At least 100 countries have provisions that allow so-called “conscientious objection” in health care, according to REDAAS (Safe Abortion Access Network of Argentina).
What International Human Rights Groups and Agreements, and Global Health Orgs, Say About “Conscientious Objection” in Healthcare
August 2024: 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 not a right.
Compiled by Joyce Arthur, Initiative for Reproductive Health Information (IRHI)
Access full document here (PDF): Intl-groups-agreements-CO
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Countries that Disallow Belief-based Care Denial
Nov 2024: It has been claimed by various researchers or NGOs over the years 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 from a variety of sources. Only three countries were found to […]
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Countries without CO
Yes We Can! Successful Examples of Disallowing ‘Conscientious Objection’ in Reproductive Health Care Christian Fiala, Kristina Gemzell Danielsson, Oskari Heikinheimo, Jens A. Guðmundsson and Joyce Arthur European Journal of Contraception & Reproductive Health Care, Vol 21, 2016 – Issue 3 Abstract Reproductive health care is the only field in medicine where health care professionals (HCPs) […]
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Croatia
Conscience-based refusal in reproductive medicine by Sanja Cesar Published 2017 Abstract (shortened and edited) This paper explains the legal principle of conscience-based refusal in reproductive medicine; analyses legislation, politics, and practice regarding refusal of health care services provision on conscientious grounds in the Republic of Croatia; and indicates the problems in legislation and practice that […]
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United States
Is Your Health Care Compromised? How the Catholic Directives Make for Unhealthy Choices CATHOLICS FOR CHOICE 2017 At a time in US history when healthcare can be challenging to access even by those with good insurance coverage, how is it possible to say that Catholic healthcare can be bad for your health? This report will […]
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Norway
Conscientious objection to referrals for abortion: pragmatic solution or threat to women’s rights? Eva M Kibsgaard Nordberg, Helge Skirbekk and Morten Magelssen BMC Medical Ethics Feb 26, 2014 https://doi.org/10.1186/1472-6939-15-15 Abstract Background: Conscientious objection has spurred impassioned debate in many Western countries. Some Norwegian general practitioners (GPs) refuse to refer for abortion. Little is know about […]
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Canada
Canadian Policies and Laws on “Conscientious Objection” in Health Care August 2023 This Appendix [to the above paper] describes and critiques the policies of the Canadian Medical Association (CMA) and each College of Physicians and Surgeons across Canada as they relate to the refusal to treat and obligation to refer , in particular for abortion […]
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Latin America
How ‘conscientious objectors’ threaten women’s newly-won abortion rights in Latin AmericaFrom Uruguay to Chile, medical staff are refusing to provide abortion services even after their legalisation. Diana Cariboni18 July 2018 Women’s rights to legal abortion have increased in Latin America – but so have campaigns and policies for medical staff to be able to ‘conscientiously […]
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Colombia
Improper Use of Conscientious Objection in Bogotá, Colombia, Presents a Barrier to Safe, Legal Abortion CareNew Study Identifies Avenues for Intervention August 10, 2016, News Release Health care providers who invoke conscientious objection to providing or participating in abortion care in Bogotá, Colombia, can be categorized along a spectrum of objection—extreme, moderate and partial—finds a […]
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Ghana
Prevalence of conscientious objection to legal abortion among clinicians in northern Ghana John K. Awoonor-Williams, Peter Baffoe, Philip K. Ayivor, Chris Fofie, Sheila Desai, Wendy Chavkin, Int J Gynecol Obstet 2017; 140: 31–36 Abstract: Objective: To assess the prevalence of conscientious objection (CO), motivations, knowledge of Ghana’s abortion law, attitudes, and behaviors toward abortion provision […]
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Poland
Dispatches: Abortion and the ‘Conscience Clause’ in Poland October 22, 2014 Hillary Margolis Researcher, Women’s Rights Division Poland is one of a select few countries in Europe where access to abortion remains extremely limited: it’s a crime to terminate a pregnancy except in cases of risk to the mother’s life or health, severe fetal abnormality, […]
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Italy
Abortion in Italy: how widespread ‘conscientious objection’ threatens women’s health and rights Claudia Torrisi, 15 June 2017 Almost 40 years after abortion was legalised – amid mass protests and a broader cultural liberation movement – women still struggle to access crucial services. A mass in St. Peter’s Square at the Vatican. A mass in St. […]
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Europe
Freedom of conscience in Europe? An analysis of three cases of midwives with conscientious objection to abortion. Fleming V, Ramsayer B, Škodič Zakšek T.J Med Ethics. 2018 Feb;44(2):104-108doi: 10.1136/medethics-2016-103529. Epub 2017 Jul 29. Abstract While abortion has been legal in most developed countries for many years, the topic remains controversial. A major area of controversy […]
Historical papers
A 2014 white paper from Global Doctors for Choice “examines the prevalence and impact of such refusals [CO] and reviews policy efforts to balance individual conscience, autonomy in reproductive decision making, safeguards for health, and professional medical integrity.” The authors discuss a range of CO policies and laws around the world, drawing upon medical, public health, legal, ethical, and social science literature of the past 15 years (since 2013) in English, French, German, Italian, Portuguese, and Spanish.
Read full report: Global Doctors for Choice – Conscientious objection and refusal to provide reproductive healthcare: A white paper examining prevalence, health consequences, and policy responses, by Wendy Chavkin, Liddy Leitman, and Kate Polin. (Note: Authors are biased in favour of “balancing” refusals with patients’ right to healthcare.)
Many countries have enshrined CO into law (Heino et al. 2013):
- Austrian law states: No one may be in any way disadvantaged . . . because he or she has refused to perform or take part in such an abortion. (Government of Austria,1975)
- France’s law says: A doctor is never required to per-form an abortion but must inform, without delay, his/her refusal and provide immediately the name of practitioners who may perform this procedure. . . No mid-wife, no nurse, no paramedic, whatever is required to contribute to an abortion. . . . A private health establishment may refuse to have abortions performed on its premises. (Government of France, 2001)
- Even though the Australian state of Victoria decriminalized abortion in 2008, the new law retains a CO clause:If a woman requests a registered health practitioner to advise on a proposed abortion, or to perform, direct, authorise or supervise an abortion for that woman, and the practitioner has a conscientious objection to abortion, the practitioner must refer the woman to another registered health practitioner [who] does not have a conscientious objection to abortion. (Australasian Legal Information Institute, 2010)
- In the United States, almost every state has passed refusal clauses allowing physicians to opt out of providing abortions and other services. In addition, federal law protects doctors and nurses who do not want to perform abortions or sterilizations, and allows health workers to file complaints if they feel discriminated against (Huffington Post,2011).