Reproductive health services and the law and ethics of conscientious objection

Med Law. 2001;20(2):283-93. Review. PubMed PMID: 11495210.

Bernard M. Dickens

Abstract:

Reproductive health services address contraception, sterilization and abortion, and new technologies such as gamete selection and manipulation, in vitro fertilization and surrogate motherhood. Artificial fertility control and medically assisted reproduction are opposed by conservative religions and philosophies, whose adherents may object to participation. Physicians’ conscientious objection to non-lifesaving interventions in pregnancy have long been accepted. Nurses’ claims are less recognized, allowing nonparticipation in abortions but not refusal of patient preparation and aftercare. Objections of others in health-related activities, such as serving meals to abortion patients and typing abortion referral letters, have been disallowed. Pharmacists may claim refusal rights over fulfilling prescriptions for emergency (post-coital) contraceptives and drugs for medical (i.e. non-surgical) abortion. This paper addresses limits to conscientious objection to participation in reproductive health services, and conditions to which rights of objection may be subject. Individuals have human rights to freedom of religious conscience, but institutions, as artificial legal persons, may not claim this right. [Full Text]

Some legal and ethical issues in assisted reproductive technology

Int J Gynaecol Obstet. 66 (1999) 55-61

BM Dickens, RJ Cook

Abstract:

The potential and actual applications of reproductive technologies have been reviewed by many governmental committees, and laws have been enacted in several countries to accommodate, limit and regulate their use. Regulatory systems have nevertheless left some legal and ethical issues unresolved, and have caused other issues to arise. Issues that regulatory systems leave unresolved, or that systems have created, include disposal of embryos that remain after patients’ treatments are concluded, and multiple implantation and pregnancy. This may result in risks to maternal, embryonic and neonatal life and health, and the contentious relief that may be achieved by selective reduction of multiple pregnancies. A further concern arises when clinics must or choose to publicize their success rates, and they compete for favorable statistics  by questionable patient selection criteria and treatment priorities. [Full Text]

Freedom of conscience, professional responsibility, and access to abortion

J Law Med Ethics 1994 Fall;22(3):280-5PMID: 7749485

Rebecca S. Dresser

Acess to abortion is becoming increasingly restricted for many women in the United States.  Besides the longstanding financial barriers facing low-income women in most states, a newer source of scar­ city has emerged. The relatively small  number of physicians willing to perform the procedure is compromising the ability of women in  certain parts of the country to obtain an abortion. Do physicians have a duty to respond to this situation? Do they have a professional responsibility  to ensure that abortions are reasonably available to the women who want to terminate their  pregnancies? Or, is abortion so morally and socially controversial as to remove any professional  obligation to provide reasonable access? [Full Text]