This page lists writings by Joyce Arthur and/or Christian Fiala (Our Publications).
It also lists those of colleagues who agree that belief-based care denial is incompatible with medical professionalism and ethics (Publications by Others).
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(Apr 2025) How to discourage belief-based denial of abortion care
Christian Fiala & Joyce Arthur Published online: 03 Apr 2025 The European Journal of Contraception & Reproductive Health Care, 1–5https://doi.org/10.1080/13625187.2025.2482828 Abstract The exercise of so-called ‘conscientious objection’ in reproductive healthcare is unchecked and subject to widespread abuse. A growing body of evidence shows that the practice creates significant harms for patients needing abortions by delaying their […]
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(Nov 2024) Countries that Disallow Belief-based Care Denial
It has been claimed by various researchers or NGOs that certain countries do not allow belief-based care denial (aka “conscientious objection”) in reproductive healthcare or healthcare in general. This document examines those claims for each of the named countries. Only three countries were found to explicitly disallow the practice – Ethiopia, Finland, and Sweden. PDF […]
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(Oct 2024) Article: Belief-based care denial – Let’s change the terms of the debate
The term “conscientious objection” is dishonest when applied to healthcare. A more accurate term is Belief-based care denial. This phrase makes it clear that treatment is being refused due to ideological reasons and not clinical considerations. Care denials are not conscientious because they cause harms to patients and create barriers to care. The new term […]
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(Sep 2024) Presentation: Origin of “Conscientious Objection” in Health Care
How Belief-Based Care Denial Became Enshrined into Law Because of Abortion The United Kingdom was the first country to officially allow care denials based on “conscientious objection” by health care professionals – in the 1967 Abortion Act. The motivations for adding the “conscience clause” were rooted in moral opposition to abortion, Catholic religious beliefs against […]
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(Sep 2024) Study: 100% of patients who were denied care oppose “Conscientious Objection”
Belief-based care denial harms patients seeking reproductive care Healthcare providers in Canada are allowed by professional associations to deny services on the basis of their personal beliefs or conscience. But allowing healthcare providers to deny care based on their personal beliefs creates barriers to accessing necessary health services. Policymakers and clinicians should reform regulations with […]
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(Sep 2024) Poster: Belief-Based Care Denial – Let’s Change the Terms of the Debate
We should ditch the misleading phrase “conscientious objection,” which has become nothing more than an anti-choice propaganda term. Let’s adopt the term belief-based care denial instead. Why should society allow belief-based care denial when we have clear evidence of its harms and of the necessity of access to abortion? Supporting it just cedes ground to […]
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(Aug 2023) What International Human Rights Groups and Agreements, and Global Health Orgs, Say About “Conscientious Objection” in Healthcare
This document is a compilation of everything relevant to “conscientious objection” in reproductive healthcare, as contained in international human rights agreements, and guidelines/reports by global health and human rights groups and governing bodies that have weighed in on the topic. The excerpts are contextualized by the view that “CO” in healthcare is inappropriate, unworkable, and […]
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(2023) The Impact of ‘conscientious objection’ on abortion-related outcomes: A synthesis of legal and health evidence
by Fiona de Londras Amanda Cleeve, Maria I. Rodriguez, Alana Farrell, Magdalena Furgalska, Antonella F. Lavelanet Health Policy, Volume 129, March 2023, 104716 Note: The authors stop short of concluding that Belief-based Care Denial should not be allowed despite finding significant evidence that it is unworkable. Their recommendation to centre abortion seekers in the regulation of “conscientious objection” is not realistic without ending or largely […]
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(2022) Conscientious objection as structural violence in the voluntary termination of pregnancy in Chile
by Adela Montero, Mirliana Ramirez-Pereira, Paz Robledo, Lidia Casas, Lieta Vivaldi, Daniela Gonzalez Frontiers in Psychology, Vol. 13. November 2, 2022 Introduction: After three decades of the absolute prohibition of abortion, Chile enacted Law 21,030, which decriminalizes voluntary pregnancy termination when the person is at vital risk, when the embryo or fetus suffers from a congenital […]
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(2021) ESCRH’s Position Paper on SRHR should not tolerate the denial of care due to personal beliefs
The Editor of the European Journal of Contraception and Reproductive Health Care initially accepted this article for publication, then recanted. The journal refused to publish the paper because peer reviewers supported the denial of reproductive healthcare by healthcare professionals who oppose such care based on their personal beliefs. Download PDF(4 pages)
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(2021) The highly complex issue of conscientious objection to abortion
Can the recent European Court of Human Rights ruling Grimmark v. Sweden redefine the notions of care before freedom of conscience? by Simona Zaami, Raffaella Rinaldi & Gianluca Montanari Vergallo The European Journal of Contraception & Reproductive Health Care, Volume 26, 2021 – Issue 4 Abstract Purpose: The article aims to elaborate on two recent European Court […]
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(2020) Beyond Money: Conscientious Objection in Medicine as a Conflict of Interest
Alberto Giubilini & Julian Savulescu Journal of Bioethical Inquiry, Vol 17, pgs 229–243 (May 2020) Abstract Conflict of interests (COIs) in medicine are typically taken to be financial in nature: it is often assumed that a COI occurs when a healthcare practitioner’s financial interest conflicts with patients’ interests, public health interests, or professional obligations more […]
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(May 2020) The inequity of conscientious objection: Refusal of emergency contraception
Chelsey Yang, May 13, 2020, Nursing Ethics, 27:6; 1408-1417. https://doi.org/10.1177/0969733020918926 Abstract 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 […]
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(2020) Implementing the liberalized abortion law in Kigali, Rwanda: Ambiguities of rights and responsibilities among health care providers
Jessica Påfs, Stephen Rulisa, Marie Klingberg-Allvin, Pauline Binder-Finnema, Aimable Musafili, Birgitta Essén et al January 2020 Midwifery, Vol 80, 102568 Partial Abstract Objective: Rwanda amended its abortions law in 2012 to allow for induced abortion under certain circumstances. We explore how Rwandan health care providers (HCP) understand the law and implement it in their clinical […]
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(Aug 2018) Lessons learnt from the past: “Conscientious objection” to abortion in Chile will lead to widespread disobedience of the new law
August 6, 2018 By Christian Fiala and Joyce H Arthur Authors Montero and Villarroel discuss problems that might arise from “conscientious objection” (CO) to the new law in Chile that legalized abortion in cases of life endangerment of the woman, fatal fetal abnormality, and rape. (“A critical review of conscientious objection and decriminalisation of abortion […]
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(Aug 2018) On the Revolutionary Road to Reproductive Justice
by Michelle Truong, International Women’s Health Coalition August 6, 2018 Dr. Willie Parker is an abortion provider because of, not despite, his Christian faith. At a moment when refusal of care due to conscience claims obstructs reproductive justice, emphasizing the role conscience plays in compassionate and ethical medical care, as Dr. Parker does, means a […]
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(July 2018) Religious Refusals and Reproductive Rights: Claims of Conscience as Discrimination and Shaming
By Louise Melling Chapter 14 – Religious Refusals and Reproductive Rights, from Part IV – Conscience, Accommodation and Its Harms. Edited by Susanna Mancini, Università di Bologna, Michel Rosenfeld. Publisher: Cambridge University Press DOI: https://doi.org/10.1017/9781316780053.015 Relevant excerpt: The stories from Indiana and Arizona illustrate the different way in which we currently view refusals to serve […]
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(July 2018) Seeking to Square the Circle: A Sustainable Conscientious Objection in Reproductive Healthcare
Emmanuelle Bribosia and Isabelle Rorive Chapter 15 in: The Conscience Wars: Rethinking the Balance between Religion, Identity, and Equality, ed. Susanna Mancini and Michel Rosenfeld (Cambridge, UK: Cambridge University Press, 2018) pp. 392-413. DOI: https://doi.org/10.1017/9781316780053.016 From Book Introduction: [In this chapter, the authors] focus on the practical and conceptual difficulties in reconciling the reproductive rights of […]
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(July 2018) IWHC Brief to Constitutional Court of Colombia: Abortion Restrictions are Ineffective and Harmful
New York City, United States, 18 July 2018 To: Señora Magistrada CRISTINA PARDO SCHLESINGER, Corte Constitucional, E.S.D. The International Women’s Health Coalition (IWHC) submitted an amicus brief to the Constitutional Court of Colombia, urging the court to defend women’s rights and health by upholding the right to safe and legal abortion. In October 2018, the […]
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(July 2018) Provider Conscientious Refusal, Medical Malpractice, and the Right to Civil Recourse
by Jane A. Hartsock American Journal of Bioethics, 18:7, 66-68 DOI: 10.1080/15265161.2018.1478020 Nelson (2018) argues that where death results from conscientious refusal to provide abortion services in an obstetrical emergency, clinicians and institutions should be held criminally liable for homicide. I wholeheartedly endorse Nelson’s position and add the following additional observations: (1) Clinicians and institutions […]