IDEAS home Printed from https://ideas.repec.org/a/eee/socmed/v232y2019icp181-189.html
   My bibliography  Save this article

Conscience reconsidered: The moral work of navigating participation in abortion care on labor and delivery

Author

Listed:
  • Czarnecki, Danielle
  • Anspach, Renee R.
  • De Vries, Raymond G.
  • Dunn, Mercedez D.
  • Hauschildt, Katrina
  • Harris, Lisa H.

Abstract

How do caregivers make decisions about participating in morally contested care, such as abortion? Debates about conscience in the delivery of health care generally assume that participation decisions stem from religious beliefs and moral values. Few studies have examined this question in the context of everyday practice. Drawing on 50 interviews with the staff of a labor and delivery unit offering abortion care—including nurses, maternal-fetal medicine specialists, obstetrics and gynecology residents, and anesthesiologists—we show that respondents have varied definitions of “participation” in abortion care and that participation decisions are driven by an array of factors beyond personal beliefs. We present a conceptual model of “moral work” that shows conscience to be an emerging, iterative process influenced not only by beliefs—religious and non-religious—but also by personal and work experiences and social and institutional contexts. Our study brings new insights into understanding conscience and participation in contested care.

Suggested Citation

  • Czarnecki, Danielle & Anspach, Renee R. & De Vries, Raymond G. & Dunn, Mercedez D. & Hauschildt, Katrina & Harris, Lisa H., 2019. "Conscience reconsidered: The moral work of navigating participation in abortion care on labor and delivery," Social Science & Medicine, Elsevier, vol. 232(C), pages 181-189.
    • Handle: RePEc:eee:socmed:v:232:y:2019:i:c:p:181-189
    DOI: 10.1016/j.socscimed.2019.03.034
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0277953619301765
    Download Restriction: Full text for ScienceDirect subscribers only
    File URL: https://libkey.io/10.1016/j.socscimed.2019.03.034?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Martin, Lisa A. & Hassinger, Jane A. & Debbink, Michelle & Harris, Lisa H., 2017. "Dangertalk: Voices of abortion providers," Social Science & Medicine, Elsevier, vol. 184(C), pages 75-83.
    2. Davidson, Laura A. & Pettis, Clare T. & Joiner, Amber J. & Cook, Daniel M. & Klugman, Craig M., 2010. "Religion and conscientious objection: A survey of pharmacists' willingness to dispense medications," Social Science & Medicine, Elsevier, vol. 71(1), pages 161-165, July.
    3. Chiarello, Elizabeth, 2013. "How organizational context affects bioethical decision-making: Pharmacists' management of gatekeeping processes in retail and hospital settings," Social Science & Medicine, Elsevier, vol. 98(C), pages 319-329.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Ramm, Alejandra & Casas, Lidia & Correa, Sara & Baba, C. Finley & Biggs, M. Antonia, 2020. "“Obviously there is a conflict between confidentiality and what you are required to do by law”: Chilean university faculty and student perspectives on reporting unlawful abortions," Social Science & Medicine, Elsevier, vol. 261(C).
    2. Mills, Lisa & Watermeyer, Jennifer, 2023. "A meta-ethnography on the experience and psychosocial implications of providing abortion care," Social Science & Medicine, Elsevier, vol. 328(C).
    3. de Londras, Fiona & Cleeve, Amanda & Rodriguez, Maria I. & Farrell, Alana & Furgalska, Magdalena & Lavelanet, Antonella F., 2023. "The Impact of ‘conscientious objection’ on abortion-related outcomes: A synthesis of legal and health evidence," Health Policy, Elsevier, vol. 129(C).

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Mills, Lisa & Watermeyer, Jennifer, 2023. "A meta-ethnography on the experience and psychosocial implications of providing abortion care," Social Science & Medicine, Elsevier, vol. 328(C).
    2. Becker, Andréa & Hann, Lena R., 2021. "“It makes it more real”: Examining ambiguous fetal meanings in abortion care," Social Science & Medicine, Elsevier, vol. 272(C).
    3. Wagner, Brandon G. & Cleland, Kelly & Batur, Pelin & Wu, Justine & Rothberg, Michael B., 2019. "Emergency contraception: Links between providers' counseling choices, prescribing behaviors, and sociopolitical context," Social Science & Medicine, Elsevier, vol. 242(C).
    4. Chiarello, Elizabeth, 2013. "How organizational context affects bioethical decision-making: Pharmacists' management of gatekeeping processes in retail and hospital settings," Social Science & Medicine, Elsevier, vol. 98(C), pages 319-329.
    5. Baumgart-McFarland, Madison & Chiarello, Elizabeth & Slay, Tayla, 2022. "Reluctant Saviors: Professional ambivalence, cultural imaginaries, and deservingness construction in naloxone provision," Social Science & Medicine, Elsevier, vol. 309(C).
    6. Xavier Richet, 2012. "Impact and Response to the Financial Crisis: Comparing the EU and China Policies," Economic Studies journal, Bulgarian Academy of Sciences - Economic Research Institute, issue 1, pages 3-15.
    7. Andaya, Elise & Campo-Engelstein, Lisa, 2021. "Conceptualizing Pain and Personhood in the Periviable Period: Perspectives from Reproductive Health and Neonatal Intensive Care Unit Clinicians," Social Science & Medicine, Elsevier, vol. 269(C).
    8. Solheim, I.H. & Moland, K.M. & Kahabuka, C. & Pembe, A.B. & Blystad, A., 2020. "Beyond the law: Misoprostol and medical abortion in Dar es Salaam, Tanzania," Social Science & Medicine, Elsevier, vol. 245(C).
    9. Puckett, Cassidy & Wong, Jenise C. & Daley, Tanicia C. & Cossen, Kristina, 2020. "How organizations shape medical technology allocation: Insulin pumps and pediatric patients with type 1 diabetes," Social Science & Medicine, Elsevier, vol. 249(C).
    10. Marianne Kjelsvik & Ragnhild J. Tveit Sekse & Asgjerd Litleré Moi & Elin M. Aasen & Eva Gjengedal, 2018. "Walking on a tightrope—Caring for ambivalent women considering abortions in the first trimester," Journal of Clinical Nursing, John Wiley & Sons, vol. 27(21-22), pages 4192-4202, November.
    11. Piercy, Cameron W. & Gist-Mackey, Angela N., 2022. "Status shields and pharmacy work: Differences among workers by role and context," Social Science & Medicine, Elsevier, vol. 293(C).
    12. Dobransky, Kerry M., 2020. "Reassessing mental illness stigma in mental health care: Competing stigmas and risk containment," Social Science & Medicine, Elsevier, vol. 249(C).
    13. Suh, Siri, 2014. "Rewriting abortion: Deploying medical records in jurisdictional negotiation over a forbidden practice in Senegal," Social Science & Medicine, Elsevier, vol. 108(C), pages 20-33.
    14. Kushida, Shuya & Kawashima, Michie & Abe, Tetsuya, 2021. "Recommending no further treatment: Gatekeeping work of generalists at a Japanese university hospital," Social Science & Medicine, Elsevier, vol. 290(C).

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:232:y:2019:i:c:p:181-189. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.