2 Conscientious objection, harm reduction and abortion care Ruth Fletcher Introduction The scope of any legal right to refuse to provide abortion care merits particular consideration following the introduction of the Protection of Life During Pregnancy Act 2013 (PLDPA). Irish health scholarship and practice may benefit from an account of conscientious objection (CO) that clarifies when CO is legitimately engaged by a refusal to provide care and whether CO is limited given its potential effect as a barrier to women’s lawful access to abortion. This chapter
As the AIDS crisis of the 1980s and 1990s recedes from popular memory,
researchers are once again beginning to engage with the subject from historical
perspectives. This collection brings together some of the exciting new work
emerging from this resurgence, addressing essential but much less well-known
histories of HIV/AIDS.
Focusing on regions of Western Europe, Histories of HIV/AIDS introduces aspects of the epidemic from places including Scotland, Wales, Italy, Norway, the Netherlands, Ireland, and Switzerland, and draws attention to the experiences and activities of often-overlooked people: sex workers, drug users, mothers, nurses, social workers, and those living and working in prisons. It also examines the challenges, opportunities, and risks at the heart of how we archive and remember this epidemic. Highlighting the importance of understanding local and national contexts, transnational interactions, and heterogeneous forms of policy, activism, and expertise, it encourages attention to the complexity of these histories and their ongoing importance today.
Of particular interest to historians of modern Europe and health, area studies specialists, and those working with archives and museums, this book is an essential addition to HIV/AIDS studies and histories.
victory, but for those involved it was a partial disappointment, and its impact on the prison service, if any, was unclear. 37 More controversial even than condoms was the question of services for those injecting drugs while in prison. This mirrored hesitation in the wider community, where ‘harm-reduction’ approaches, such as the prescribing of opioid substitutes like methadone or the provision of clean
reduction and the politics of HIV Within the ‘treatment’ discourse, one truly libertarian thread has emerged: harm reduction. This side-steps the issue of the legal position of drugs and takes at its base the notion that the most important issue is not prohibition but the prevention of the worst harms that are associated with drug use. As a result of this 138 Part II Doing perspective it is possible, for example, to develop programmes for the prescription of ‘substitute’ drugs such as methadone in the place of heroin and to establish needle exchanges. The concept of
book could be described as forms of ‘harm reduction’, remote ancestors of movements which developed in the late twentieth century around the time of the HIV epidemic to mitigate some of the consequences of drug, alcohol and tobacco use, without wasting time and effort on ‘the eradication of intractable human behaviors’.1 The medieval minus malum could perhaps be translated as ‘the smaller harm’, though the term ‘the lesser evil’ is more consonant with the language of the past and with the moral judgements commonly pronounced at the time on dishonoured women and base
would help reduce excessive drinking late at night; as such, the Government had hoped that it would fit neatly with their publication of a delayed Alcohol Harm Reduction Strategy for England in March 2004. However, the publication of this Strategy (whose unfortunate acronym greatly amused sceptical commentators) reinforced the impression that England was facing a deeply worrying increase in consumption, while seeming – to its critics, at least – to provide a ‘recipe for ineffectiveness’ in dealing with that problem.10 The Alcohol Harm Reduction Strategy estimated that
relations. Devising useful political strategies therefore requires breaking with classical dualistic categories that posed revolutionary actions against reformist ones, a model of a political world long departed. The result is not as clear-cut as one would always want it to be, theoretically, strategically or ethically. For example, despite a challenging look at the social construction of addiction, Colin Craig’s chapter (chapter 7) still appears to be supporting ‘liberal’ local courses of action such as harm reduction through needle exchange schemes. He also suggests
workers were themselves at risk, and some prevention strategies included activists and people who sold sex. Ultimately, HIV/AIDS gave impetus to early sex worker activism. Today, activists continue to oppose the criminalisation of sex work and call for the inclusion of sex workers in harm-reduction policy. The story of Norway’s HIV/AIDS crisis shows how public health policy can reinforce the
, explores the practices of HIV/AIDS policy development, negotiation, and contestation in Germany, Poland, Turkey, the UK, and at the European level. While the research topic for certain EUROPACH researchers was focused on a specific field of HIV/AIDS activism, such as harm reduction in prisons and prisoners’ rights in Germany, other researchers investigated a multitude of grassroots responses to HIV/AIDS to
rather as means towards an end, resulting in blatant violations of bodily integrity and autonomy. Ruth Fletcher addresses the issue of conscientious objection, arguing that individuals who are conscientious objectors ought to be respected in some circumstances but that organisations should not. Recognising the context in which conscientious objection in respect of lawful abortion takes place, she adopts a harm reduction approach, seeking to address both the harm to those who would have to act against their most intimate convictions in providing abortion and to women