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Health Care Analysis
Published in: Health Care Analysis 2/2021

Open Access 01-06-2021 | Original Article

Quotas: Enabling Conscientious Objection to Coexist with Abortion Access

Authors: Daniel Rodger, Bruce P. Blackshaw

Published in: Health Care Analysis | Issue 2/2021

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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.
Footnotes
1
Whether or not this could be expanded to other healthcare professions or specialties is outside of the scope of this essay. In principle, providing there is strong enough evidence that patients' access to a legal service is being compromised, then the wider use of quotas to ensure access may be indicated.
 
2
Nevertheless, the relationship between conscientious objection and abortion remains complex, and the limitations of the study by Autorino et al. [1] show that the picture remains incomplete.
 
3
This has been shown to negatively affect the health of mothers [2].
 
4
An obvious candidate to meet this criterion would be the practice of non-therapeutic infant male circumcision. Despite being legal, many bioethicists are now challenging the assumption that it is acceptable for male infants to have parts of their sexual organs removed before they are able to understand the consequences of doing so [14].
 
5
Other candidates would be for specialties and professions involved with euthanasia or physician assisted suicide.
 
6
For instance, in the Christian tradition, the practice of abortion is described as morally licit as early as the late first century and early second century in the Didache and the Epistle of Barnabas [24].
 
7
It could be objected that by advocating a quota system we become more complicit in the provision of abortion. However, unless the implementation of a quota system leads to an increase in the number of abortions (which is not self-evident), it is not clear that this would make us (or anyone else) any more complicit than we already are as participants in a democratic society that legally permits abortion. Moreover, our belief is that the system we have proposed will serve to prevent conscientious objection rights from being completely removed in countries where it is clearly affecting service provision, and enable conscientious objection to be introduced in countries which currently do not permit it.
 
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Metadata
Title
Quotas: Enabling Conscientious Objection to Coexist with Abortion Access
Authors
Daniel Rodger
Bruce P. Blackshaw
Publication date
01-06-2021
Publisher
Springer US
Published in
Health Care Analysis / Issue 2/2021
Print ISSN: 1065-3058
Electronic ISSN: 1573-3394
DOI
https://doi.org/10.1007/s10728-020-00419-5

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