Kim Claire Junga
Department of Medical Education, Ewha Womans University College of Medicine, 52 Ewhayeodae-gil, Seodaemun-gu, Seoul, 03760, Republic of Korea.
BMC Med Ethics. 2020 Aug 6;21(1):70. doi: 10.1186/s12910-020-00512-3.
In 2019, the Constitutional Court of South Korea ruled that the anti-abortion provisions in the Criminal Act, which criminalize abortion, do not conform to the Constitution. This decision will lead to a total reversal of doctors' legal duty from the obligation to refuse abortion services to their requirement to provide them, given the Medical Service Act that states that a doctor may not refuse a request for treatment or assistance in childbirth. I argue, confined to abortion services in Korea that will take place in the near future, that doctors should be granted the legal right to exercise conscientious objection to abortion.
Considering that doctors in Korea have been ethically and legally obligated to refrain from abortions for many years, imposing a universal legal duty to provide abortions that does not allow exception may endanger the moral integrity of individual doctors who chose a career when abortion was illegal. The universal imposition of such a duty may result in repudiation of doctors as moral agents and damage trust in doctors that forms the basis of medical professionalism. Even if conscientious objection to abortion is granted as a legal right, most patients would experience no impediment to receiving abortion services because the healthcare environment of Korea provides options in which patients can choose their doctors based on prior information, there are many doctors who would be willing to provide an abortion, and Korea is a relatively small country. Finally, the responsibility to effectively balance and guarantee the respective rights of the two agents involved in abortion, the doctor and the patient, should be imposed on the government rather than individual doctors. This assertion is based on the government's past behaviours, the nature of its relationship with doctors, and the capacity it has to satisfy both doctors' right to conscientious objection and patients' right to legal medical services.
With regard to abortion services that will be sought in the near future, doctors should be granted the legal right to exercise conscientious objection based on the importance of doctor's moral integrity, lack of impediment to patients, and government responsibility.
2019年，韩国宪法法院裁定，《刑法》中将堕胎定为犯罪的反堕胎条款不符合宪法。鉴于《医疗服务法》规定医生不得拒绝治疗或分娩协助请求，这一决定将导致医生的法律义务从拒绝堕胎服务的义务彻底转变为提供堕胎服务的要求。我认为，就韩国近期即将进行的堕胎服务而言，应赋予医生出于良心拒行堕胎的合法权利。
鉴于韩国医生多年来在道德和法律上都有义务避免堕胎，强制规定普遍的提供堕胎的法律义务且不允许有例外情况，可能会危及那些在堕胎非法时选择从事该职业的个体医生的道德操守。普遍施加这样的义务可能会导致医生作为道德主体被否定，并损害对医生的信任，而这种信任是医学专业精神的基础。即使将出于良心拒行堕胎作为一项合法权利，大多数患者在接受堕胎服务时也不会受到阻碍，因为韩国的医疗环境提供了多种选择，患者可以根据事先了解的信息选择医生，有许多医生愿意提供堕胎服务，而且韩国是一个相对较小的国家。最后，有效平衡并保障堕胎所涉及的两个主体，即医生和患者各自权利的责任，应该由政府承担，而不是个体医生。这一主张基于政府过去的行为、其与医生的关系性质以及它满足医生出于良心拒行的权利和患者获得合法医疗服务权利的能力。
对于近期寻求的堕胎服务，基于医生道德操守的重要性、对患者无阻碍以及政府责任，应赋予医生出于良心拒行堕胎的合法权利。
