Dispensing with Liberty: Conscientious Refusal and the "Morning-After Pill"

Fenton, Elizabeth; Lomasky, Loren Ε.

doi:10.1080/03605310500421389

Cited by 26 publications

(14 citation statements)

References 7 publications

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“…In 2006 the FDA made the drug available without prescription for women 18 years and older, but kept it behind the pharmacy counter, simplifying access for some (but not all) women. However, reports emerged that some pharmacies refused to stock the medicine [3], and some pharmacists refused to dispense it, potentially limiting patients’ access to the drug within the 72-h window of peak effectiveness [4,5]. …”

Section: Introductionmentioning

confidence: 99%

Obstetrician–gynecologist physicians' beliefs about emergency contraception: a national survey

et al. 2010

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Background-Although emergency contraception (EC) is available without a prescription, women still rely on doctors' advice about its safety and effectiveness. Yet little is known about doctors' beliefs and practices in this area.Study Design-We surveyed 1800 US obstetrician-gynecologists. Criterion variables were doctors' beliefs about EC's effects on pregnancy rates, and patients' sexual practices. We also asked which women are offered EC. Predictors were demographic, clinical, and religious characteristics.Results-Response rate 66% (1154/1760). Most (89%) believe EC access lowers unintended pregnancy rates. Some believe women use other contraceptives less (27%), initiate sex at younger ages (12%), and have more sexual partners (15%). Half of physicians offer EC to all women (51%), while others offer it never (6%) or only after sexual assault (6%). Physicians critical of EC, males, and religious physicians were more likely to offer it never or only after sexual assault (odds ratios 2.1-12).Conclusion-Gender, religion, and divergent beliefs about EC's effects shape physicians' beliefs and practices.

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Section: Introductionmentioning

confidence: 99%

Obstetrician–gynecologist physicians' beliefs about emergency contraception: a national survey

et al. 2010

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“…Local variation in circumstance makes broad policy recommendations difficult. 17 Conversely, physicians have obligations to their patients. These obligations include disclosure, provision of informed consent, referral, and emergency treatment.…”

Section: Conscientious Objection In Health Carementioning

confidence: 99%

“…17,20 Licensure requirements constrain others from providing similar services and limit patients' access. Physicians' relative monopoly on health care services and their fiduciary obligations to patients create an obligation to treat, irrespective of conscientious objection, in emergencies.…”

Section: Conscientious Objection In Health Carementioning

confidence: 99%

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Physician Refusal to Provide Information or Treatment on the Basis of Claims of Conscience

2009

Pediatrics

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Health care professionals may have moral objections to particular medical interventions. They may refuse to provide or cooperate in the provision of these interventions. Such objections are referred to as conscientious objections. Although it may be difficult to characterize or validate claims of conscience, respecting the individual physician's moral integrity is important. Conflicts arise when claims of conscience impede a patient's access to medical information or care. A physician's conscientious objection to certain interventions or treatments may be constrained in some situations. Physicians have a duty to disclose to prospective patients treatments they refuse to perform. As part of informed consent, physicians also have a duty to inform their patients of all relevant and legally available treatment options, including options to which they object. They have a moral obligation to refer patients to other health care professionals who are willing to provide those services when failing to do so would cause harm to the patient, and they have a duty to treat patients in emergencies when referral would significantly increase the probability of mortality or serious morbidity. Conversely, the health care system should make reasonable accommodations for physicians with conscientious objections.

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“…nicht nur kirchliche autoritäten [6] oder weltanschauliche interessensgruppen [33], sondern auch pluralistisch ausgerichtete berufsvereinigungen [2] und die ethische Scientific Community [13] engagieren sich in dieser Diskussion. Das derzeit wohl umstrittenste thema betrifft die notfallverhütung ("Plan b", "morning-after pill") [20].…”

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Gewissensfreiheit in der Apotheke

Wallner

2010

Ethik Med

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3O r i g i n a l a r b e i t Zusammenfassung in den letzten Jahren wird intensiv darüber diskutiert, ob und in welcher Weise das gewissen im Kontext der apotheke zu schützen ist. Der Status quo in Deutschland und Österreich sieht keine gesetzliche regelung für dieses Problem vor. Der ethische rahmen für eine bewältigungsstrategie im Umgang mit dem Problem der gewissensfreiheit in der apotheke wird deutlich gemacht. Unter anwendung des rechtsethischen Verhältnismäßigkeitsprinzips wird das Problem mit berücksichtigung des deutschen und österreichischen Verfassungsrechts sowie der europäischen Menschenrechtskonvention auf individueller, korporativer und gesellschaftlicher ebene analysiert. auf individueller ebene sind die berechtigten interessen und güter des apothekers einerseits und der Patientin andererseits durch eine grundrechtliche Verhältnismäßigkeitsprüfung zu einem schonenden ausgleich zu bringen. auf korporativer ebene legitimiert das auf der religions-und Weltanschauungsfreiheit basierende Selbstbestimmungsrecht die ideologisch profilierte Apotheke als Organisation und kann in der Binnenbeziehung der Apotheke einen Loyalitätskonflikt verursachen. Auf gesellschaftlicher Ebene stehen vier Optionen der proaktiven rechtspolitischen gestaltung der gewissensproblematik zur Verfügung: sozialstaatlich, libertär, professionsbezogen und kommunitär. Wie Konflikte auf individueller oder korporativer ebene gelöst werden können, hängt von den Optionen ab, die auf gesellschaftlicher ebene gewählt werden. Für den Fall einer Änderung des Status quo wird für zwei Lösungsansätze argumentiert: a) die Einführung einer qualifizierten Gewissensklausel für Apotheker (mit Beratungs-, Verweis-, Notfall-und Verständigungspflicht); b) die auf einen Kompromiss zwischen ideologisch profilierter pharmazeutischer Korporation (apotheke oder apothekervereinigung) und Sozialstaat abzielende "weiche" kommunitäre Option. beide ansätze werden einem schonenden ausgleich berechtigter güter gerecht.Abstract Background in recent years, it has been intensively debated whether and how the conscience must be protected in the context of pharmacies. Currently, germany and austria have no legal regulation regarding this problem. Objective the ethical framework for a coping strategy dealing with the problem of freedom of conscience in the pharmacy will be outlined. Method by applying legal ethics' principle of proportionality within german and austrian constitutional law as well as the european Convention on Human rights, the problem is analyzed on its individual, corporative, and societal level. Results On the individual level, the pharmacist's and the patient's stakes and rights (e.g., the freedom of conscience) are carefully balanced by using the principle of proportionality. On the corporative level, the autonomy granted by the fundamental right of freedom of religion and belief legitimatizes a pharmacy's ideological profile as an organization and may cause conflicts of loyalty within the pharmacy. On the societal level, four pro-active options of s...

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Dispensing with Liberty: Conscientious Refusal and the "Morning-After Pill"

Cited by 26 publications

References 7 publications

Obstetrician–gynecologist physicians' beliefs about emergency contraception: a national survey

Obstetrician–gynecologist physicians' beliefs about emergency contraception: a national survey

Physician Refusal to Provide Information or Treatment on the Basis of Claims of Conscience

Gewissensfreiheit in der Apotheke

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