Conscientious Objection to Sexual and Reproductive Health Services: International Human Rights Standards and European Law and Practice
Conscientious Objection to Sexual and Reproductive Health Services: International Human Rights Standards and European Law and Practice
复制标题
DOI：
10.1163/157180912x639116
复制
发表时间：
2012-01-01
影响因子：
0.8
通讯作者：
Andion-Ibanez, Ximena
中科院分区：
文献类型：
--
作者：
Zampas, Christina;Andion-Ibanez, Ximena
依良心拒服兵役的做法往往发生在个人拒绝履行义务兵役要求的领域，其依据是受国家、国际和区域人权法保护的思想、良心和宗教自由权。出于良心拒服兵役的做法也出现在保健领域，即个别保健提供者或机构基于宗教、道德或哲学上的反对而拒绝提供某些保健服务。卫生保健提供者利用良心拒服兵役的生殖保健服务，包括堕胎、避孕药方和产前检查等服务，在整个欧洲是一个日益严重的现象。然而，尽管欧洲人权法院最近在这一问题上取得了进展(RR诉波兰，2011年)，但各国以及国际和区域机构普遍未能全面和有效地监管这一做法，使许多妇女无法获得她们依法有权获得的生殖保健服务。意大利卫生部报告称，2008年，意大利近70%的妇科医生以道德为由拒绝堕胎。研究发现，2003至2007年间，妇科医生拒绝堕胎时出于良心拒服兵役的比例从58.7%上升到69.2%。意大利并不是唯一的欧洲国家，例如，这种做法在波兰、斯洛伐克很普遍，在英国也在增长。本文概述了关于这一问题的国际和区域人权义务和医疗标准，并强调了这些标准中的一些主要差距。它说明了欧洲国家如何规范或未能规范依良心拒服兵役，以及这些规定如何在实践中发挥作用，包括国家一级法院的判例和欧洲人权法院审理的案例。最后，该条将就如何规范依良心拒服兵役行为向各国政府以及国际和区域机构提出建议，以便既尊重依良心拒服兵役的做法，又保护个人的生殖健康保健权。
The practice of conscientious objection often arises in the area of individuals refusing to fulfil compulsory military service requirements and is based on the right to freedom of thought, conscience and religion as protected by national, international and regional human rights law. The practice of conscientious objection also arises in the field of health care, when individual health care providers or institutions refuse to provide certain health services based on religious, moral or philosophical objections. The use of conscientious objection by health care providers to reproductive health care services, including abortion, contraceptive prescriptions, and prenatal tests, among other services is a growing phenomena throughout Europe. However, despite recent progress from the European Court of Human Rights on this issue (RR v. Poland, 2011), countries and international and regional bodies generally have failed to comprehensively and effectively regulate this practice, denying many women reproductive health care services they are legally entitled to receive. The Italian Ministry of Health reported that in 2008 nearly 70% of gynaecologists in Italy refuse to perform abortions on moral grounds. It found that between 2003 and 2007 the number of gynaecologists invoking conscientious objection in their refusal to perform an abortion rose from 58.7 percent to 69.2 percent. Italy is not alone in Europe, for example, the practice is prevalent in Poland, Slovakia, and is growing in the United Kingdom. This article outlines the international and regional human rights obligations and medical standards on this issue, and highlights some of the main gaps in these standards. It illustrates how European countries regulate or fail to regulate conscientious objection and how these regulations are working in practice, including examples of jurisprudence from national level courts and cases before the European Court of Human Rights. Finally, the article will provide recommendations to national governments as well as to international and regional bodies on how to regulate conscientious objection so as to both respect the practice of conscientious objection while protecting individual's right to reproductive health care.