0
items
£0
Myth-busting Blog #2 - Conscientious Objection
By Jill McManus of Drs for Choice UK & NI, MSFC.
A letter in the press recently outlined some inaccuracies around Conscientious Objection for Healthcare professionals in Northern Ireland come 22nd October. As part of our ongoing myth-busting blog series, we have one here that will outline the landscape with regard to Conscientious Objection (CO).
Proponents of CO believe that doctors may object due to deeply held personal religious beliefs for certain procedures, however may give excellent care in other areas of medicine; for example a doctor in Obstetrics & Gynaecology, who objects to abortion may be extremely skilled in handling complex deliveries or in caring for patients with gynaecological cancers.
It is also possible to personally object to a procedure while respecting the patient and maintaining their dignity by referring them immediately to another medical professional who can accommodate their needs. Those in favour of CO see it ideally as happening in a way that does not impede patients in accessing healthcare.
Finally, forcing healthcare professionals to participate in procedures to which they conscientiously object may result in the patient having a negative experience and ideally those providing in terminations of pregnancy would be doing so to provide the best quality care to their patients. Similarly, patients would prefer to be treated by medics who are supportive of their decisions.
It is of course important that patient care and patient safety is always put first, and conscientious objection should be treated conscientiously. It should not be a ‘default’ position and those working in healthcare must be educated and informed on all options regarding pregnancy. Otherwise we could end up in a situation like Italy where CO becomes a barrier to accessible abortion healthcare.
In order to prevent CO being used as a tactical barrier to abortion care:
1. Only an individual can conscientiously object, not a whole department, hospital or practice.
2. One cannot conscientiously object to providing emergency or life-saving care.
3. One must refer a patient to another member of staff who can provide the service to which they conscientiously object, quickly.
The General Medical Council guidance makes this very clear for doctors in Northern Ireland; conscientious objection is possible, but patients need to know that they have a right to see another doctor within a reasonable time frame.
Doctors must also not express their personal beliefs to patients in a way to cause them distress, which includes not implying any judgement of the patient on their choice to access care.
Doctors must not obstruct patients in accessing care. Doctors acting outside of this guidance may have their registration put at risk.
Alliance for Choice support the concept of ‘conscientious commitment’ and the provision of role models to healthcare staff, medical students, doctors, nurses and midwives who commit to providing high quality, patient-centred abortion care. Termination of pregnancy is a hugely important and common aspect of reproductive and sexual healthcare services.
“Conscientious objection
8. You may choose to opt out of providing a particular procedure because of your personal beliefs and values, as long as this does not result in direct or indirect discrimination against, or harassment of, individual patients or groups of patients. This means you must not refuse to treat a particular patient or group of patients because of your personal beliefs or views about them.5 And you must not refuse to treat the health consequences of lifestyle choices to which you object because of your beliefs.6
9. Employing and contracting bodies are entitled to require doctors to fulfil contractual requirements7 that may restrict doctors’ freedom to work in accordance with their conscience. This is a matter between doctors and their employing or contracting bodies.
10. If, having taken account of your legal and ethical obligations, you wish to exercise a conscientious objection to particular services or procedures, you must do your best to make sure that patients who may consult you about it are aware of your objection in advance. You can do this by making sure that any printed material about your practice and the services you provide explains if there are any services you will not normally provide because of a conscientious objection.
11. You should also be open with employers, partners or colleagues about your conscientious objection. You should explore with them how you can practise in accordance with your beliefs without compromising patient care and without overburdening colleagues.
12. Patients have a right to information about their condition and the options open to them. If you have a conscientious objection to a treatment or procedure that may be clinically appropriate for the patient, you must do the following.
Tell the patient that you do not provide the particular treatment or procedure, being careful not to cause distress. You may wish to mention the reason for your objection, but you must be careful not to imply any judgement of the patient.
Tell the patient that they have a right to discuss their condition and the options for treatment (including the option that you object to) with another practitioner who does not hold the same objection as you and can advise them about the treatment or procedure you object to.
Make sure that the patient has enough information to arrange to see another doctor who does not hold the same objection as you.
13. If it’s not practical for a patient to arrange to see another doctor, you must make sure that arrangements are made – without delay – for another suitably qualified colleague to advise, treat or refer the patient. You must bear in mind the patient’s vulnerability and act promptly to make sure they are not denied appropriate treatment or services. If the patient has a disability, you should make reasonable adjustments8 to your practice to allow them to receive care to meet their needs. In emergencies, you must not refuse to provide treatment necessary to save the life of, or prevent serious deterioration in the health of, a person because the treatment conflicts with your personal beliefs.
14. You will not necessarily need to end a consultation with your patient because you have an objection to a treatment or procedure that may be appropriate for them. However, if you feel (or the patient feels) that your conscientious objection prevents you from making an objective assessment, you should suggest again that the patient seeks advice and treatment elsewhere.
15. You must not obstruct patients from accessing services or leave them with nowhere to turn.
16. Whatever your personal beliefs about the procedure in question, you must be respectful of the patient’s dignity and views
”