Conscientious Objection in Colombia

Improper Use of Conscientious Objection in Bogotá, Colombia, Presents a Barrier to Safe, Legal Abortion Care
New Study Identifies Avenues for Intervention

August 10, 2016, News Release

Health care providers who invoke conscientious objection to providing or participating in abortion care in Bogotá, Colombia, can be categorized along a spectrum of objection—extreme, moderate and partial—finds a new study published in International Perspectives on Sexual and Reproductive Health. The study, “‘The Fetus Is My Patient, Too’: Attitudes Toward Abortion and Referral Among Physician Conscientious Objectors in Bogotá, Colombia,” by Lauren Fink of Emory University, ” by Lauren Fink of Emory University, et al., seeks to understand conscientious objection from the perspective of objectors themselves in order to help identify potential interventions to ease the burden of conscientious objection as a barrier to care.

When the Colombian Constitutional Court partially decriminalized abortion in 2006, the Court established a right to abortion in three circumstances: when the life or health (including mental well-being) of the mother is at risk; when a fetal anomaly is incompatible with life; and when the pregnancy is the result of rape, incest or forced insemination. The Court also outlined guidelines for health care providers who wish to invoke conscientious objection. Individuals can object, but institutions cannot; objecting physicians have a duty to refer patients to another provider; and conscientious objection “may not involve disregard for the rights of women.” Nevertheless, improperly exercised conscientious objection is not uncommon in Colombia, leading many women to seek clandestine abortions, which are often unsafe. The authors conducted in-depth interviews with 13 key informants and 15 Colombian physicians who self-identified as conscientious objectors to better understand how conscientious objection is exercised.

Read full article: Guttmacher Institute


(The following article rebuts the idea that regulation of “conscientious objection” is working, using Colombia as an example).

There is no defence for ‘Conscientious objection’ in reproductive health care
by Christian Fiala and Joyce H.Arthur
https://doi.org/10.1016/j.ejogrb.2017.07.023
European Journal of Obstetrics & Gynecology and Reproductive Biology
Volume 216, September 2017, Pages 254-258

Abstract
A widespread assumption has taken hold in the field of medicine that we must allow health care professionals the right to refuse treatment under the guise of ‘conscientious objection’ (CO), in particular for women seeking abortions. At the same time, it is widely recognized that the refusal to treat creates harm and barriers for patients receiving reproductive health care. In response, many recommendations have been put forward as solutions to limit those harms. Further, some researchers make a distinction between true CO and ‘obstructionist CO’, based on the motivations or actions of various objectors.

This paper argues that ‘CO’ in reproductive health care should not be considered a right, but an unethical refusal to treat. Supporters of CO have no real defence of their stance, other than the mistaken assumption that CO in reproductive health care is the same as CO in the military, when the two have nothing in common (for example, objecting doctors are rarely disciplined, while the patient pays the price). Refusals to treat are based on non-verifiable personal beliefs, usually religious beliefs, but introducing religion into medicine undermines best practices that depend on scientific evidence and medical ethics. CO therefore represents an abandonment of professional obligations to patients. Countries should strive to reduce the number of objectors in reproductive health care as much as possible until CO can feasibly be prohibited. Several Scandinavian countries already have a successful ban on CO.

Read full article: Science Direct