Because Christian Fiala and Joyce Arthur absolutely oppose conscientious objection (CO) to abortion,they reject our very research question.1 We were not debating the desirability of CO but, rather, evaluatingthe efficacy of laws and policies that regulate the practice of CO in countries in which CO to abortion ispermitted by law. Regardless of Fiala and Arthur’s opposition, CO is lodged in the abortion laws of the fourcountries we chose, as well as in 15 of the 22 we had found in an earlier search.2 We explained our rationalefor country selection in the methods section, which was based on normative research concerns regardingstudy design, data availability, and feasibility.We concur that there is much to debate about the political desirability of CO to health care and wouldadd that there is also much to debate about which tactics strategically improve women’s access to care,and engage and support willing clinicians and health sectors. As it is a reality that CO is legally permittedin many countries, this study was intended to assess whether access to care could be maintained in thosecases where CO is currently enshrined in law, to extract pragmatic lessons for other such jurisdictions andto provide evidence to inform political and strategic deliberations.
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