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Conscientious objection in euthanasia and assisted suicide: A systematic review.

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Conscientious objection (CO) in euthanasia and assisted suicide (EAS) is debated, with differing views on its meaning and application. Dialogue is crucial for balancing professional conscience and patient rights.

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Area of Science:

  • Bioethics
  • Medical Law
  • Professional Ethics

Background:

  • Euthanasia and assisted suicide (EAS) legalization raises ethical concerns regarding healthcare professionals' conscientious objection (CO).
  • CO is viewed as both a protection of moral integrity and a potential barrier to patient access to care.
  • This review synthesizes ethical literature on CO in EAS, addressing its definition, ethical positions, and underlying presuppositions.

Purpose of the Study:

  • To comprehensively synthesize the ethical literature concerning conscientious objection (CO) in euthanasia and assisted suicide (EAS).
  • To clarify the meaning and application of CO within the context of EAS.
  • To identify and analyze the ethical positions and presuppositions shaping the debate on CO in EAS.

Main Methods:

  • Systematic review of argument-based publications using PRISMA, RESERVE, and TARCiS guidelines.
  • Searched 13 major databases across biomedical, philosophical, and theological literature without date or language restrictions.
  • Independent screening of titles and abstracts, followed by full-article selection based on predefined criteria.

Main Results:

  • 58 pertinent articles were reviewed, with 51 published between 2015-2024, indicating recent focus on the topic.
  • While the definition of CO is generally agreed upon, its interpretation and application in EAS remain contentious.
  • Three main ethical positions emerged: conscience absolutism, the compromise approach, and the incompatibility thesis, each with distinct supporting arguments and presuppositions regarding conscience, morality, religion, medicine, and end-of-life care.

Conclusions:

  • The debate on CO in EAS risks polarization, highlighting the need for dialogue between theoretical and context-sensitive perspectives.
  • Effective implementation of CO requires clearer guidelines to balance respect for conscience, patient rights, and professional responsibilities.
  • Further research and discussion are essential for navigating this complex ethical landscape.