15760Columbia University, USA.
Nurs Ethics. 2020 Sep;27(6):1408-1417. doi: 10.1177/0969733020918926. Epub 2020 May 13.
In the medical field, conscientious objection is claimed by providers and pharmacists in an attempt to forgo administering select forms of sexual and reproductive healthcare services because they state it goes against their moral integrity. Such claim of conscientious objection may include refusing to administer emergency contraception to an individual with a medical need that is time-sensitive. Conscientious objection is first defined, and then a historical context is provided on the medical field's involvement with the issue. An explanation of emergency contraception's physiological effects is provided along with historical context of the use on emergency contraception in terms of United States Law. A comparison is given between the United States and other developed countries in regard to conscientious objection. Once an understanding of conscientious objection and emergency contraception is presented, arguments supporting and contradicting the claim are described. Opinions supporting conscientious objection include the support of moral integrity, religious diversity, and less regulation on government involvement in state law will be offered. Finally, arguments against the effects of conscientious objection with emergency contraception are explained in terms of financial implications and other repercussions for people in lower socioeconomic status groups, especially people of color. Although every clinician has the right and responsibility to treat according to their sense of responsibility or conscience, the ethical consequences of living by one's conscience are limiting and negatively impact underprivileged groups of people. It is the aim of this article to advocate against the use of provider's and pharmacist's right to claim conscientious objection due to the inequitable impact the practice has on people of color and individuals with lower incomes.
在医疗领域,医护人员和药剂师声称出于良心拒绝对某些特定形式的性健康和生殖健康护理服务,因为他们认为这违背了他们的道德操守。这种出于良心的拒绝对医护人员和药剂师的影响可能包括拒绝为有医疗需求且时间紧迫的个人提供紧急避孕措施。本文首先定义了出于良心拒绝对医护人员和药剂师的影响,然后提供了医疗领域参与这一问题的历史背景。本文还解释了紧急避孕的生理作用及其在美国法律中的使用历史背景。本文还对美国和其他发达国家在出于良心拒绝对医护人员和药剂师的影响问题上进行了比较。在介绍了出于良心拒绝对医护人员和药剂师的影响以及紧急避孕的相关内容后,本文还描述了支持和反对这一说法的论点。支持出于良心拒绝对医护人员和药剂师的观点包括对道德操守、宗教多样性和减少政府对州法律干预的支持。最后,本文还从经济影响和对处于较低社会经济地位群体(尤其是有色人种)的其他影响方面解释了反对出于良心拒绝对医护人员和药剂师的影响的论点。尽管每个临床医生都有根据自己的责任感或良心治疗的权利和责任,但按照自己的良心生活的伦理后果是有限的,并对弱势群体产生负面影响。本文的目的是反对医护人员和药剂师出于良心拒绝对医护人员和药剂师的影响的做法,因为这种做法对有色人种和收入较低的个人产生了不公平的影响。