Table 3 Moral Reasons
Moral Reasons | |
|---|---|
Respecting importance of conscience or CO (+ 11/− 1; rm.:24) | |
+ | Conscience is an inner voice that requires to be listened to (6) |
+ | Freedom of conscience is a moral right (4) |
+ | CO reflects objective moral truth (2) |
+ | Conflicts of conscience are a regular feature of moral life (2) |
+ | Degree of intensity and magnitude of an act underlies moral judgment (2) |
+ | Society and Values, individual liberty and autonomy (1) |
+ | Respects personal beliefs (1) |
- | Moral judgment leads to` values´ (2) |
+ | Conscience is the “law of the intellect” (1) |
+ | Conscience is related to personal identification (1) |
+ | Conscience implies a strong moral conviction (1) |
+ | Conscience involves a certain intensity of conviction (1) |
Criteria for CO (+ 9/−2; rm.:36) | |
- | Physicians must separate moral belief from professional life (9) |
+ | HCP’s position must be consistent with their other beliefs and actions (7) |
+ | Conscience is not one-sided (7) |
+ | HCP have differing attitudes towards conscience (2) |
+ | Objection must be to the treatment (2) |
+ | Position held must be sincere (2) |
+ | Rationale must reflect valid view of service’s goals (2) |
+ | Position emerges after alternatives considered (2) |
+ | Position must fit within coherent system of ethical beliefs (1) |
+ | Mystifying characteristic: Not backed by reason or logic (1) |
- | Position poses risk to HCP’s moral integrity (1) |
Moral integrity needs to be respected (+ 5/−1; rm.:22) | |
- | Women have an access right (12) |
+ | Acting against own conscience causes moral distress (4) |
+ | Patient has a moral right to informed consent and refusal (3) |
+ | Conscience may extend beyond moral reasoning (1) |
+ | Most compelling moral basis (1) |
+ | Protection of individual liberty (1) |
Normative value of CO (+ 4/−1; rm.:13) | |
+ | Fundamental principle of a pluralistic society (4) |
+ | Core of humanity (3) |
+ | Intrinsic value is autonomy and human flourishing (3) |
+ | Conscience is not infallible (2) |
- | CO as synonym for refusal to deliver abortions (1) |
CO protects HCP (+ 5/−0; rm.:9) | |
+ | Conscientious position is an “ethical position” of a HCP (5) |
+ | CO credits the individual conviction against general perception (1) |
+ | CO encompasses more than simply not performing the intervention (1) |
+ | CO considers one’s own conduct not that of another (1) |
+ | CO is a vehicle for HCP who regard such requests objectionable (1) |
Conscience is closely related to identity and sense of self (+ 4/−1; rm.:8) | |
+ | Conscience is central to being a whole person (2) |
+ | Conscience is experienced in relation to own actions (2) |
- | Toleration of moral diversity is plausible and questionable (2) |
+ | Conscience is a driver of human behaviour (1) |
+ | Failure to follow own conscience generates regret and guilt (1) |
Respect for autonomy (+ 3/−1; rm.:10) | |
- | CO may heighten risk for women living in precarious circumstances (5) |
+ | Value-neutral care is impossible to be provided (3) |
+ | Professional CO reflects autonomy of the profession (1) |
+ | Choices of the patient may be ethically unacceptable (1) |
Ignoring conscience of HCP is a form of discrimination (+ 3/− 0; rm.:3) | |
+ | Loss of self-respect (1) |
+ | Discrimination against well-performing practitioners (1) |
+ | Discrimination related to religious conscience (1) |
Requirement to offer a service (+ 1/−2; rm.:11) | |
- | Three main arguments for “access” can be rebutted (4) |
- | There are biased assumptions of forced access position (4) |
+ | Consequences follow when conscience rights are eliminated (3) |
Freedom of conscience (+ 2/−0; rm.:7) | |
+ | Both the “willing” / “refusing” provider have conscience (6) |
+ | Conscience is a societal value (1) |
Imposing own beliefs (+ 0/−2; rm.:7) | |
- | Violation of physician’s conscience (5) |
- | Patient care over adherence to religious doctrines or self-interest (2) |