To access the Spanish translation of this article, please click the tab above. To access the full-featured version in English, please click the link above.
In 2006, the Colombian Constitutional Court partially decriminalized abortion. However, barriers to access, including improper use of conscientious objection, remain.
To explore conscientious objection from the objectors’ perspectives, in-depth interviews were conducted in 2014 with 13 key informants and with 15 Colombian physicians who self-identified as conscientious objectors. Recruitment included snowball and purposive sampling techniques. Analysis was conducted in tandem with data collection and focused on objectors’ attitudes, beliefs and behaviors related to abortion and referral.
Objectors had varied perspectives. Three types of objectors were evident: extreme, moderate and partial. Extreme objectors refused to perform abortions or make referrals, and often lectured their patients; they also provided misleading or false medical and legal information, preventing women from accessing abortions to which they were legally entitled. Moderate objectors would not perform abortions, but respected their patients and viewed referral as a way to save “one out of two” lives. Partial objectors performed some abortions but refused to do others on the basis of gestational age or case-by-case circumstances. Across the typology, objectors linked conscientious objection with medical ethics, and many described a duty to protect the fetus, which they conceptualized as a patient.
Conscientious objectors exhibit diverse opinions and behaviors. Potential areas for future investigation include identifying factors that lead objectors to refer and estimating the prevalence of each type of objector. Results suggest potential interventions that could reduce the role of conscientious objection as a barrier to care.
Lauren R. Fink is a graduate student, Department of Global Epidemiology; Kaitlyn K. Stanhope is a doctoral candidate, Department of Epidemiology; and Roger W. Rochat is professor, Departments of Global Health and Epidemiology—all at the Rollins School of Public Health, Emory University, Atlanta, GA. Oscar A. Bernal is professor, Department of Public Health, Universidad de los Andes, Bogotá, Colombia.
The authors would like to thank Chelsey Brack and Kalie Richardson for their integral role in the creation and implementation of this project, notably their collaboration with the first two authors in developing and conducting the key informant interviews. They are also grateful for technical guidance provided by Cristina Villarreal of Oriéntame and Wendy Chavkin of Global Doctors for Choice. This research was made possible by financial support from the Emory University Global Health Institute, the Global Elimination of Maternal Mortality from Abortion Fund and the Emory Interfaith Health Program.