International journal of gynaecology and obstetrics : the official organ of the International Federation of Gynaecology and Obstetrics
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Int J Gynaecol Obstet · Dec 2013
ReviewConscientious objection and refusal to provide reproductive healthcare: a White Paper examining prevalence, health consequences, and policy responses.
Global Doctors for Choice-a transnational network of physician advocates for reproductive health and rights-began exploring the phenomenon of conscience-based refusal of reproductive healthcare as a result of increasing reports of harms worldwide. The present White Paper examines the prevalence and impact of such refusal and reviews policy efforts to balance individual conscience, autonomy in reproductive decision making, safeguards for health, and professional medical integrity. ⋯ Empirical evidence is essential for varied political actors as they respond with policies or regulations to the competing concerns at stake. Further research and training in diverse geopolitical settings are required. With dual commitments toward their own conscience and their obligations to patients' health and rights, providers and professional medical/public health societies must lead attempts to respond to conscience-based refusal and to safeguard reproductive health, medical integrity, and women's lives.
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Int J Gynaecol Obstet · Dec 2013
ReviewConscientious objection or fear of social stigma and unawareness of ethical obligations.
Conscientious objection is a legitimate right of physicians to reject the practice of actions that violate their ethical or moral principles. The application of that principle is being used in many countries as a justification to deny safe abortion care to women who have the legal right to have access to safe termination of pregnancy. ⋯ Any conscientious objection to treating a patient is secondary to this primary duty. One of the jobs of the FIGO Working Group for the Prevention of Unsafe Abortion is to change this paradigm and make our colleagues proud of providing legal abortion services that protect women's life and health, and concerned about disrespecting the human rights of women and professional ethical principles.
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Int J Gynaecol Obstet · Dec 2013
ReviewLegal and ethical standards for protecting women's human rights and the practice of conscientious objection in reproductive healthcare settings.
The practice of conscientious objection by healthcare workers is growing across the globe. It is most common in reproductive healthcare settings because of the religious or moral values placed on beliefs as to when life begins. It is often invoked in the context of abortion and contraceptive services, including the provision of information related to such services. ⋯ Under international human rights law, states have a positive obligation to act in this regard. While ethical and human rights standards regarding this issue are growing, they do not yet exhaustively cover all the situations in which women's health and human rights are in jeopardy because of the practice. The present article sets forth existing ethical and human rights standards on the issue and illustrates the need for further development and clarity on balancing these rights and interests.
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Several recent studies in low-resource countries have claimed that training in-and increased use of-newborn resuscitation resulted in reduced stillbirth rates. In the present article, we explore the ability of various types of birth attendant in some low-resource country locations to gather data that accurately differentiate a stillbirth from a live birth/early neonatal death. We conclude that, in many situations, it cannot be determined whether the infant was a stillbirth or a live birth/early neonatal death, and therefore the least-biased description of study outcomes includes a combined stillbirth and live birth/neonatal death outcome. However, because defining the burden of stillbirth and neonatal death is important from a public health perspective, every effort should be made, in low-income countries and elsewhere, to distinguish between stillbirths and live births/neonatal deaths and to report the results independently.
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Int J Gynaecol Obstet · Dec 2013
ReviewConscientious objection to provision of legal abortion care.
Despite advances in scientific evidence, technologies, and human rights rationale for providing safe abortion, a broad range of cultural, regulatory, and health system barriers that deter access to abortion continues to exist in many countries. When conscientious objection to provision of abortion becomes one of these barriers, it can create risks to women's health and the enjoyment of their human rights. To eliminate this barrier, states should implement regulations for healthcare providers on how to invoke conscientious objection without jeopardizing women's access to safe, legal abortion services, especially with regard to timely referral for care and in emergency cases when referral is not possible. In addition, states should take all necessary measures to ensure that all women and adolescents have the means to prevent unintended pregnancies and to obtain safe abortion.