Conscientious objection to abortion provision: Why context matters

ABSTRACT

Conscientious objection to abortion – a clinician’s refusal to perform abortions because of moral or religious beliefs – is a limited right, intended to protect clinicians’ convictions while maintaining abortion access. This paper argues that conscientious objection policies and debates around the world generally do not take into account the social, political, and economic pressures that profoundly influence clinicians who must decide whether to claim objector status. Lack of clarity about abortion policies, high workload, low pay, and stigma towards abortion providers can discourage abortion provision. As the only legal way to refuse to provide abortions that are permitted by law, conscientious objection can become a safety valve for clinicians under pressure and may be claimed by clinicians who do not have moral or religious objections. Social factors including stigma also shape how stakeholders and policy-makers approach conscientious objection. To appropriately limit the scope of conscientious objection and make protection of conscience more meaningful, more information is needed about how conscientious objection is practised. Additionally, abortion trainings should include information about conscientious objection and its limits, reproductive rights, and creating an enabling environment for abortion provision. Policy-makers and all stakeholders should also focus on creating an enabling environment and reducing stigma.

KEYWORDS:

• Abortion
• conscientious objection
• conscience-based refusal
• stigma
• enabling environment

Acknowledgments

Sarah Baum, Clare Cameron, Kelly Knight, and Melissa Murray gave valuable feedback on drafts of this paper. Conversations with members of the UC Berkeley–UCSF Joint Medical Program, Seth Holmes, Lori Freedman, and members of Global Doctors for Choice helped to provide background for the paper.

Disclosure statement

No potential conflict of interest was reported by the authors.

ORCiD

Laura Florence Harris http://orcid.org/http://orcid.org/0000-0002-0683-0617

Additional information

Funding

A grant from a family endowment, the Helen Marguerite Schoeneman Fund, supported Laura Harris’s time writing this manuscript.