{"title":"医疗保健中“良心反对”的起源:由于堕胎,医疗拒绝如何成为法律。","authors":"Christian Fiala, Joyce Arthur, Amelia Martzke","doi":"10.1017/jme.2025.46","DOIUrl":null,"url":null,"abstract":"<p><p>The United Kingdom was the first country to legalize the refusal to provide health care in the name of \"conscientious objection\", allowing doctors to refuse to provide abortions based on personal or religious beliefs.A historical review into the origins and motivation behind the \"conscientious objection\" clause in the 1967 Abortion Act found that Parliamentarians and the medical profession wanted to preserve doctors' authority over patients, protect objecting doctors from liability, and appease religious anti-abortion beliefs.These factors point to an unprincipled basis for the introduction of \"conscientious objection\" into healthcare, which ultimately came at the expense of patients' rights and health. The \"conscience clause\" also represented a negation of basic ethical directives in medical practice including patient autonomy and physicians' fiduciary duty to patients. The term \"conscientious objection\"- borrowed from the military but misapplied to healthcare - helped mask the practice as a moral \"right\" of doctors, even while it disregarded patients' health and dignity.Refusing to provide treatment on the basis of \"conscience\" is harmful and discriminatory, and should be phased out gradually using disincentives and other measures to encourage objectors to choose other fields.</p>","PeriodicalId":50165,"journal":{"name":"Journal of Law Medicine & Ethics","volume":" ","pages":"1-14"},"PeriodicalIF":1.6000,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12179533/pdf/","citationCount":"0","resultStr":"{\"title\":\"Origin of \\\"Conscientious Objection\\\" in Health Care: How Care Denials Became Enshrined into Law Because of Abortion.\",\"authors\":\"Christian Fiala, Joyce Arthur, Amelia Martzke\",\"doi\":\"10.1017/jme.2025.46\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>The United Kingdom was the first country to legalize the refusal to provide health care in the name of \\\"conscientious objection\\\", allowing doctors to refuse to provide abortions based on personal or religious beliefs.A historical review into the origins and motivation behind the \\\"conscientious objection\\\" clause in the 1967 Abortion Act found that Parliamentarians and the medical profession wanted to preserve doctors' authority over patients, protect objecting doctors from liability, and appease religious anti-abortion beliefs.These factors point to an unprincipled basis for the introduction of \\\"conscientious objection\\\" into healthcare, which ultimately came at the expense of patients' rights and health. The \\\"conscience clause\\\" also represented a negation of basic ethical directives in medical practice including patient autonomy and physicians' fiduciary duty to patients. The term \\\"conscientious objection\\\"- borrowed from the military but misapplied to healthcare - helped mask the practice as a moral \\\"right\\\" of doctors, even while it disregarded patients' health and dignity.Refusing to provide treatment on the basis of \\\"conscience\\\" is harmful and discriminatory, and should be phased out gradually using disincentives and other measures to encourage objectors to choose other fields.</p>\",\"PeriodicalId\":50165,\"journal\":{\"name\":\"Journal of Law Medicine & Ethics\",\"volume\":\" \",\"pages\":\"1-14\"},\"PeriodicalIF\":1.6000,\"publicationDate\":\"2025-05-09\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12179533/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Law Medicine & Ethics\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1017/jme.2025.46\",\"RegionNum\":4,\"RegionCategory\":\"哲学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"ETHICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Law Medicine & Ethics","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1017/jme.2025.46","RegionNum":4,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ETHICS","Score":null,"Total":0}
Origin of "Conscientious Objection" in Health Care: How Care Denials Became Enshrined into Law Because of Abortion.
The United Kingdom was the first country to legalize the refusal to provide health care in the name of "conscientious objection", allowing doctors to refuse to provide abortions based on personal or religious beliefs.A historical review into the origins and motivation behind the "conscientious objection" clause in the 1967 Abortion Act found that Parliamentarians and the medical profession wanted to preserve doctors' authority over patients, protect objecting doctors from liability, and appease religious anti-abortion beliefs.These factors point to an unprincipled basis for the introduction of "conscientious objection" into healthcare, which ultimately came at the expense of patients' rights and health. The "conscience clause" also represented a negation of basic ethical directives in medical practice including patient autonomy and physicians' fiduciary duty to patients. The term "conscientious objection"- borrowed from the military but misapplied to healthcare - helped mask the practice as a moral "right" of doctors, even while it disregarded patients' health and dignity.Refusing to provide treatment on the basis of "conscience" is harmful and discriminatory, and should be phased out gradually using disincentives and other measures to encourage objectors to choose other fields.
期刊介绍:
Material published in The Journal of Law, Medicine & Ethics (JLME) contributes to the educational mission of The American Society of Law, Medicine & Ethics, covering public health, health disparities, patient safety and quality of care, and biomedical science and research. It provides articles on such timely topics as health care quality and access, managed care, pain relief, genetics, child/maternal health, reproductive health, informed consent, assisted dying, ethics committees, HIV/AIDS, and public health. Symposium issues review significant policy developments, health law court decisions, and books.