The no correlation argument: can the morality of conscientious objection be empirically supported? the Italian case

BMC Medical Ethics 2017 18:64
Authors: Marco Bo, Carla Maria Zotti, Lorena Charrier
“The legitimacy of conscientious objection to abortion continues to fuel heated debate in Italy. In two recent decisions, the European Committee for Social Rights underlined that conscientious objection places safe, legal, and accessible care and services out of reach for most Italian women and that the measures that Italy has adopted to guarantee free access to abortion services are inadequate. Nevertheless, the Ministry of Health states that current Italian legislation, if appropriately applied, accommodates both the right to conscientious objection and the right to voluntary abortion.”
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Professional and conscience-based refusals: the case of the psychiatrist’s harmful prescription

JME 2017;43:841-844.
Author: Morten Magelssen
“By way of a case story, two common presuppositions in the academic debate on conscientious objection in healthcare are challenged. First, the debate typically presupposes a sharp division between conscience-based refusals based on personal core moral beliefs and refusals based on professional (eg, medical) reasons. Only the former might involve the moral gravity to warrant accommodation. The case story challenges this division, and it is argued that just as much might sometimes be at stake morally in refusals based on professional reasons.”
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Is there a place for CPR and sustained physiological support in brain-dead non-donors?

Journal of Medical Ethics 2017; 43: 679-683.
Author: Stephen D Brown
“The paper first focuses narrowly on requests for CPR and then expands its scope to address extended physiological support. It describes how refusing the brain-dead non-donor’s requests for either CPR or extended support would represent enduring harm to the antemortem or previously autonomous individual by negating their beliefs and self-identity. The paper subsequently discusses potential implications of policy that would allow greater accommodations to those with conscientious objections to currently accepted brain-based death criteria, such as for cost, insurance, higher brain formulations and bedside communication. The conclusion is that granting wider latitude to personal conceptions around the definition of death, rather than forcing a contested definition on those with valid moral and religious objections, would benefit both individuals and society.”
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Mother who refuses to follow court order to vaccinate son: ‘Most likely, I’ll be going to jail’

SMH, 30 September 2017
Author: Kristine Phillips
“The American Medical Association has long decried allowing parents to decline vaccination for nonmedical reasons and has cited vaccines’ ability to prevent diseases such as measles, mumps and other infectious diseases. Still, a majority of states allow religious exemptions for vaccinations. Nearly 20, including Michigan, provide exemption for religious and personal reasons. Only three, California, Mississippi and West Virginia, don’t allow nonmedical exemptions.”
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New Frontiers in End-of-Life Ethics (and Policy): Scope, Advance Directives and Conscientious Objection

Bioethics, 31(6) 2017, 422-423
Author: Udo Schuklenk
“However, it would be premature to conclude that all arguments are settled now, if not in politics and law, and that, certainly in ethics, nothing much original could be added to the existing corpus of critical analysis and argument. In fact jurisdictions considering the decriminalization of medical aid in dying are grappling today with three issues that deserve further analysis.”
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Italy has introduced mandatory vaccinations and other countries should follow its lead

The Conversation, 2 June 2017
Author: Alberto Giubilini
“Parents will have to provide proof of vaccination when they enrol their children in nursery or preschool. In this respect, the Italian policy follows the example of vaccination policies in the US. But there’s one crucial difference: the Italian law doesn’t allow parents to opt out on the grounds of ‘conscientious objection’.”
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Conscientious objection in healthcare and the duty to refer

Journal of Medical Ethics 2017; 43:207-212.
Author: Cowley C
“Although some healthcare professionals have the legal right to conscientiously object to authorise or perform certain lawful medical services, they have an associated duty to provide the patient with enough information to seek out another professional willing to authorise or provide the service (the ‘duty to refer’).”
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Conscientious objection in healthcare: why tribunals might be the answer

Journal of Medical Ethics 2017; 43:213-217.
Author: Hughes JA
“A recent focus of the debate on conscientious objection in healthcare is the question of whether practitioners should have to justify their refusal to perform certain functions. A recent article by Cowley addresses a practical aspect of this controversy, namely the question of whether doctors claiming conscientious objector status in relation to abortion should be required, like their counterparts claiming exemption from military conscription, to defend their claim before a tribunal. Cowley argues against the use of tribunals in the medical case, on the grounds that there are likely to be fewer unjustified claims to conscientious objection in this context than in the military, and that in any case tribunals will not be an effective way of distinguishing genuine and false cases. I reject these arguments and propose a different conception of the role of a medical conscientious objection tribunal.”
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Conscientious refusal in healthcare: the Swedish solution

Journal of Medical Ethics 2017; 43:257-259.
Author: Munthe C
“The Swedish solution to the legal handling of professional conscientious refusal in healthcare is described. No legal right to conscientious refusal for any profession or class of professional tasks exists in Sweden, regardless of the religious or moral background of the objection. The background of this can be found in strong convictions about the importance of public service provision and related civic duties, and ideals about rule of law, equality and non-discrimination.”
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The BMA’s guidance on conscientious objection may be contrary to human rights law

Journal of Medical Ethics 2017; 43:260-263.
Author: Adenitire JO
“It is argued that the current policy of the British Medical Association (BMA) on conscientious objection is not aligned with recent human rights developments. These grant a right to conscientious objection to doctors in many more circumstances than the very few recognised by the BMA. However, this wide-ranging right may be overridden if the refusal to accommodate the conscientious objection is proportionate. It is shown that it is very likely that it is lawful to refuse to accommodate conscientious objections that would result in discrimination of protected groups. It is still uncertain, however, in what particular circumstances the objection may be lawfully refused, if it poses risks to the health and safety of patients. The BMA’s policy has not caught up with these human rights developments and ought to be changed.”
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