Impacts of CO on women’s autonomy and human rights
Abortion is a necessary health intervention, as well as highly ethical. Women with wanted pregnancies can experience serious medical or fetal complications to the point where abortion becomes the ‘‘standard of care’’ — a medically required, evidence-based service that any practitioner should be expected to provide. CO undermines the standard of care by preventing patients from receiving accurate and unbiased information about their treatment options, and by inhibiting their ability to access such care (Weitz and Berke Fogel, 2010).
Termination of unwanted pregnancy is ethical because women do so only if they don’t see any responsible way to care for that potential child. It protects their families and their future, since women may have existing children that they can barely afford to care for, or they may want to delay their first child until they finish school (Finer et al., 2008). Their decision is well-thought out and based on personal circumstances that only they can fully appreciate. Once the decision to terminate is made, most women will go to great lengths to carry it out, regardless of the law or the risk to their safety. Globally, 40% of all pregnancies are unintended (Guttmacher Institute, 2011). Over a quarter of all pregnant women will have either an abortion or an unwanted birth (Koyama and Williams, 2005), but 49% of the 43.8 million abortions that take place every year are unsafe and mostly illegal (Sedgh et al., 2012). An estimated 47,000 women die annually from unsafe abortion (Shah and Ahman, 2010) and 8.5 million are injured (Guttmacher Institute, 2010). This is why legalizing abortion has a dramatic impact on saving women’s lives and improving their health, a phenomenon that has been demonstrated in dozens of countries over the last few decades. Internationally, women have established human rights and constitutional equality in most western countries, and the exercise of CO infringes those rights. Access to abortion (and contraception) frees women to pursue an education and career and to participate fully in public life, thereby advancing their equality, liberty, and other human rights. It allows women to better plan and provide for their families (well over half of all women requesting an abortion already have at least one child (Guttmacher Institute, 2013b)), which also benefits the entire community and society. Births of unwanted children can be detrimental to women who were denied abortion (and to their families),leading to a higher risk of poverty, health complications,and domestic violence (Foster et al., 2012). Unwanted children themselves are at higher risk for lifelong dysfunction, including child abuse or neglect, emotional handicaps, and stunted intellectual and educational development (Arthur,1999; David, 2011).
Further, the decision to have an abortion is closely linked to social and economic circumstances, and the support or sanction of the societies that women live in. Women are much more likely to experience unintended pregnancy and seek abortion if they are adolescents, live in poverty, have chaotic lives or an abusive partner, or have poor access to contraception (Major et al., 2009).
Historically, one of the prime objectives of past governments was to increase their population, with little if any consideration for the quality of life of women and their children. Former monarchies, dictatorships, and warleading countries wanted soldiers to increase their empires and serve as cannon fodder (Museum of Contraception and Abortion, 1916). This fundamental conflict between the state and the individual resulted in laws in almost everycountry that essentially forced women to have more children than they wanted. Much progress has been made over the last century, with many countries liberalizing their abortion laws. In 2010, the United Nations Special Rapporteur on the Right to Health called for immediate decriminalization of abortion around the world because legal restrictions had discriminatory and stigmatizing effects and violated the right to health by leading to preventable deaths and injuries (United Nations General Assembly, 2011). Canada already struck down its law entirely in 1988 and never replaced it, proving that criminal abortion laws are unnecessary and counter-productive. The Supreme Court of Canada said:‘‘Forcing a woman, by threat of criminal sanction, to carry a fetus to term unless she meets certain criteria unrelated to her own priorities and aspirations, is a profound interference with a woman’s body and thus a violation of her security of the person.’’ (Abortion Rights Coalition of Canada, 2013).
In western countries today, the anti-choice movement wants women to bear children to reverse declining population levels and mitigate the effects of an ageing demographic. Invoking CO is one strategy to achieve this goal. But history provides ample evidence of the ineffectiveness of such restrictive strategies and the catastrophic consequences they lead to. Perhaps the most well-known‘‘social experiment’’ took place in Romania between 1966 and 1990. Former dictator Nicolae Ceausescu decided to increase the population by criminalizing contraception and abortion. Women were even subjected to regular gynaecological examinations to detect any pregnancy. But underground abortion networks mushroomed (as they do in any society where abortion is banned), and over the course of 20 years, an estimated 10,000 women died needlessly from illegal abortions alone. As a consequence of many unwanted pregnancies carried to term, state orphanages were overwhelmed with tens of thousands of children abandoned every year, most of whom ended up living on the street (U.S. Embassy, 2001; Westend Film+TV Produktion, 2004)
Anti-choice objections to providing abortions are based on a denial of this evidence and historical experience. The provision of safe, legal abortion is a vital public interest that negates any grounds for CO.
Source: Fiala C, Arthur JH. ‘‘Dishonourable disobedience’’ — Why refusal to treat in reproductive healthcare is not conscientious objection. Woman – Psychosom Gynaecol Obstet (2014), http://dx.doi.org/10.1016/j.woman.2014.03.001