Skip to main content

Table 3 Moral Reasons

From: Conscientious objection to participation in abortion by midwives and nurses: a systematic review of 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)