Whose Self-Determination? Barriers to Access to Emergency Hormonal Contraception in Italy. Ceva, E. & Moratti, S. Kennedy Institute of Ethics Journal, 23(2):139--167, June, 2013.
Whose Self-Determination? Barriers to Access to Emergency Hormonal Contraception in Italy [link]Paper  doi  abstract   bibtex   
Abstract Abstract: In Italy, Emergency Hormonal Contraception (EHC) is a prescription drug, available only in pharmacies. Evidence suggests that a number of doctors and pharmacists refuse to provide EHC, on grounds of conscience, although the exact frequency of this phenomenon is unknown. This creates a barrier to access to EHC for women, thus risking undermining their right to reproductive self-determination. In this article, we aim to offer a clearer empirical and theoretical understanding of the situation and to assess the force of doctors’ and pharmacists’ claims against providing EHC. Unlike standard discussions of the issue, we argue that the category of conscientious objection is not the most appropriate one for making sense of these claims, because they are not grounded in a conflict between two contrasting moral duties. The seemingly forced choice between protecting doctors’ and pharmacists’ professional self-determination and women’s reproductive self-determination could be prevented by distributing EHC without medical prescription and in a number of outlets (including supermarkets), thus relieving doctors and pharmacists from the legal duty to provide it.
@article{ ceva_whose_2013,
  title = {Whose Self-Determination? Barriers to Access to Emergency Hormonal Contraception in Italy},
  volume = {23},
  issn = {1086-3249},
  shorttitle = {Whose Self-Determination?},
  url = {http://muse.jhu.edu/journals/kennedy_institute_of_ethics_journal/v023/23.2.ceva.html},
  doi = {10.1353/ken.2013.0004},
  abstract = {Abstract Abstract: In Italy, Emergency Hormonal Contraception ({EHC}) is a prescription drug, available only in pharmacies. Evidence suggests that a number of doctors and pharmacists refuse to provide {EHC}, on grounds of conscience, although the exact frequency of this phenomenon is unknown. This creates a barrier to access to {EHC} for women, thus risking undermining their right to reproductive self-determination. In this article, we aim to offer a clearer empirical and theoretical understanding of the situation and to assess the force of doctors’ and pharmacists’ claims against providing {EHC}. Unlike standard discussions of the issue, we argue that the category of conscientious objection is not the most appropriate one for making sense of these claims, because they are not grounded in a conflict between two contrasting moral duties. The seemingly forced choice between protecting doctors’ and pharmacists’ professional self-determination and women’s reproductive self-determination could be prevented by distributing {EHC} without medical prescription and in a number of outlets (including supermarkets), thus relieving doctors and pharmacists from the legal duty to provide it.},
  language = {eng},
  number = {2},
  urldate = {2014-02-22},
  journal = {Kennedy Institute of Ethics Journal},
  author = {Ceva, Emanuela and Moratti, Sofia},
  month = {June},
  year = {2013},
  pmid = {23888835},
  keywords = {Attitude of Health Personnel, Conscience, Contraception, Postcoital, Contraceptives, Oral, Hormonal, Drug Prescriptions, Female, Health Services Accessibility, Humans, Italy, Jurisprudence, Personal Autonomy, Pharmacists, Physicians, Prescription Drugs},
  pages = {139--167},
  file = {Project MUSE Snapshot:C\:\\Users\\jdodell\\AppData\\Roaming\\Mozilla\\Firefox\\Profiles\\gngr6308.default\\zotero\\storage\\9H5WE33F\łogin.html:text/html}
}

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