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Professionalismo medico e obiezione di coscienza nell’IVG. Alcune ipotesi di ricerca
Titolo Rivista: SALUTE E SOCIETÀ 
Autori/Curatori: Elena Spina 
Anno di pubblicazione:  2019 Fascicolo: Lingua: Italiano 
Numero pagine:  17 P. 117-133 Dimensione file:  182 KB
DOI:  10.3280/SES2019-001008
Il DOI è il codice a barre della proprietà intellettuale: per saperne di più:  clicca qui   qui 


While legalizing voluntary interruption of pregnancy (VIP) in Italy, law n.194/1978 intro-duced the clause of conscientious objection and, since then, many gynaecologists have in-voked this right. While the literature on this issue is extensive, there is a lack of contributions that, adopting the perspective of the sociology of the professions, focus on the consequences of this choice on professional group. After all, the debate on medical professionalism is overly crystallizing on some aspects by neglecting some others which still appear crucial. Some hypotheses were then formulated: the first is that conscientious objection represents a rift within the gynaecology; the second is that pro-choice gynaecologists experience marginality; finally, the third is that they better identify themselves in a constructed community, including professionals who share the same values rather than the same knowledge, undermining the unity of the professional group.


Keywords: Professionalismo; interruzione volontaria di gravidanza; obiezione di coscienza; marginalità; frattura intra-professionale; comunità costruita.

  1. Abbott A. (1988). The System of Professions: An Essay on the Division of Expert Labour. Chicago: University of Chicago Press.
  2. Adler P., Kwon S., Hecksher C. (2008). Professional Work: The Emergence of Collaborative Community. Organization Science, 19(2): 359-376., 10.1287/ORSC.1070.029DOI: 10.1287/ORSC.1070.029
  3. Arliaud M., Robelet M. (2000). Professional associations and their engagement with health consumer groups in the UK. Paper presented to the ISA World Conference, Brisbane.
  4. Baggott R., Foster R. (2008). Health consumer and patients’ organizations in Europe: towards a comparative analysis. Health Expectations, 11(1): 85-94.
  5. Baird R.M., Rosenbaum S.E. (2001). The ethics of abortion: pro-life vs pro-choice. New York: Prometheus Books.
  6. Calzavara V. (2016). Solo 3 medici non obiettori con cento casi ciascuno. La tribuna di Treviso, 12 April 2016. -- Testo disponibile al sito: https://www.cislveneto.it/Rassegna-stampa-Veneto/Solo-3-medici-non-obiettori-con-cento-casi-ciascuno, (15/02/2018).
  7. Carcano R. (2016). La scelta di vita di chi pensa di averne una sola. Roma: Nessun Dogma.
  8. Card R.F. (2007). Conscientious objection and emergency contraception. The American Journal of Bioethics, 7(6), 8-14., 10.1080/1526516070134723DOI: 10.1080/1526516070134723
  9. Cassel C.K., Reuben D.B. (2011). Specialization, subspecialization, and subsubspecialization in internal medicine. NEJM, 364(12): 1169-1173.
  10. Halpern S.A. (1990). Medicalization as professional process: Post-war trends in pediatrics. Journal of Health and Social Behavior, 31: 28-42., 10.2307/213704DOI: 10.2307/213704
  11. Chavkin W., Leitman L., Polin K. (2013). Conscientious objection and refusal to provide reproductive healthcare: a White Paper examining prevalence, health consequences, and policy responses. International Journal of Gynecology & Obstetrics, 123: S41–S56., 10.1016/S0020-7292(13)60002-DOI: 10.1016/S0020-7292(13)60002-
  12. Chavkin W., Swerdlow L., Fifield J. (2017). Regulation of Conscientious Objection to Abortion. An International Comparative Multiple-Case Study. Health Human Rights Journal, 19(1): 55-68.
  13. Cirant E. (2012). Una su cinque non lo fa. Maternità e altre scelte. Milano: FrancoAngeli.
  14. Cook R., Dickens B. (2006). The growing abuse of conscientious objection. Virtual Mentor, 8: 337-340,, 10.1001/VIRTUALMENTOR.2006.8.5.OPED1-060DOI: 10.1001/VIRTUALMENTOR.2006.8.5.OPED1-060
  15. Cowan S.K. (2017). Enacted abortion stigma in the United States. Social Science &. Medicine, 177(3): 259-268., 10.1016/J.SOCSCIMED.2017.01.01DOI: 10.1016/J.SOCSCIMED.2017.01.01
  16. De Zordo S. (2015). I veri motivi dell’obiezione di coscienza sull’aborto. -- Testo disponibile al sito: https://abortoinchiesta.wordpress.com/2015/05/23/obiezione-coscienza-aborto-ricerca-antropologica/, (01/02/ 2018).
  17. Dent M., Bourgeault I.L., Denis J.L., Kuhlmann E. (a cura di) (2016). The Routledge Companion to the Professions and Professionalism. London: Routledge.
  18. Dent M., Fallon C., Wendt C., Vuori J., Puhor M., De Pietro C., Silva S. (2011). Medicine and user involvement within European healthcare: a typology for European comparative research. International Journal of Clinical Practice, 65 (12): 1218-1220., 10.1111/J.1742-1241.2011.02803.DOI: 10.1111/J.1742-1241.2011.02803.
  19. Dickens M.B. (2006). Ethical misconduct by abuse of conscientious objection laws. Medicine and Law, 25 (3): 513-522.
  20. Dickens M.B. (2008). The art of medicine: conscientious commitment. Lancet, 371(April): 1240-1241.
  21. Dickens M.B. (2009). Unethical protection of conscience: defending the powerful against the weak. Virtual Mentor, 11(9): 725-729., 10.1001/VIRTUALMENTOR.2009.11.9.OPED2-090DOI: 10.1001/VIRTUALMENTOR.2009.11.9.OPED2-090
  22. Evetts J. (2011). A New Professionalism? Challenges and Opportunities. Current Sociology, 59 (4): 406-422., 10.1177/001139211140258DOI: 10.1177/001139211140258
  23. Fallaci O. (1975). Lettera a un bambino mai nato. Roma: Bur Editore.
  24. Ferrara M., Langiano E., Grego E., De Sio S., Vecchiarini A., Esposito M., De Vito E. (2017). Social Awareness on Voluntary Termination of Pregnancy: A cross-section study. Salute e Società, 1: 170-182., 10.3280/SES2017-00101DOI: 10.3280/SES2017-00101
  25. Fiala A., Hartur J. (2014). “Dishonourable disobedience” – Why refusal to treat in reproductive healthcare is not conscientious objection. Woman - Psychosomatic Gynaecology and Obstetric, 1: 12-23., 10.1016/J.WOMAN.2014.03.00DOI: 10.1016/J.WOMAN.2014.03.00
  26. Freedman L., Landy U., Darney P., Steinauer J. (2010). Obstacles to the integration of abortion into obstetrics and gynecology practice. Perspectives on Sexual and Reproductive Health, 42(3): 146-151., 10.1363/421461DOI: 10.1363/421461
  27. Freidson E. (1985). The reorganization of the medical profession. Medical Care Review, 42: 11-35.
  28. Freidson E. (2002). La dominanza medica. Le basi sociali della malattia e delle istituzioni sanitarie, Introduzione e cura di Giovanna Vicarelli. Milano: FrancoAngeli.
  29. Giarelli G., Nigris D., Spina E. (2012). La sfida dell’auto-mutuo aiuto. Associazioni-smo di cittadinanza e sistema socio-sanitario. Roma: Carocci.
  30. Giarelli G., Spina E. (2014). Self-help/mutual aid as active citizenship associations: a case study of the chronically ill in Italy. Social Science & Medicine, 123: 242-249.
  31. Goffman E. (1963). Stigma: Notes on the management of spoiled identity. New York: Prentice Hall.
  32. Halpern S.A. (1992). Dynamics of professional control: Internal coalitions and cross professional boundaries. American Journal of Sociology, 97(4): 994-1021.
  33. Harris L.H., Debbink M., Martin L., Hassinger J. (2011). Dynamics of stigma in abortion work: findings from a pilot study of the Providers Share Workshop. Social Science & Medicine, 73 (7): 1062-1070., 10.1016/J.SOCSCIMED.2011.07.00DOI: 10.1016/J.SOCSCIMED.2011.07.00
  34. Heino A., Gissler M., Apter D., Fiala C. (2013). Conscientious objection and induced abortion in Europe. The European Journal of Contraception & Reproductive Health Care, 18(4), 231-233., 10.3109/13625187.2013.81984DOI: 10.3109/13625187.2013.81984
  35. Hughes E.C. (1956). Social role and the division of labor. Midwest Sociologist, 18(2): 3-7.
  36. Hughes E.C. (1958). Men and their work. Glencoe: Gree Press.
  37. Hughes E.C. (1971). Work and self. The sociological eye: Selected paper. New Brunswick: Transaction Publishers.
  38. Joffe C. (1995). Doctors of conscience: The struggle to provide abortions before and after Roe v. Wade. Boston: Beacon Press.
  39. Kirkpatrick I., Bullinger B., Dent M., Lega F. (2012). The development of medical-manager roles in European hospital systems: a framework for comparison. International Journal of Clinical Practice, 66(2): 121–124., 10.1111/J.1742-1241.2011.02844.DOI: 10.1111/J.1742-1241.2011.02844.
  40. La Stampa (1989), L’ordine dei medici annuncia “Piano di controlli sull’aborto”, 19 febbraio 1989 -- testo disponibile al sito http://www.archiviolastampa.it/component/option,com_lastampa/task,search/mod,libera/action,viewer/Itemid,3/page,2/articleid,0929_01_1989_0041_0002_24173135/ (20/01/2018)
  41. Lalli C. (2011). C’è chi dice no. Dalla leva all’aborto. Come cambia l’obiezione di coscienza. Torino: Il Saggiatore.
  42. Lazarus E.S. (1997). Politicizing abortion: Personal morality and professional responsability of residents training in the United States. Social Science & Medicine, 44(9): 1417-1425., 10.1016/S0277-9536(96)00329-DOI: 10.1016/S0277-9536(96)00329-
  43. Malatesta M. (a cura di) (2001). Corpi e professioni tra passato e futuro. Milano: Giuffrè.
  44. Martin L.A. (2017). Dangertalk: Voices of abortion providers. Social Science & Medicine, 184(7): 75-83., 10.1016/J.SOCSCIMED.2017.05.00DOI: 10.1016/J.SOCSCIMED.2017.05.00
  45. Ministry of Health (2017). Relazione del Ministro della salute sulla attuazione della legge contenente norme per la tutela sociale della maternità e per l’interruzione volontaria di gravidanza (legge 194/78), -- testo disponibile al sito: http://www.salute.gov.it/imgs/C_17_pubblicazioni_2686_allegato.pdf (18 /01/ 2018).
  46. Momigliano A. (2016). L’obiezione è davvero una questione di coscienza? Testo disponibile al sito: http://www.rivistastudio.com/standard/aborto-medici-obiettori-di-coscienza/, (1/02/ 2018).
  47. Muzio D., Kirkpatrick I. (2011). Introduction: Professions and organizations - a conceptual framework. Current Sociology, 59(4): 389-405., 10.1177/001139211140258DOI: 10.1177/001139211140258
  48. Muzio D., Kirkpatrick I., Kipping M. (2011). Professions, organizations and the state: Applying the sociology of the professions to the case of management consultancy. Current Sociology, 59(6): 805-824., 10.1177/001139211141975DOI: 10.1177/001139211141975
  49. Noordegraaf M. (2007). From “Pure” to “Hybrid” Professionalism Present-Day Professionalism in Ambiguous Public Domains. Administration & Society, 39(6): 761-785., 10.1177/009539970730443DOI: 10.1177/009539970730443
  50. Noordegraaf M. (2011). Remaking Professionals? How Associations and Professional Education Connect Professionalism and Organizations. Current Sociology, 59(4): 465-488., 10.1177/001139211140271DOI: 10.1177/001139211140271
  51. Noordegraaf M. (2015). Hybrid Professionalism and Beyond: (New) Forms of Public Professionalism in Changing Organizational and Societal Contexts. Journal of Professions and Organization, 2 (2): 187-206., 10.1093/JPO/JOV00DOI: 10.1093/JPO/JOV00
  52. Noordegraaf M. (2016). Reconfiguring Professional Work: Changing Forms of Professionalism in Public Services. Administration & Society, 48(7): 783-810., 10.1177/009539971350924DOI: 10.1177/009539971350924
  53. Norris A., Bessett D., Steinberg J.R., Kavanaugh M.L., Zordo S. and Becker D. (2011). Abortion stigma: A reconceptualization of constituents, causes and consequences. Women Health Issues, 21(Suppl. 3): 49-54., 10.1016/J.WHI.2011.02.01DOI: 10.1016/J.WHI.2011.02.01
  54. O’Donnell J., Weitz T.A., Freedman L.R. (2011). Resistance and vulnerability to stigmatization in abortion work. Social Science & Medicine, 73(9): 1357-1364.
  55. Oliva M. (2010). Il sistema di potere di Comunione e liberazione. Il Fatto Quotidiano, 22 August 2010, -- testo disponibile al sito: https://www.ilfattoquotidiano.it/2010/08/22/il-sistema-di-potere-di-comunione-e-liberazione/51990/(15/02/2018).
  56. Opie A. (1997). Thinking teams thinking clients: issues of discourse and representation in the work of health care teams. Sociology of Health & Illness,19(3): 259-280., 10.1111/J.1467-9566.1997.TB00019.DOI: 10.1111/J.1467-9566.1997.TB00019.
  57. Orciani B.M., Radin A., Spina E. (2018). Naissance et objection de conscience: les raisons des professionnels. In Ferréol G. (sous la direction de) Systèmes de santé et politiques de soins: vers de nouveaux défis? Louvrain-la-Neuve: EME éditions, pp.119-134.
  58. Pavolini E., Spina E. (2015). Users’ involvement in the Italian NHS: the role of associations and self-help groups. Journal of Health Organization and Manage-ment, 29(5): 570-581., 10.1108/JHOM-05-2014-008DOI: 10.1108/JHOM-05-2014-008
  59. Pinotti F. (2010). La lobby di Dio. Fede, affari e politica. La prima inchiesta su Comunione e Liberazione e la Compagnia delle opere. Milano: Chiarelettere.
  60. Portanova M. (2009). Commistione e lottizzazione. Altreconomia, 25 August 2009, -- testo disponibile al sito: https://altreconomia.it/commistione-e-lottizzazione/ (15/02/2018).
  61. Quotidianosanità.it (2014). Ivg. La Laiga denuncia: “Aumento degli obiettori di coscienza blocca l’applicazione della 194”. -- Testo disponibile al sito: http://www.quotidianosanita.it/lavoro-e-professioni/articolo.php?articolo_id=24713 (15/02/ 2018).
  62. Santini F. (1988), Medici abortisti: troppi obbiettori, La Stampa, 2 dicembre 1988, -- testo disponibile al sito http://www.archiviolastampa.it/component/option,com_lastampa/task,search/mod,libera/action,viewer/Itemid,3/page,8/articleid,0967_01_1988_0268_0008_24023292/ (10/01/2018).
  63. Schwarz S. (1990). The Moral Question of Abortion. Chicago: Loyola University Press.
  64. Segato M., Pasqualetto A. (2017). L’ho fatto per le donne. Confessioni di un ginecologo non obiettore. Milano: Mondadori.
  65. Thomson J.J. (1971). A Defense of Abortion. Philosophy and Public Affairs, 1(1): 47-66.
  66. Tousijn W. (2008). Opportunità e vincoli per una nuova logica professionale. In Speranza L., Tousijn W., Vicarelli G., I medici in Italia: motivazioni, autonomia, appartenenza. Bologna: Il Mulino, pp. 147-162.
  67. Tousijn W. (2011). Professionalismo e rapporti inter-professionali nelle equipe multidisciplinari. In: Bronzini M. a cura di. Dieci anni di welfare territoriale. Milano: FrancoAngeli, pp. 91-108.
  68. Tousijn W., Vicarelli G. (2006). Medical Autonomy: Open Challenges from Consumerism and Managerialism. Knowledge, Work & Society, 4: 155-179.
  69. UN Human Rights Committee – HRC (2017). Concluding observations on the sixth periodic report of Italy, -- testo disponibile al sito: http://www.refworld.org/docid/591e9a6b4.html (26 /02/2018)
  70. Van Bogaert, L. J. (2002). The limits of conscientious objection to abortion in the developing world. Developing world bioethics, 2(2), pp. 131-143., 10.1111/1471-8847.0004DOI: 10.1111/1471-8847.0004
  71. Vicarelli G. (2003). Identità e percorsi professionali delle donne medico in Italia. Polis 1, pp.93-124.
  72. Vicarelli G. (2008). Donne di medicina. Il percorso professionale delle donne medico in Italia. Bologna: Il Mulino.
  73. Vicarelli G., Spina E. (2013). Being professional in changing times: an analysis tool. Paper presented at ISA RC52 “Professional Groups” Interim Conference Challenging Professionalism: New Directions in Policies, Publics and the Professions. November 2013.
  74. Vicarelli, G., Pavolini, E. (2017). Dynamics between doctors and managers in the Italian National Health Care System. Sociology of Health & Illness, 39(8): 1381–1397., 10.1111/1467-9566.1259DOI: 10.1111/1467-9566.1259
  75. Wicklund S., Kesselheim A. (2007). This Common Secret: My Journey as an Abortion Doctor. New York: PublicAffairs.
  76. Zetka J.R. (2001). Occupational divisions of labour and their technology politics: The case of surgical scopes and gastrointestinal medicine. Social Forces,79(4): 1495- 1520.

Elena Spina, in "SALUTE E SOCIETÀ" 1/2019, pp. 117-133, DOI:10.3280/SES2019-001008

   

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