Abortion and Health Care Ethics

Unfortunately for Kate, a private faith-based healthcare institution in the United States generally has a legal right to refuse access to abortion based on the principle of conscientious objection (Levin, 2016; Fiala & Arthur, 2017). Conscientious objection refers to the health care provider (or in this case, the insurance provider’s) ability to refuse to take action based on religious principles or beliefs. In this case, and in all similar cases, the legal right to refuse treatment should be separated from Kate’s rights as a patient.
Ultimately, Kate’s rights to ethical treatment, medical justice, and autonomy far outweigh the hospital’s right to conscientious objection. The only compromise that can possibly be reached in this case would be for the institution to refer Kate to a nearby institution that could perform the procedure. If, however, no such institution existed then Kate must be able to access the abortion services through her primary care facility. As Fiala & Arthur (2017) point out, conscientious objection in health care “should not be considered a right, but an unethical refusal to treat,” (p. 254). A doctor has professional obligations to the patient that supersede the doctor’s personal beliefs. Put another way, “introducing religion into medicine undermines best practices that depend on scientific evidence and medical ethics,” (p. 254). There is no medical reason to refuse the patient’s abortion.
Refusing the right to conscientious objection in no way detracts from the tremendous benefits in forging relationships between faith-based health care plans and institutions and their communities. As Levin (2016) points out, spirituality and religion play important roles in holistic care. If an institution wishes to uphold the tenets of the faith that provides financial support for its operations, then that ideal must be tempered with the overarching medical ethic that should be—but is not yet—entrenched in law. Health care is a universal human right, not a commodity. Only a commodity-driven or market-driven view of health care could conceive of conscientious objection as a more inalienable right than a patient’s right to receive treatment. If Kate lived in an area with plentiful healthcare options and a healthcare plan that covers abortion, then there would be less of an ethical dilemma. As Rosell (n.d.) presents the facts, though, Kate’s insurance provider is actually presided over and managed by a faith-based organization. This represents a potential conflict of interest. No health care insurance should categorically deny a patient access to an essential service. Forcing Kate to have a child is an inhumane solution; Kate’s human rights and human liberties are much more important than presumed ascription to religious ideals. The healthcare system is secular, and must stay that way even when the faith-based sector does provided much-needed financial support for services. Religious organizations need to recognize that they coexist in a pluralistic society, one in which no law can favor one religion over another. The Constitution expressly guarantees this.
Until a federal injunction exists that categorically denies any insurance provider or health care institution the right to conscientious objection to abortion, it is the ethical duty of the staff to provide Kate with the services she needs. Patient autonomy and beneficence are the two most obvious ethical tenets guiding healthcare decisions in this case. Other ethical tenets like procedural and distributive justice are also important to consider when weighing the merits of this case. Kate’s background as a person who does not routinely view abortion as a means of birth control shows that she is making this decision with sound mind, and should be viewed as an adult and not as a minor. At 17, Kate has legal emancipation and therefore has a legal right to the same ethical considerations of a citizen who has reached the age of majority. The healthcare workers in this case have a moral obligation to advocate on behalf of Kate, finding out ways they can direct Kate to affordable, safe, and legal abortion services.





References

Fiala, C. & Arthur, J.H. (2017). There is no defense for ‘conscientious objection” in reproductive health care. European Journal of Obstetrics and Gynecology and Reproductive Biology 216(2017): 254-258.
Levin, J. (2016). Partnerships between faith-based and medical sectors. Prev Med Rep 2016(4): 344-350.
Rosell, T. (n.d.). Abortion rights and/or wrongs. Center for Practical Bioethics. http://practicalbioethics.org/case-studies-abortion-rights-and-or-wrongs