption of pregnancy service, otherwise the obligation to refer patients by the physician who is an objector is impossible; b) the specific hiring of health professionals who are not objectors, without this having an impact on the work rights of the objecting professionals, is absolutely legitimate and may not be deemed as a form of discrimination; c) only in the event it is really impossible to hire professionals who can render this service is it possible to refer patients to other institutions. Therefore, reconciling conscientious objection and the right of users is necessarily an institutional obligation that does not imply analyzing the reasons why objectors refuse to render the service or creating registries of objectors, since the reason for conscientious objections is confidential.
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