Conscientious objection, harm reduction and abortion care

Abstract

The scope of any legal right to refuse abortion care merits particular consideration given the recent passing of the Protection of Life During Pregnancy Act 2013 (PLDPA). Irish health scholarship and practice may benefit from an account of conscientious objection (CO) that clarifies when CO is legitimately engaged by a refusal to provide care and whether CO is limited given its potential effect as a barrier to women’s lawful access to abortion. This chapter responds to these concerns by arguing for a harm reduction approach to conscientious objection. Those who wish to refuse provision of healthcare in spite of a legal obligation, and those who wish to provide healthcare in spite of a legal prohibition, may be harmed by having to act against their most intimate convictions. Moreover, public reasoning about the proper scope of healthcare provision could be disadvantaged by a failure to recognize a space for critical consciousness. The need to reduce the risk of harm to women, whose lawful entitlement to access abortion has been hard-won, also animates the justification for legal limits on CO. In arguing for a harm reduction approach, the account offered here draws on but distinguishes itself from those who have relied on public obligations to refute CO and those who have relied on an individual right to moral integrity to ground CO.