Freedom of conscience in Europe? An analysis of three cases of midwives with conscientious objection to abortion

While abortion has been legal in most developed countries for many years, the topic remains controversial. A major area of controversy concerns women’s rights vis a vis the rights of health professionals to opt out of providing the service on conscience grounds. Although scholars from various disciplines have addressed this issue in the literature there is a lack of empirical research on the topic. This paper provides a documentary analysis of three examples of conscientious objection on religious grounds to performing abortion-related care by midwives in different Member States of the European Union, two of which have resulted in legal action. These examples show, that as well as the laws of the respective countries and the European Union, professional and church law each played a part in the decisions made. However, support from both professional and religious sources was inconsistent both within and between the examples. The authors conclude that there is a need for clear guidelines at both local and pan-European level for health professionals and recommends a European wide forum to develop and test them

Tensions Between Ethics and the Law: Examination of a Legal Case by Two Midwives Invoking a Conscientious Objection to Abortion in Scotland

This paper examines a legal case arising from a workplace grievance that progressed to being heard at the UK’s Supreme Court. The case of Doogan and Wood versus Greater Glasgow and Clyde Health Board concerned two senior midwives in Scotland, both practicing Roman Catholics, who exercised their perceived rights in accordance with section 4(1) of the Abortion Act not to participate in the treatment of women undergoing abortions. The key question raised by this case was: “Is Greater Glasgow and Clyde Health Board entitled to require the midwives to delegate, supervise and support staff in the treatment of patients undergoing termination of pregnancy?” The ethical issues concerning conscientious objection to abortion have been much debated although the academic literature is mainly concerned with the position of medical practitioners rather than what the World Health Organization terms “mid-level professionals” such as midwives. This paper examines the arguments put forward by the midwives to justify their refusal to carry out tasks they felt contravened their legal right to make a conscientious objection. We then consider professional codes, UK legislation and church legislation. While the former are given strong weighting the latter was been ignored in this case, although cases in other European countries have been prevented from escalating to such a high level by the intervention of prominent church figures. The paper concludes by stating that the question put to the courts remains as yet unanswered but offers some recommendations for future policy making and research

Accuracy analysis of vertical deflection data observed with the Hannover Digital Zenith Camera System TZK2-D

This paper analyses the accuracy of vertical deflection measurements carried out with the Digital Zenith Camera System TZK2-D, an astrogeodetic state-of-the-art instrumentation developed at the University of Hannover. During 107 nights over a period of 3.5 years, the system was used for repeated vertical deflection observations at a selected station in Hannover. The acquired data set consists of about 27,300 single measurements and covers 276 h of observation time, respectively. For the data collected at an earlier stage of development (2003 to 2004), the accuracy of the nightly mean values has been found to be about 0".10-0".12. Due to applying a refined observation strategy since 2005, the accuracy of the vertical deflection measurements was enhanced into the unprecedented range of 0".05-0".08. Accessing the accuracy level of 0".05 requires usually 1 h of observational data, while the 0".08 accuracy level is attained after 20 min measurement time. In comparison to the analogue era of geodetic astronomy, the accuracy of vertical deflection observations is significantly improved by about one order of magnitude

Maternal emotions during the first three postnatal months: Gaining an hermeneutic understanding.

BACKGROUND: Maternal emotions in the first three postnatal months are rarely explored yet in the German context despite it is known that they play an important role in the complexity of maternal health and well-being. AIM: Gaining understanding of maternal emotions and how the developmental process of the infant circadian rhythm influences them during the first three months of the postnatal period. METHODS: A Gadamerian-based research method was used to explore the experiences of 15 mothers in Germany. FINDINGS: 'Being needed' and 'being in need' emerged as the first two themes and were further explored hermeneutically. This resulted in the findings of 'emotional balance and conflicting emotions' as underlying maternal emotions during the first three months following birth. DISCUSSION: Understanding maternal emotions during the first three months of the postnatal period has the potential of opening new pathways for improving maternal health and well-being. CONCLUSION: A spectrum of maternal emotions, maternal uncertainties and maternal needs exists in the first three months of the postnatal period

Error sources and data limitations for the prediction ofsurface gravity: a case study using benchmarks

Gravity-based heights require gravity values at levelled benchmarks (BMs), whichsometimes have to be predicted from surrounding observations. We use EGM2008 andthe Australian National Gravity Database (ANGD) as examples of model and terrestrialobserved data respectively to predict gravity at Australian national levelling network(ANLN) BMs. The aim is to quantify errors that may propagate into the predicted BMgravity values and then into gravimetric height corrections (HCs). Our results indicatethat an approximate ±1 arc-minute horizontal position error of the BMs causesmaximum errors in EGM2008 BM gravity of ~ 22 mGal (~55 mm in the HC at ~2200 melevation) and ~18 mGal for ANGD BM gravity because the values are not computed atthe true location of the BM. We use RTM (residual terrain modelling) techniques toshow that ~50% of EGM2008 BM gravity error in a moderately mountainous regioncan be accounted for by signal omission. Non-representative sampling of ANGDgravity in this region may cause errors of up to 50 mGals (~120 mm for the Helmertorthometric correction at ~2200 m elevation). For modelled gravity at BMs to beviable, levelling networks need horizontal BM positions accurate to a few metres, whileRTM techniques can be used to reduce signal omission error. Unrepresentative gravitysampling in mountains can be remedied by denser and more representative re-surveys,and/or gravity can be forward modelled into regions of sparser gravity

Conscience and conscientious objection: The midwife's role in abortion services.

Traditionally, the role of midwives has been to be with women throughout the pregnancy continuum, from conception until the end of the postnatal period. Midwives, however, have been named as key providers of abortion services. While freedom of conscience is legally protected within Europe, discrepancies exist between midwifery and conscientious objection to abortion-related services. Midwives are largely ignored within the academic discussion despite the care and support they give to women undergoing abortions. Those discrepancies led to the aim of this article to address this issue by discussing some of the key ethical and legal concepts that are relevant to midwives' role in the provision of abortion services. This article shows that the decision to provide or object to abortion services remains ethically very complex because arguments exist both for and against its provision. Being with women can be interpreted differently and individual situations of care are multifaceted. Conscientious objection to abortion services is a highly contentious issue that has an overall importance to midwives. Noting that decisions are individual, may change or may be situationally dependant; a definitive position of midwives for or against conscientious objection cannot be assumed. Respecting conscience and acknowledging that there are various arguments for and against conscientious objection promotes widespread understanding. It accommodates both the opportunity for midwives to object on conscience grounds to the provision of abortion services and respect women's autonomy so that mutual agreement may be reached on issues that may have far reaching consequences

Rapid evolutionary adaptation to elevated salt concentrations in pathogenic freshwater bacteria Serratia marcescens

Rapid evolutionary adaptions to new and previously detrimental environmental conditions can increase the risk of invasion by novel pathogens. We tested this hypothesis with a 133-day-long evolutionary experiment studying the evolution of the pathogenic Serratia marcescens bacterium at salinity niche boundary and in fluctuating conditions. We found that S.marcescens evolved at harsh (80g/L) and extreme (100g/L) salt conditions had clearly improved salt tolerance than those evolved in the other three treatments (ancestral conditions, nonsaline conditions, and fluctuating salt conditions). Evolutionary theories suggest that fastest evolutionary changes could be observed in intermediate selection pressures. Therefore, we originally hypothesized that extreme conditions, such as our 100g/L salinity treatment, could lead to slower adaptation due to low population sizes. However, no evolutionary differences were observed between populations evolved in harsh and extreme conditions. This suggests that in the study presented here, low population sizes did not prevent evolution in the long run. On the whole, the adaptive potential observed here could be important for the transition of pathogenic S.marcescens bacteria from human-impacted freshwater environments, such as wastewater treatment plants, to marine habitats, where they are known to infect and kill corals (e.g., through white pox disease).Peer reviewe

The effect of EGM2008-based normal, normal-orthometric and Helmert orthometric height systems on the Australian levelling network

This paper investigates the normal-orthometric correction used in the definition of the Australian Height Datum, and also computes and evaluates normal and Helmert orthometric corrections for the Australian National Levelling Network (ANLN). Testing these corrections in Australia is important to establish which height system is most appropriate for any new Australian vertical datum. An approximate approach to assigning gravity values to ANLN benchmarks (BMs) is used, where the EGM2008-modelled gravity field is used to "re-construct" observed gravity at the BMs. Network loop closures (for first- and second-order levelling) indicate reduced misclosures for all height corrections considered, particularly in the mountainous regions of south eastern Australia. Differences between Helmert orthometric and normal-orthometric heights reach 44 cm in the Australian Alps, and differences between Helmert orthometric and normal heights are about 26 cm in the same region. Normal orthometric heights differ from normal heights by up to 18 cm in mountainous regions >2,000 m. This indicates that the quasigeoid is not compatible with normal-orthometric heights in Australia

Environmental pleiotropy and demographic history direct adaptation under antibiotic selection

Evolutionary rescue following environmental change requires mutations permitting population growth in the new environment. If change is severe enough to prevent most of the population reproducing, rescue becomes reliant on mutations already present. If change is sustained, the fitness effects in both environments, and how they are associated-termed 'environmental pleiotropy'-may determine which alleles are ultimately favoured. A population's demographic history-its size over time-influences the variation present. Although demographic history is known to affect the probability of evolutionary rescue, how it interacts with environmental pleiotropy during severe and sustained environmental change remains unexplored. Here, we demonstrate how these factors interact during antibiotic resistance evolution, a key example of evolutionary rescue fuelled by pre-existing mutations with pleiotropic fitness effects. We combine published data with novel simulations to characterise environmental pleiotropy and its effects on resistance evolution under different demographic histories. Comparisons among resistance alleles typically revealed no correlation for fitness-i.e., neutral pleiotropy-above and below the sensitive strain's minimum inhibitory concentration. Resistance allele frequency following experimental evolution showed opposing correlations with their fitness effects in the presence and absence of antibiotic. Simulations demonstrated that effects of environmental pleiotropy on allele frequencies depended on demographic history. At the population level, the major influence of environmental pleiotropy was on mean fitness, rather than the probability of evolutionary rescue or diversity. Our work suggests that determining both environmental pleiotropy and demographic history is critical for predicting resistance evolution, and we discuss the practicalities of this during in vivo evolution

Evolutionary rescue:Linking theory for conservation and medicine

Evolutionary responses that rescue populations from extinction when drastic environmental changes occur can be friend or foe. The field of conservation biology is concerned with the survival of species in deteriorating global habitats. In medicine, in contrast, infected patients are treated with chemotherapeutic interventions, but drug resistance can compromise eradication of pathogens. These contrasting biological systems and goals have created two quite separate research communities, despite addressing the same central question of whether populations will decline to extinction or be rescued through evolution. We argue that closer integration of the two fields, especially of theoretical understanding, would yield new insights and accelerate progress on these applied problems. Here, we overview and link mathematical modelling approaches in these fields, suggest specific areas with potential for fruitful exchange, and discuss common ideas and issues for empirical testing and prediction.ISSN:1752-4571ISSN:1752-456