Bioethics Blogs

Reframing Conscientious Care: Q&A with Mara Buchbinder

Much of the conversation about conscience in health care has focused on the ethics of physician refusal to perform procedures that they object to. However, this framework seems insufficient for thinking about contemporary abortion provision, where new legislation is routinely passed to restrict the ability of practitioners to provide care that they believe to be morally justified.

In the March-April issue of the Hastings Center Report, University of North Carolina at Chapel Hill anthropologist Mara Buchbinder and several colleagues report on interviews they conducted with North Carolina practitioners who work within the confines of the state’s 2011 Woman’s Right to Know (WRTK) Act, which requires providers to pair counseling with state-mandated content with a 24-hour waiting period between consultation and abortion provision. They found that many abortion providers, rather than refusing to abide by the parts of the law that they disagree with (which could result in the loss of their licenses, which would further limit access to abortion care), aim instead to “conscientiously comply.” They follow the law, but find ways to distance themselves from its objectionable requirements, instead deploying it in ways that build trust and rapport with their patients. Some do so by sharing their personal stances on the law, providing patients with an opening to share their own frustrations. Others contextualize parts of the required information, such as the risks of an early-term abortion, by emphasizing the fact that the risks of a full-term pregnancy are comparatively far greater. Several physicians the researchers interviewed make it a point to do the counseling themselves, and they found that an unexpected benefit of the law is the additional patient contact it occasions.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.