{"id":9564,"date":"2017-11-23T13:56:50","date_gmt":"2017-11-23T13:56:50","guid":{"rendered":"https:\/\/www.wma.net\/wp-content\/uploads\/2017\/05\/Gastmans-WMA-EoL-Presentation-Vatican-Nov2017.pdf"},"modified":"2017-11-23T13:56:50","modified_gmt":"2017-11-23T13:56:50","slug":"gastmans-wma-eol-presentation-vatican-nov2017-2","status":"inherit","type":"attachment","link":"https:\/\/www.wma.net\/fr\/gastmans-wma-eol-presentation-vatican-nov2017-2\/","title":{"rendered":"Gastmans-WMA EoL Presentation Vatican-Nov2017"},"author":5,"comment_status":"closed","ping_status":"closed","template":"","meta":[],"acf":[],"description":{"rendered":"

\"\"<\/a><\/p>\n

1
\nConscientious objections
\nin end-of-life care
\nChris Gastmans
\nKU Leuven, Belgium
\nIntroduction
\nn Belgian euthanasia act came into force in 2002
\nn Interesting case to study relationships between
\nculture, religion, and end-of-life care
\nn Flanders: cultural transformation from dominant
\nChristian culture into post-traditional Christian,
\npluralist culture, characterized by ideological
\ndiversity
\nn Appropriateness of conscientious objections
\nremains controversial
\nn How can personal ethical convictions and beliefs of
\nindividual caregivers (conscientious objections) be
\nrespected?
\nArgument-based
\nliterature review:
\nmethodology
\nn Focused questions:
\n– What are the primary positions
\naddressing conscientious objections in
\nend-of-life care?
\n– Upon what arguments are these
\npositions based?
\nArgument-based
\nliterature review:
\nmethodology
\nn Search methods:
\n– Pubmed, Embase, Cinahl, Web of
\nScience, Philosopher\u2019s Index
\n– Argument-based literature
\n– Excluded: empirical studies, editorials,
\ncomments, case studies, ethics codes,
\nposition papers
\nArgument-based
\nliterature review:
\nmethodology
\nn Nonconventional compatibilists
\nn Conventional compatibilists
\nn Conventional incompatibilists
\nConscientious objections:
\n3 categories
\nn Non-conventional compatibilists
\n– Socio-cultural conventions do not serve as a
\nvalid basis to override CO
\n– Right to personal objection is compatible
\nwith professional obligations
\n– No dichotomy between personal moral
\nobligation and professional obligation
\n– Moral person is viewed holistically
\n– When individual is compelled to act against
\nhis conscience, his personal identity is
\nviolated, resulting in moral distress
\n2
\nConscientious objections:
\n3 categories
\n– Obligation to provide continuum of
\ncare until transfer to another caregiver
\n– Obligation to disclose objections to
\ninvolved parties
\n– Religious sourced, e.g. Edmund
\nPellegrino
\nConscientious objections:
\n3 categories
\nn Conventional compatibilists
\n– Conscientious objections are compatible
\nwith professional obligations so long as
\nconventional standards of society permit
\nsuch objection
\n– Willingness to disclose their positions
\n– Willingness to cooperate in referral
\n– Patient may not be burdened (counseling)
\n– Social contract theory and individual
\nautonomy, e.g. Dan Brock
\n– Care relation as contract between 2
\nparticipants to respect their beliefs, \u2026
\nConscientious objections:
\n3 categories
\nn Conventional incompatibilists
\n– Conscientious objection is personal
\npreference and is incompatible with
\ncaregiver\u2019s professional obligation to render
\nlegally accepted services according to
\nsocietal conventions
\n– Patient autonomy should be of greater
\nimportance than physician autonomy
\n– Society expects that physician will not
\nchoose treatments by referring to their own
\npersonal preferences.
\nConscientious objections:
\n3 categories
\n– Temporary toleration until
\nconscientious objections are made
\nillegal
\n– Secular progressive, e.g. Julian
\nSavulescu
\nDiscussion
\nn Unsolvable clash?: conscience is part
\nof identity of whole person versus
\nconscience is personally acquired
\nsocial construct
\nDiscussion
\nn Agreement:
\n– Patient should be adequately informed
\nabout conscientious objection;
\n– Disclosure at the beginning of care
\nrelationship;
\n– Cooperation in transfer.
\n3
\nDiscussion
\nn Argument contra:
\n– Negative impact on patient\u2019s
\nautonomy
\nn Argument pro:
\n– Making CO illegal would de-motivate
\nsome people to become a physician
\n– How providing good care when you
\nshould act against your conscience?
\nReferences
\nn Wernow J., Gastmans C. (2010) A Review and taxonomy of
\nargument-based ethics literature regarding conscientious
\nobjections to end-of-life procedures. Christian Bioethics 16,
\n274-295.
\nn Lemiengre J. et al. (2009) Content analysis of euthanasia
\npolicies of nursing homes in Flanders (Belgium). Medicine,
\nHealth Care and Philosophy 12, 313-322.
\nn Gastmans C. et al. (2006) Pluralism and ethical dialogue in
\nChristian healthcare institutions. The view of Caritas Catholica
\nFlanders. Christian Bioethics 12,265-280.<\/p>\n"},"caption":{"rendered":"

1 Conscientious objections in end-of-life care Chris Gastmans KU Leuven, Belgium Introduction n Belgian euthanasia act came into force in 2002 n Interesting case to study relationships between culture, religion, and end-of-life care n Flanders: cultural transformation from dominant Christian culture into post-traditional Christian, pluralist culture, characterized by ideological diversity n Appropriateness of conscientious objections […]<\/p>\n"},"alt_text":"","media_type":"file","mime_type":"application\/pdf","media_details":{"sizes":{"thumbnail":{"file":"Gastmans-WMA-EoL-Presentation-Vatican-Nov2017-pdf-106x150.jpg","width":106,"height":150,"mime_type":"image\/jpeg","source_url":"https:\/\/www.wma.net\/wp-content\/uploads\/2017\/05\/Gastmans-WMA-EoL-Presentation-Vatican-Nov2017-pdf-106x150.jpg"},"medium":{"file":"Gastmans-WMA-EoL-Presentation-Vatican-Nov2017-pdf-212x300.jpg","width":212,"height":300,"mime_type":"image\/jpeg","source_url":"https:\/\/www.wma.net\/wp-content\/uploads\/2017\/05\/Gastmans-WMA-EoL-Presentation-Vatican-Nov2017-pdf-212x300.jpg"},"large":{"file":"Gastmans-WMA-EoL-Presentation-Vatican-Nov2017-pdf-724x1024.jpg","width":724,"height":1024,"mime_type":"image\/jpeg","source_url":"https:\/\/www.wma.net\/wp-content\/uploads\/2017\/05\/Gastmans-WMA-EoL-Presentation-Vatican-Nov2017-pdf-724x1024.jpg"},"full":{"file":"Gastmans-WMA-EoL-Presentation-Vatican-Nov2017-pdf.jpg","width":1058,"height":1497,"mime_type":"application\/pdf","source_url":"https:\/\/www.wma.net\/wp-content\/uploads\/2017\/05\/Gastmans-WMA-EoL-Presentation-Vatican-Nov2017-pdf.jpg"}}},"post":null,"source_url":"https:\/\/www.wma.net\/wp-content\/uploads\/2017\/05\/Gastmans-WMA-EoL-Presentation-Vatican-Nov2017.pdf","_links":{"self":[{"href":"https:\/\/www.wma.net\/fr\/wp-json\/wp\/v2\/media\/9564"}],"collection":[{"href":"https:\/\/www.wma.net\/fr\/wp-json\/wp\/v2\/media"}],"about":[{"href":"https:\/\/www.wma.net\/fr\/wp-json\/wp\/v2\/types\/attachment"}],"author":[{"embeddable":true,"href":"https:\/\/www.wma.net\/fr\/wp-json\/wp\/v2\/users\/5"}],"replies":[{"embeddable":true,"href":"https:\/\/www.wma.net\/fr\/wp-json\/wp\/v2\/comments?post=9564"}]}}