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Table 4 Practical Reasons

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

Practical Reasons
Institutional refusal (+ 4/− 10; rm.:23)
- Greater risk of patient injury in emergencies (3)
- Patients have fewer options (3)
- Fear that CO becomes widespread (2)
- Encourages refusal unrelated to moral reasoning (2)
- CO as exemption from general duties to obey the law (2)
+ CO cannot be limited to individuals (2)
+ Ethical and religious directives for Catholic health care (2)
+ May help HCP to change initial view (1)
+ Undervaluation of moral associations (1)
- Limits patient access (1)
- Failure of dissenting staff for emergencies (1)
- Best practice may not be possible for the HCP (1)
- Right to refuse may end in right to dictate care (1)
- Conflicts between CO and medical technologies (1)
Justifying professional CO (+ 3/−3; rm.:9)
- No common sense of what is “wrong” causes no need for provision (3)
+ CO is evidence-based (2)
- HCP with strong CO is torn between belief and requirement (1)
- Formalistic argument to provide no exemption officials (1)
+ Institutions can be selective in offering services (1)
+ HCP may lack the intellectual or verbal skill to express CO (1)
Practice of disclosure creates risk for the HCP (+ 5/−0; rm.:13)
+ Professional disadvantages (7)
+ Suffers embarrassment and inconvenience (2)
+ Vulnerable to attacks from the other side (2)
+ Disadvantages in asserting claims (1)
+ Experiences personal safety in danger (1)
Degree of involvement among HCP is different (+ 1/− 2; rm.:5)
+ Expectations change over time (2)
- Intrinsic relevance is debatable (2)
- Function in a job is straightforward (1)
Organisational ethics require consideration (+ 1/−1; rm.:2)
- Choices constrained in emergencies when the closest hospital is far off (1)
+ Benefit for society (1)