Bo Marco, Zotti Carla Maria, Charrier Lorena
Research Group in Bioethics, University of Turin, Turin, Italy.
Consulta di Bioetica onlus, Turin, Italy.
BMC Med Ethics. 2017 Nov 21;18(1):64. doi: 10.1186/s12910-017-0221-x.
The legitimacy of conscientious objection to abortion continues to fuel heated debate in Italy. In two recent decisions, the European Committee for Social Rights underlined that conscientious objection places safe, legal, and accessible care and services out of reach for most Italian women and that the measures that Italy has adopted to guarantee free access to abortion services are inadequate. Nevertheless, the Ministry of Health states that current Italian legislation, if appropriately applied, accommodates both the right to conscientious objection and the right to voluntary abortion.
One empirical argument used to demonstrate that conscientious objection does not create barriers to abortion is the "no correlation" argument, which the Italian Committee for Bioethics employed to demonstrate that no association exists between conscientious objection and waiting times for voluntary abortion in Italy and to support the weak form of conventional comprise adopted by the Italian legislation to balance the conflict between women' autonomy and healthcare professionals' moral integrity. Conversely, we showed how the "no correlation" argument fails to demonstrate the absence of a relationship between the number of conscientious objectors and waiting times for voluntary abortion, and that the limitations of the "no correlation" argument itself demonstrate how it is still difficult to describe the real effect of conscientious objection on the access to abortion services and to evaluate the suitability of conventional compromise to effectively balance conflicting moral principles.
Further studies are needed to better describe the relationship between conscientious objection and waiting times for voluntary abortion. If new evidence would show that the increasing proportion of objectors does undermine the efficacy of the Italian law and the right of a woman to freely obtain a voluntary abortion, new ways will need to be found to address the conflict between moral principles and restrict the protection accorded to the principle of moral integrity. This would inevitably imply the need to constrain and to redefine the terms and conditions for claiming conscientious objection.
在意大利，基于良心拒做堕胎手术的合法性问题持续引发激烈辩论。欧洲社会权利委员会在最近的两项裁决中强调，基于良心拒做堕胎手术使大多数意大利女性无法获得安全、合法且可及的护理和服务，并且意大利为保障免费堕胎服务所采取的措施并不充分。尽管如此，意大利卫生部表示，现行意大利法律若得到恰当实施，既能兼顾基于良心拒做堕胎手术的权利，也能保障自愿堕胎的权利。
一个用于证明基于良心拒做堕胎手术不会造成堕胎障碍的实证论据是“无关联”论据，意大利生物伦理委员会曾用此论据来证明在意大利基于良心拒做堕胎手术与自愿堕胎的等待时间之间不存在关联，并支持意大利立法所采用的传统折衷的弱形式，以平衡女性自主权与医护人员道德操守之间的冲突。相反，我们展示了“无关联”论据未能证明基于良心拒做堕胎手术者的数量与自愿堕胎等待时间之间不存在关系，而且“无关联”论据本身的局限性表明，要描述基于良心拒做堕胎手术对堕胎服务可及性的实际影响以及评估传统折衷方案对有效平衡相互冲突的道德原则的适用性仍然困难。
需要开展进一步研究，以更好地描述基于良心拒做堕胎手术与自愿堕胎等待时间之间的关系。如果新的证据表明反对者比例的增加确实损害了意大利法律的效力以及女性自由进行自愿堕胎的权利，就需要找到新的方法来解决道德原则之间的冲突，并限制对道德操守原则的保护。这将不可避免地意味着需要对基于良心拒做堕胎手术的申请条件进行限制和重新定义。
