- Email: [email protected]
Ethical guidelines on conscientious objection in training
International Journal of Gynecology and Obstetrics 128 (2015) 89–90
Contents lists available at ScienceDirect
International Journal of Gynecology and Obstetrics journal homepage: www.elsevier.com/locate/ijgo
FIGO COMMITTEE REPORT
Ethical guidelines on conscientious objection in training FIGO Committee for the Ethical Aspects of Human Reproduction and Women’s Health
The FIGO Committee for the Ethical Aspects of Human Reproduction and Women’s Health considers the ethical aspects of issues that impact the discipline of obstetrics, gynecology, and women’s health. The following document represents the result of that carefully researched and considered discussion. This material is intended to provide material for consideration and debate about these ethical aspects of our discipline for member organizations and their constituent membership. B. Dickens, Chair FIGO Committee for the Ethical Aspects of Human Reproduction and Women’s Health E-mail: figo@figo.org Website: www.figo.org Bernard Dickens University of Toronto Faculty of Law 84 Queen’s Park Toronto M5S 2C5, Canada Tel.: +1 416 978 4849 Fax: +1 416 978 7899 E-mail: [email protected]
Background 1. The primary commitment of obstetrician/gynecologists and those in training is to serve women’s reproductive health and well-being and foster a depth of knowledge that will allow them to offer the highest quality and safety of care possible both during training and when they are certified, whether in obstetrics/gynecology or in another specialty. 2. Medical students and postgraduate trainees may find themselves unable to train to deliver certain medically indicated care for reasons of their personal conscience. 3. Students and postgraduate trainees bear ethical responsibilities to women in whose care they are involved during training, and to the women who will expect a level of knowledge and training when they are qualified to practice. 4. Students and postgraduate trainees have duties to inform their teachers and/or supervisors of their conscientious objections in a timely fashion, to assure that alternate arrangements can be made to insure appropriate care of patients. 5. Students and postgraduate trainees have duties to inform their patients of all medically indicated options for their care, including options in which they decline to participate. 6. Students and postgraduate trainees are ethically bound to develop broad knowledge of medicine and reproductive science in order to apply this understanding to present and future patient care, and to not superimpose characterizations of procedures based on their personal beliefs that differ from professionally accepted medical evidence and/or guidelines. 7. When in an emergency, a patient’s life, or physical or mental health, can be preserved only by a procedure in which the student or postgraduate trainee usually objects to participate, and they cannot find a non-objecting trainee to render critical assistance in a timely way, the trainee, like a practitioner, must give priority to the patient’s life, health, and well-being by performing or participating in the indicated procedure. Guidelines 1. The primary conscientious duty of trainees in obstetrics and gynecology is at all times to treat, or provide benefit and prevent harm to, the patients in whose care they are involved. Any conscientious objection to treating a patient is secondary to this primary duty. 2. Provision of benefit and prevention of harm require that trainees assist in providing such patients with timely access to medical services, giving accurate information about the medically indicated options for their care, including any such procedures or care in which the trainee objects to participate on grounds of conscience. 3. Trainees have a professional duty to develop knowledge in and abide by scientifically and professionally determined definitions of reproductive health services, and to exercise care and integrity not to misrepresent or mischaracterize them on the basis of their personal beliefs. 4. Trainees have a right to respect for their conscientious convictions in regard to both undertaking and not undertaking the delivery of lawful procedures, and not to suffer discrimination on the basis of their convictions. 5. Trainees’ right to respect for their choices in the medical procedures and care in which they participate requires that they respect patient choices within the medically indicated options for their care.
http://dx.doi.org/10.1016/j.ijgo.2014.10.005 0020-7292/© 2014 Published by Elsevier Ireland Ltd. on behalf of International Federation of Gynecology and Obstetrics.
90
B. Dickens / International Journal of Gynecology and Obstetrics 128 (2015) 89–90
6. Trainees cannot decline training in procedures being performed for medically indicated purposes to which they cannot or do not object even though the same procedures can be used for medical indications to which they object. They should be trained, for instance, in management of abortion complications. 7. When in an emergency, a patient’s life, or physical or mental health, can be preserved only by a procedure in which the student or
postgraduate trainee usually objects to participate, and they cannot find a non-objecting trainee to render critical assistance in a timely way, the trainee, like a practitioner, must give priority to the patient’s life, health, and well-being by performing or participating in the indicated procedure. London, March 2014
Contents lists available at ScienceDirect
International Journal of Gynecology and Obstetrics journal homepage: www.elsevier.com/locate/ijgo
FIGO COMMITTEE REPORT
Ethical guidelines on conscientious objection in training FIGO Committee for the Ethical Aspects of Human Reproduction and Women’s Health
The FIGO Committee for the Ethical Aspects of Human Reproduction and Women’s Health considers the ethical aspects of issues that impact the discipline of obstetrics, gynecology, and women’s health. The following document represents the result of that carefully researched and considered discussion. This material is intended to provide material for consideration and debate about these ethical aspects of our discipline for member organizations and their constituent membership. B. Dickens, Chair FIGO Committee for the Ethical Aspects of Human Reproduction and Women’s Health E-mail: figo@figo.org Website: www.figo.org Bernard Dickens University of Toronto Faculty of Law 84 Queen’s Park Toronto M5S 2C5, Canada Tel.: +1 416 978 4849 Fax: +1 416 978 7899 E-mail: [email protected]
Background 1. The primary commitment of obstetrician/gynecologists and those in training is to serve women’s reproductive health and well-being and foster a depth of knowledge that will allow them to offer the highest quality and safety of care possible both during training and when they are certified, whether in obstetrics/gynecology or in another specialty. 2. Medical students and postgraduate trainees may find themselves unable to train to deliver certain medically indicated care for reasons of their personal conscience. 3. Students and postgraduate trainees bear ethical responsibilities to women in whose care they are involved during training, and to the women who will expect a level of knowledge and training when they are qualified to practice. 4. Students and postgraduate trainees have duties to inform their teachers and/or supervisors of their conscientious objections in a timely fashion, to assure that alternate arrangements can be made to insure appropriate care of patients. 5. Students and postgraduate trainees have duties to inform their patients of all medically indicated options for their care, including options in which they decline to participate. 6. Students and postgraduate trainees are ethically bound to develop broad knowledge of medicine and reproductive science in order to apply this understanding to present and future patient care, and to not superimpose characterizations of procedures based on their personal beliefs that differ from professionally accepted medical evidence and/or guidelines. 7. When in an emergency, a patient’s life, or physical or mental health, can be preserved only by a procedure in which the student or postgraduate trainee usually objects to participate, and they cannot find a non-objecting trainee to render critical assistance in a timely way, the trainee, like a practitioner, must give priority to the patient’s life, health, and well-being by performing or participating in the indicated procedure. Guidelines 1. The primary conscientious duty of trainees in obstetrics and gynecology is at all times to treat, or provide benefit and prevent harm to, the patients in whose care they are involved. Any conscientious objection to treating a patient is secondary to this primary duty. 2. Provision of benefit and prevention of harm require that trainees assist in providing such patients with timely access to medical services, giving accurate information about the medically indicated options for their care, including any such procedures or care in which the trainee objects to participate on grounds of conscience. 3. Trainees have a professional duty to develop knowledge in and abide by scientifically and professionally determined definitions of reproductive health services, and to exercise care and integrity not to misrepresent or mischaracterize them on the basis of their personal beliefs. 4. Trainees have a right to respect for their conscientious convictions in regard to both undertaking and not undertaking the delivery of lawful procedures, and not to suffer discrimination on the basis of their convictions. 5. Trainees’ right to respect for their choices in the medical procedures and care in which they participate requires that they respect patient choices within the medically indicated options for their care.
http://dx.doi.org/10.1016/j.ijgo.2014.10.005 0020-7292/© 2014 Published by Elsevier Ireland Ltd. on behalf of International Federation of Gynecology and Obstetrics.
90
B. Dickens / International Journal of Gynecology and Obstetrics 128 (2015) 89–90
6. Trainees cannot decline training in procedures being performed for medically indicated purposes to which they cannot or do not object even though the same procedures can be used for medical indications to which they object. They should be trained, for instance, in management of abortion complications. 7. When in an emergency, a patient’s life, or physical or mental health, can be preserved only by a procedure in which the student or
postgraduate trainee usually objects to participate, and they cannot find a non-objecting trainee to render critical assistance in a timely way, the trainee, like a practitioner, must give priority to the patient’s life, health, and well-being by performing or participating in the indicated procedure. London, March 2014