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

Danielle Czarnecki; Renee R. Anspach; Raymond G. De Vries; Mercedez D. Dunn; Katrina Hauschildt; Lisa H. Harris

doi:10.1016/j.socscimed.2019.03.034

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

Danielle Czarnecki^*, Renee R. Anspach, Raymond G. De Vries, Mercedez D. Dunn, Katrina Hauschildt, Lisa H. Harris

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

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.

Original language	English
Pages (from-to)	181-189
Number of pages	9
Journal	Social Science & Medicine
Volume	232
DOIs	https://doi.org/10.1016/j.socscimed.2019.03.034
Publication status	Published - Jul 2019

Keywords

USA
Abortion
Conscience
Moral work
Care moments
Qualitative research
Decision-making
Bioethics
Sociology
DECISION-MAKING
OBJECTION
PHYSICIANS
PHARMACISTS
WILLINGNESS
ETHICS
NURSES

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10.1016/j.socscimed.2019.03.034

Cite this

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

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.",

keywords = "USA, Abortion, Conscience, Moral work, Care moments, Qualitative research, Decision-making, Bioethics, Sociology, DECISION-MAKING, OBJECTION, PHYSICIANS, PHARMACISTS, WILLINGNESS, ETHICS, NURSES",

author = "Danielle Czarnecki and Anspach, {Renee R.} and {De Vries}, {Raymond G.} and Dunn, {Mercedez D.} and Katrina Hauschildt and Harris, {Lisa H.}",

note = "Funding Information: We thank the University of Michigan's Mcubed 1.0 , Office of Research , and the Institute for Research on Women and Gender for supporting this research. We also thank the participants in the Medicine, Aging, Science, and Health workshop; and Natalja Czarnecki, Kim Greenwell, Mushfeq Khan, Rebekah Lewis, Skye Miner, and Stephanie Nairn for their helpful feedback on earlier drafts of the manuscript. We are deeply grateful to the study participants for sharing their experiences. Publisher Copyright: {\textcopyright} 2019 Elsevier Ltd",

year = "2019",

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doi = "10.1016/j.socscimed.2019.03.034",

language = "English",

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journal = "Social Science & Medicine",

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AU - Dunn, Mercedez D.

AU - Hauschildt, Katrina

AU - Harris, Lisa H.

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