Quotas: Enabling Conscientious Objection to Coexist with Abortion Access
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Quotas: Enabling Conscientious Objection to Coexist with Abortion Access Daniel Rodger1 · Bruce P. Blackshaw2 Accepted: 11 November 2020 © The Author(s) 2020
Abstract The debate regarding the role of conscientious objection in healthcare has been protracted, with increasing demands for curbs on conscientious objection. There is a growing body of evidence that indicates that in some cases, high rates of conscientious objection can affect access to legal medical services such as abortion—a major concern of critics of conscientious objection. Moreover, few solutions have been put forward that aim to satisfy both this concern and that of defenders of conscientious objection—being expected to participate in the provision of services that compromise their moral integrity. Here we attempt to bring some resolution to the debate by proposing a pragmatic, long-term solution offering what we believe to be an acceptable compromise—a quota system for medical trainees in specialties where a conscientious objection can be exercised, and is known to cause conflict. We envisage two main objectives of the quota system we propose. First, as a means to introduce conscientious objection into countries where this is not presently permitted. Second, to minimise or eliminate the effects of high rates of conscientious objection in countries such as Italy, where access to legal abortion provision can be negatively affected. Keywords Conscientious objection · abortion · rights · quotas · professional obligations · pregnancy
Introduction The protracted debate regarding the role of conscientious objection in healthcare has recently intensified [5, 10, 21–23, 36, 45, 51], and there have been few practical solutions suggested likely to satisfy both opponents and proponents of conscientious * Daniel Rodger [email protected] 1
School of Health and Social Care, Allied Health Sciences, London South Bank University, 103 Borough Rd, London SE1 0AA, UK
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Department of Philosophy, University of Birmingham, Birmingham B15 2TT, UK
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Health Care Analysis
objection. One of the primary concerns of opponents to conscientious objection is ensuring that eligible patients have access to legal medical services that they need or request. They see conscientious objection as an obstacle to this, and consequently believe the right to conscientious objection should be removed [19, 50]. Conversely, conscientious objectors typically have deeply held moral beliefs regarding certain services such as abortion, and do not wish to participate in their provision. Of course, supporters of a right to conscientious objection are not necessarily objectors themselves, but they are still concerned that those who do wish to object are able to do so. Our contention is that in a liberal society, the right of healthcare professionals to conscientiously object to their involvement in the provision of certain healthcare services such as abortion is of considerable value, both to themselves, and to the healthcare system in general. However, if t
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