Do physicians reserve the right to refuse treating patients on moral or personal beliefs? A scoping review, examining the extent of Conscientious Objection

Conscientious objection (CO) is the refusal to perform a legal role or responsibility because of personal beliefs. The right to conscientious objection is founded on human rights to act according to individuals' religious and other conscience. In health care, conscientious objection can involve practitioners not providing certain treatments to their patients and hence affects someone else's access to care because the refusal interrupts the delivery of health services. The goal of this study is to analyses the role of conscientious objection in scenarios a physician faces in the real world today namely: abortion, physician assisted death and critical care and attempt to look at the solutions being formulated globally for the same. We also give a global overview of laws formulated protecting and limiting the physician's rights of conscience and their duties in morally complex scenarios. PRISMA Guidelines for scoping review was followed. We searched on Pubmed, Embase and Cochrane databases. Search Terms like "Contentious" and "objection"; "Contentious" and "refusal" etc. were used. After exclusion 47 articles were finally reviewed. We found that most countries that legally allow doctors to conscientiously object to treat their patients are required to refer the patient to a non-objecting doctor without any delay. They were also not allowed to object when a patient required emergency treatment. Studies included also shed light on the social and religious dimension of CO.