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Conscientious objection and barriers to abortion within a specific regional context - an expert interview study
Robin Krawutschke1, Tania Pastrana2, Dagmar Schmitz3
1Institute for History, Theory and Ethics in Medicine, RWTH Aachen University, Wendlingweg 2, Aachen, D-52074, Germany. robin.krawutschke@rwth-aachen.de.
BMC Medical Ethics
|February 6, 2024
Summary
Conscientious objection (CO) in Germany may create barriers to abortion access, particularly for late-term procedures. Obliging hospitals to provide abortions could mitigate these negative impacts on women's rights.
Area of Science:
- Medical Ethics
- Public Health Policy
- Reproductive Health Services
Background:
- Most countries permitting abortion allow physician conscientious objection (CO), which can impede access.
- The impact of CO on abortion access in Germany remains understudied.
- This study examines abortion processes and CO effects in a German city.
Purpose of the Study:
- To reconstruct abortion processes in a German city.
- To identify the effects of conscientious objection on abortion access.
- To analyze the impact of CO on healthcare structures and patient care.
Main Methods:
- Conducted five semi-structured expert interviews in April 2020.
- Interviewees provided insights into abortion care, CO practices, and impacts.
- Performed content analysis on transcribed interviews.
Main Results:
- CO effects differ between early and late abortions, posing structural barriers.
- CO reduces provider availability, especially for early abortions.
- Late abortions are particularly vulnerable to CO-related barriers in individual encounters.
Conclusions:
- CO potentially creates barriers to both early and late abortion provision.
- Ethical concerns arise from CO's impact on final procedural steps.
- Mandating hospital participation in abortion provision could protect women's rights.
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