Abortion objectors' lists, scrutinized warily by Christian doctors in Spain

In Spain, a policy allowing healthcare professionals to refuse participation in abortion procedures based on moral, ethical, or religious grounds has been a subject of ongoing discussions. This policy, while recognising the right of healthcare providers to object, has raised concerns about potential barriers to access for patients seeking abortion services, particularly in public healthcare settings.

Critics argue that extensive conscientious objection may undermine the practical availability of abortion care, effectively restricting access despite legal rights. This is particularly concerning in regions where many providers refuse participation, causing a geographic or systemic scarcity of abortion services.

The Spanish government, however, has taken steps to regulate conscientious objection. In May 2022, an abortion law reform was approved, which includes the regulation of conscientious objection for health workers. The ministry of health has also approved a protocol for the creation of a list of conscientious objectors.

This list will include all professionals directly involved in the process of voluntary termination of pregnancy: gynaecologists and obstetricians, anaesthetists, family doctors, nurses, and midwives. The protocol provides for two types of objection: total or partial. The total type refers to health workers who refuse to intervene in an abortion under any circumstance. The partial type includes some cases in which it is possible to object, such as at the request of the woman within the first 14 weeks of pregnancy; a serious risk to the woman's life up to 22 weeks; a serious risk to the baby also up to 22 weeks; or anomalies incompatible with life or extremely serious and incurable illness in the foetus.

Reactions to the regulation have been mixed. Some healthcare providers and organisations, such as the Spanish Evangelical Alliance and the Observatory for Religious Freedom and Freedom of Conscience, have rejected the procedure, stating that it violates human rights and discriminates. On the other hand, supporters argue that the protection of healthcare workers' conscience is fundamental to pluralism in medical ethics.

The creation of a register of conscientious objectors will be done in each region and at the National Institute of Health Management. The process was initiated in March 2023 by the Spanish minister of health, Monica Garcia.

The debate surrounding Spain's conscientious objection policy highlights a tension between healthcare providers’ rights and women's reproductive autonomy. As the policy continues to evolve, discussions about its regulation and the safeguarding of abortion access are expected to persist.

[1] Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8196416/ [5] Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8196416/

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