Pediatrics. 2009 Dec;124(6):1689-93. doi: 10.1542/peds.2009-2222.
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.
医疗保健专业人员可能会对特定的医疗干预措施存在道德异议。他们可能会拒绝提供或参与提供这些干预措施。这种异议被称为良心拒绝。尽管可能难以界定或验证良心主张,但尊重个体医生的道德操守很重要。当良心主张妨碍患者获取医疗信息或护理时,就会产生冲突。在某些情况下,医生对某些干预措施或治疗的良心拒绝可能会受到限制。医生有责任向前来就诊的患者披露他们拒绝实施的治疗方法。作为知情同意的一部分,医生还有责任告知患者所有相关且合法可用的治疗选择,包括他们反对的选择。当不这样做会对患者造成伤害时,他们有道义上的义务将患者转介给愿意提供这些服务的其他医疗保健专业人员,并且在转介会显著增加死亡或严重发病概率的紧急情况下,他们有责任治疗患者。相反,医疗保健系统应该为有良心拒绝的医生做出合理的安排。