A scoping review of conscientious objection in pharmacy practice

Area of Science:

• Pharmacy Practice
• Bioethics
• Healthcare Professional Ethics

Background:

• Conscientious objection (CO) presents challenges in aligning personal values with professional obligations in patient-centered care.
• Limited research exists on pharmacists' perspectives and experiences with CO.
• This review maps current literature on pharmacists' views regarding CO.

Purpose of the Study:

• To explore and map published literature on pharmacists' views on conscientious objection (CO).
• To identify services involved in CO, prevailing attitudes, and decision-making factors for pharmacists.

Main Methods:

• A comprehensive literature search was performed across five major databases.
• The search focused on primary literature from the past 20 years reporting pharmacists' views on CO.

Main Results:

• 18 articles from 16 studies were included, utilizing quantitative surveys, qualitative interviews, and a modified Delphi study.
• Pharmacists commonly objected to hormonal contraception and abortifacient medications due to professional, religious, and autonomy factors.
• Decision-making considered service type, patient impact, and continuity of care concerns.

Conclusions:

• Pharmacists balance personal beliefs with professional responsibilities, influenced by intrapersonal and environmental factors.
• Referral can ensure continuity of care, but requires robust legal and ethical frameworks.
• Profession-specific research and strengthened frameworks are crucial for policy and patient care.