September 1, 2025 • 14 mins
As hard-fought gains in reproductive medicine, voluntary assisted dying and LGBTQI health care have been made – another story has emerged.
One where religious pharmacists, doctors and hospital systems believe it's justifiable to withhold medication or support… often with devastating consequences.
Now, 1 in 5 pharmacists in Australia will refuse you care if the medication you’re asking for doesn’t align with their beliefs… and in some parts of the country, that number is closer to half.
Today, writer and reproductive health advocate Hannah Bambra on the unconscionable reality of conscientious objection.
You can read Hannah Bambra's reporting in the latest edition of The Monthly: https://www.themonthly.com.au/
If you enjoy 7am, the best way you can support us is by making a contribution at 7ampodcast.com.au/support.
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Guest: Writer and reproductive health advocate Hannah Bambra
Photo: AAP Image/Abe Maddison
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:01):
I'm Ruby Jones and you're listening to seven AM. As
hard fought gains in reproductive medicine, voluntary assisted dying, and
LGBTQI healthcare have been made, another story has emerged, one
where religious pharmacists, doctors and hospital systems believe it's justifiable
(00:23):
to withhold medication or support, often with devastating consequences. Now,
one in five pharmacists in Australia will refuse you care
if the medication you're asking for doesn't align with their beliefs,
and in some parts of the country that number is
closer to half. Today. Writer and reproductive health advocate Hannah
Bambra on the unconscionable reality of conscientious objection. It's Tuesday,
(00:51):
September two, So Hannah, I thought we could start with
the story of Ava, although I know that isn't her
real name, but tell me about her. Yeah.
Speaker 2 (01:04):
So, Aver is twenty two and she's studying medicine in
Ballarat and as a young person, she went to her
local pharmacy thinking that she would be able to pick
up emergency contraception and she was shocked when the pharmacist
in one of the local pharmacies in Ballarat refused her
access to what's commonly known as the morning after pill.
(01:28):
The pharmacist sort of brushed her off and said, I
don't have time for that today. All of her friends
describe her as a really kind of non confrontational person,
but she was really angry and upset and frustrated that
pharmacist did not recommend another pharmacy where she would be
(01:48):
able to get emergency contraception. So she was left scrambling
trying to find an alternative option, and eventually she did,
but it took up most of her day trying to
find the contraception that she needed and.
Speaker 1 (02:02):
Just tell me more about why that pharmacy would not
give her them morning after hell.
Speaker 2 (02:07):
So, even though she's a non confrontational person, she went
back to that pharmacy and had a chat with her.
She realized that this person was a religious conscientious objector,
and healthcare professionals are meant to explain that they are
denying access on religious grounds, and they are supposed to
refer to someone on to somewhere where they can get
(02:28):
their medication. But we see it playing out very differently,
and it's really hard to police. So if someone has
a bad experience with a healthcare professional. They can report them,
but at the end of the day that often isn't recorded.
It's very difficult to prove, and I feel like nobody's
(02:50):
talking about it, but it's actually really prevalent and prolific.
A lot of people are denied a huge range of drugs,
including consciousception.
Speaker 1 (03:01):
Okay, well, let's talk more about that. As you started
looking into this further, what did you uncover about all
the different ways in which people can be denied medical
care if their needs somehow come into conflict with this
idea of conscientious objection.
Speaker 2 (03:17):
So conscientious objection is broadly accepted in Australia, but the
rules kind of vary state by state, so it can
happen at every stage of the healthcare system in Australia, GPS, hospitals, nurses, pharmacists,
and a survey from a few years ago said that
twenty percent more than twenty percent, up to one in
(03:39):
five pharmacists would happily deny someone healthcare if it was
against their personal beliefs and they felt that that was justifiable,
even if it meant that that individual person didn't go
on to get the health care required that they needed.
Conscientious objection is broadly about religious beliefs, so a lot
(04:00):
of people think about that as abortion and particularly medical
abortion is something that people need to pick up in pharmacies,
but it's also for things like PREP, which is HIV prevention.
Same sex couples can also be denied IVF medication that
they've paid hundreds of dollars to be able to access, contraception,
(04:22):
medical terminations. There's a huge range of things that pharmacists, doctors, nurses,
and even entire hospitals are allowed to deny people based
on their personal beliefs, even if they are legally entitled
and eligible for that medication.
Speaker 1 (04:40):
Right. And as you've said, this is particularly a problem
when it happens in a regional town where there may
not be another option. Ava did eventually find the medication,
but what happens when that is not possible.
Speaker 2 (04:54):
So through my reporting on conscientious objection, another person that
I spoke to call her Anika. Anika worked in high
schools as a nurse and also in clinics as a
sexual health nurse for a long time, and she is
really passionate about increasing access in regional areas. But speaking
(05:14):
to her really opened my eyes at how bad this
can be in some regional and remote towns and cities.
So Anika told me about a young girl and her
late teens who approached her after her contraception had failed.
She asked Anakar if she was able to find her
emergency contraception, and unfortunately, the pharmacist in that town was
(05:38):
a conscientious objector because that pharmacist refused them access to
the morning after pill and the young girl couldn't drive.
That girl then went on to become pregnant unfortunately, and
the only doctors in the town also wouldn't prescribe abortion,
medical abortion or refer her on to surgical abortion. This
(06:03):
young girl then had to figure out how to access
a surgical abortion, and at that time she wasn't able
to drive to Melbourne. She didn't want her parents to know,
but it's pretty hard for someone to leave their country town,
find their way to an abortion clinic and get back
by the end of the school bell, that girl was
(06:26):
eventually able to go to a regional hospital and get
an abortion, and at that time they were allowing protesters
at the front. So she had been denied contraception because
of her pharmacist and her doctor, who were the only
people in the town who could issue those drugs, and
then she had to walk through a sea of people
telling her that she was a murderer at eighteen years
(06:49):
old to be able to get an abortion.
Speaker 1 (06:54):
Coming up, Where does conscientious objection in healthcare come from? Hannah?
The idea of conscientious objection in healthcare? Where does it
come from? And has it always been a feature of
(07:16):
the way that our healthcare system works.
Speaker 2 (07:19):
It hasn't, really, So it's over the past, let's say,
fifty sixty years, as some aspects of healthcare and medicine
have become more wildly available to people, it's been a
bit of a compromise with religious groups. So, for example,
abortion in Australia has taken since the nineteen seventies to
(07:41):
be completely legalized. Their last state to completely decriminalize abortion
was Western Australia and that was last year, which I
think would shock a lot of people that Victoria was
one of the early adopters and completely decriminalized abortion in
two thousand and eight. And decriminalized of abortion is relevant
(08:02):
to this because before decriminalization of abortion, people didn't have
to think of reasons not to give access to this care,
so they didn't have to conscientiously object because there was
nothing to conscientiously object from. And similarly, voluntary assisted dying
and forms of contraception and things like PREP which is
(08:24):
a HIV prevention have only come about and become accessible
to people over the past couple of decades. So since decriminalization.
One of the kind of bargaining tools that the federal
government and healthcare system was able to use with religious
groups was well, we're not going to force anyone to
issue these medications. Doctors can opt out if they want to,
(08:48):
and that's where the idea of conscientious objection in health
care came from. But healthcare is very different to other professions.
Speaker 1 (08:57):
Yeah, tell me about that, because you don't really hear
of conscientious objection in any other professional context.
Speaker 2 (09:05):
Yeah. Absolutely, if you're a lawyer. The legal profession in
Australia really upholds this idea that everyone is deserving of
legal rights and representation. There is some parts of sort
of private institutions I guess, where someone can say, oh,
I don't want to sell products to these particular people,
(09:27):
but those institutions exist in a free market. Healthcare is
publicly funded.
Speaker 1 (09:33):
Yeah, it sounds like there is a real issue around
transparency here that it is not always made clear to
the person why they are being denied care. But also
they aren't necessarily able to access that kind of information
about a provider ahead of time.
Speaker 2 (09:50):
Yeah. Absolutely, And I think that's partially why it's so problematic.
There's people who really need timely, safe and trustworthy care
and they're being turned away without even realizing what they're
going into. So if a practitioner did list on their
website or in a publicly available register, which doesn't exist
(10:11):
at the moment, that they don't offer these kinds of care,
then someone would be able to make informed choices. But
at the moment, people might be going into a GP's office,
sometimes it's even their family doctor that they've seen since
they were young, But they might be heading in thinking
that they're able to ask for something which is legal,
(10:32):
which they're eligible for, which is widely accessible, and that
GP can make a decision based on their own personal
values that they think that person should not access that care.
Speaker 1 (10:44):
Okay, and so I mean, perhaps this is a controversial question,
but do you think that there is a case to
be made here that the idea of conscientious objection in
health care should be reconsidered absolutely.
Speaker 2 (11:00):
I think religious groups use the example that you can't
force someone to perform abortions, but this isn't about asking
people to perform surgical abortions or administer drugs for voluntary
assisted dying. Those are very specialized skills that people opt into.
What this is about is about access to getting that care.
(11:23):
So at the moment, nurses, doctors, pharmacists, entire hospitals or
age care facilities can create barriers for very vulnerable people.
And personally, I have very little sympathy for someone who
thinks their right to avoid writing or filling a script
is more important than a teenager having to keep a
(11:44):
pregnancy or a terminally ill patient having to continue suffering
or dying without the dignity that they deserve. And I
think there is some peak bodies like the Australian Nursing
and Midwife Free Federation, which says if practitioners are thinking
(12:05):
that conscientious objection is going to frequently come up, then
maybe they need to seriously consider other employment. And I
think that arguably, if you're working in reproductive healthcare, if
you're a midwife, it's really likely that you are going
to need to talk to people about things like contraception,
(12:25):
fetal abnormality testing, pregnancy options. If you're unwilling to put
your personal beliefs aside and talk about some of these
very real things that are coming up for people, even
with wanted pregnancies, then you're in the wrong job.
Speaker 1 (12:46):
Well, Henna, thank you so much for your time, Thank
you for having me. Also in the news today, around
two hundred and eighty former immigration detainees released into the
Australian community after a twenty twenty three High Court decision
(13:08):
will soon be deported to Niru. Home Affairs Minister Tony
Burke quietly inked a deal with the Neruan president that
will see Australia pay Narou four hundred and eight million
dollars up front and then seventy million each following year
in exchange for the group to be grunted visas to
live freely in the Pacific nation. And more reports have
(13:28):
emerged of ugly scenes from the weekend's anti immigration marches
in Melbourne. Video has been circulated showing up to thirty
men in black attacking an Indigenous protest camp, with the
men using flag poles as weapons. Police have also reported
a number of arrests including six in Melbourne, three in
Sydney and three in Adelaide. I'm Ruby Jones. This is
(13:50):
seven AM. Thanks for listening.
I'm Ruby Jones and you're listening to seven AM. As
hard fought gains in reproductive medicine, voluntary assisted dying, and
LGBTQI healthcare have been made, another story has emerged, one
where religious pharmacists, doctors and hospital systems believe it's justifiable
(00:23):
to withhold medication or support, often with devastating consequences. Now,
one in five pharmacists in Australia will refuse you care
if the medication you're asking for doesn't align with their beliefs,
and in some parts of the country that number is
closer to half. Today. Writer and reproductive health advocate Hannah
Bambra on the unconscionable reality of conscientious objection. It's Tuesday,
(00:51):
September two, So Hannah, I thought we could start with
the story of Ava, although I know that isn't her
real name, but tell me about her. Yeah.
Speaker 2 (01:04):
So, Aver is twenty two and she's studying medicine in
Ballarat and as a young person, she went to her
local pharmacy thinking that she would be able to pick
up emergency contraception and she was shocked when the pharmacist
in one of the local pharmacies in Ballarat refused her
access to what's commonly known as the morning after pill.
(01:28):
The pharmacist sort of brushed her off and said, I
don't have time for that today. All of her friends
describe her as a really kind of non confrontational person,
but she was really angry and upset and frustrated that
pharmacist did not recommend another pharmacy where she would be
(01:48):
able to get emergency contraception. So she was left scrambling
trying to find an alternative option, and eventually she did,
but it took up most of her day trying to
find the contraception that she needed and.
Speaker 1 (02:02):
Just tell me more about why that pharmacy would not
give her them morning after hell.
Speaker 2 (02:07):
So, even though she's a non confrontational person, she went
back to that pharmacy and had a chat with her.
She realized that this person was a religious conscientious objector,
and healthcare professionals are meant to explain that they are
denying access on religious grounds, and they are supposed to
refer to someone on to somewhere where they can get
(02:28):
their medication. But we see it playing out very differently,
and it's really hard to police. So if someone has
a bad experience with a healthcare professional. They can report them,
but at the end of the day that often isn't recorded.
It's very difficult to prove, and I feel like nobody's
(02:50):
talking about it, but it's actually really prevalent and prolific.
A lot of people are denied a huge range of drugs,
including consciousception.
Speaker 1 (03:01):
Okay, well, let's talk more about that. As you started
looking into this further, what did you uncover about all
the different ways in which people can be denied medical
care if their needs somehow come into conflict with this
idea of conscientious objection.
Speaker 2 (03:17):
So conscientious objection is broadly accepted in Australia, but the
rules kind of vary state by state, so it can
happen at every stage of the healthcare system in Australia, GPS, hospitals, nurses, pharmacists,
and a survey from a few years ago said that
twenty percent more than twenty percent, up to one in
(03:39):
five pharmacists would happily deny someone healthcare if it was
against their personal beliefs and they felt that that was justifiable,
even if it meant that that individual person didn't go
on to get the health care required that they needed.
Conscientious objection is broadly about religious beliefs, so a lot
(04:00):
of people think about that as abortion and particularly medical
abortion is something that people need to pick up in pharmacies,
but it's also for things like PREP, which is HIV prevention.
Same sex couples can also be denied IVF medication that
they've paid hundreds of dollars to be able to access, contraception,
(04:22):
medical terminations. There's a huge range of things that pharmacists, doctors, nurses,
and even entire hospitals are allowed to deny people based
on their personal beliefs, even if they are legally entitled
and eligible for that medication.
Speaker 1 (04:40):
Right. And as you've said, this is particularly a problem
when it happens in a regional town where there may
not be another option. Ava did eventually find the medication,
but what happens when that is not possible.
Speaker 2 (04:54):
So through my reporting on conscientious objection, another person that
I spoke to call her Anika. Anika worked in high
schools as a nurse and also in clinics as a
sexual health nurse for a long time, and she is
really passionate about increasing access in regional areas. But speaking
(05:14):
to her really opened my eyes at how bad this
can be in some regional and remote towns and cities.
So Anika told me about a young girl and her
late teens who approached her after her contraception had failed.
She asked Anakar if she was able to find her
emergency contraception, and unfortunately, the pharmacist in that town was
(05:38):
a conscientious objector because that pharmacist refused them access to
the morning after pill and the young girl couldn't drive.
That girl then went on to become pregnant unfortunately, and
the only doctors in the town also wouldn't prescribe abortion,
medical abortion or refer her on to surgical abortion. This
(06:03):
young girl then had to figure out how to access
a surgical abortion, and at that time she wasn't able
to drive to Melbourne. She didn't want her parents to know,
but it's pretty hard for someone to leave their country town,
find their way to an abortion clinic and get back
by the end of the school bell, that girl was
(06:26):
eventually able to go to a regional hospital and get
an abortion, and at that time they were allowing protesters
at the front. So she had been denied contraception because
of her pharmacist and her doctor, who were the only
people in the town who could issue those drugs, and
then she had to walk through a sea of people
telling her that she was a murderer at eighteen years
(06:49):
old to be able to get an abortion.
Speaker 1 (06:54):
Coming up, Where does conscientious objection in healthcare come from? Hannah?
The idea of conscientious objection in healthcare? Where does it
come from? And has it always been a feature of
(07:16):
the way that our healthcare system works.
Speaker 2 (07:19):
It hasn't, really, So it's over the past, let's say,
fifty sixty years, as some aspects of healthcare and medicine
have become more wildly available to people, it's been a
bit of a compromise with religious groups. So, for example,
abortion in Australia has taken since the nineteen seventies to
(07:41):
be completely legalized. Their last state to completely decriminalize abortion
was Western Australia and that was last year, which I
think would shock a lot of people that Victoria was
one of the early adopters and completely decriminalized abortion in
two thousand and eight. And decriminalized of abortion is relevant
(08:02):
to this because before decriminalization of abortion, people didn't have
to think of reasons not to give access to this care,
so they didn't have to conscientiously object because there was
nothing to conscientiously object from. And similarly, voluntary assisted dying
and forms of contraception and things like PREP which is
(08:24):
a HIV prevention have only come about and become accessible
to people over the past couple of decades. So since decriminalization.
One of the kind of bargaining tools that the federal
government and healthcare system was able to use with religious
groups was well, we're not going to force anyone to
issue these medications. Doctors can opt out if they want to,
(08:48):
and that's where the idea of conscientious objection in health
care came from. But healthcare is very different to other professions.
Speaker 1 (08:57):
Yeah, tell me about that, because you don't really hear
of conscientious objection in any other professional context.
Speaker 2 (09:05):
Yeah. Absolutely, if you're a lawyer. The legal profession in
Australia really upholds this idea that everyone is deserving of
legal rights and representation. There is some parts of sort
of private institutions I guess, where someone can say, oh,
I don't want to sell products to these particular people,
(09:27):
but those institutions exist in a free market. Healthcare is
publicly funded.
Speaker 1 (09:33):
Yeah, it sounds like there is a real issue around
transparency here that it is not always made clear to
the person why they are being denied care. But also
they aren't necessarily able to access that kind of information
about a provider ahead of time.
Speaker 2 (09:50):
Yeah. Absolutely, And I think that's partially why it's so problematic.
There's people who really need timely, safe and trustworthy care
and they're being turned away without even realizing what they're
going into. So if a practitioner did list on their
website or in a publicly available register, which doesn't exist
(10:11):
at the moment, that they don't offer these kinds of care,
then someone would be able to make informed choices. But
at the moment, people might be going into a GP's office,
sometimes it's even their family doctor that they've seen since
they were young, But they might be heading in thinking
that they're able to ask for something which is legal,
(10:32):
which they're eligible for, which is widely accessible, and that
GP can make a decision based on their own personal
values that they think that person should not access that care.
Speaker 1 (10:44):
Okay, and so I mean, perhaps this is a controversial question,
but do you think that there is a case to
be made here that the idea of conscientious objection in
health care should be reconsidered absolutely.
Speaker 2 (11:00):
I think religious groups use the example that you can't
force someone to perform abortions, but this isn't about asking
people to perform surgical abortions or administer drugs for voluntary
assisted dying. Those are very specialized skills that people opt into.
What this is about is about access to getting that care.
(11:23):
So at the moment, nurses, doctors, pharmacists, entire hospitals or
age care facilities can create barriers for very vulnerable people.
And personally, I have very little sympathy for someone who
thinks their right to avoid writing or filling a script
is more important than a teenager having to keep a
(11:44):
pregnancy or a terminally ill patient having to continue suffering
or dying without the dignity that they deserve. And I
think there is some peak bodies like the Australian Nursing
and Midwife Free Federation, which says if practitioners are thinking
(12:05):
that conscientious objection is going to frequently come up, then
maybe they need to seriously consider other employment. And I
think that arguably, if you're working in reproductive healthcare, if
you're a midwife, it's really likely that you are going
to need to talk to people about things like contraception,
(12:25):
fetal abnormality testing, pregnancy options. If you're unwilling to put
your personal beliefs aside and talk about some of these
very real things that are coming up for people, even
with wanted pregnancies, then you're in the wrong job.
Speaker 1 (12:46):
Well, Henna, thank you so much for your time, Thank
you for having me. Also in the news today, around
two hundred and eighty former immigration detainees released into the
Australian community after a twenty twenty three High Court decision
(13:08):
will soon be deported to Niru. Home Affairs Minister Tony
Burke quietly inked a deal with the Neruan president that
will see Australia pay Narou four hundred and eight million
dollars up front and then seventy million each following year
in exchange for the group to be grunted visas to
live freely in the Pacific nation. And more reports have
(13:28):
emerged of ugly scenes from the weekend's anti immigration marches
in Melbourne. Video has been circulated showing up to thirty
men in black attacking an Indigenous protest camp, with the
men using flag poles as weapons. Police have also reported
a number of arrests including six in Melbourne, three in
Sydney and three in Adelaide. I'm Ruby Jones. This is
(13:50):
seven AM. Thanks for listening.
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