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Development of the Inclination Toward Conscientious Objection Scale for Physicians

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Abstract

This study aims to develop a valid and reliable scale to assess whether a physician is inclined to take conscientious objection when asked to perform medical services that clash with his/her personal beliefs. The scale, named the Inclination toward Conscientious Objection Scale, was developed for physicians in Turkey. Face validity, content validity, criterion-related validity, and construct validity of the scale were evaluated in the development process. While measuring criterion-related validity, Student’s t-test was used to identify the groups that did and did not show inclination toward conscientious objection. There were 126 items in the initial item pool, which reduced to 42 after content validity evaluation by five experts. After necessary adjustments, the scale was administered to 224 participants. Both exploratory and confirmatory factor analyses were performed to investigate factor structure. The split-half method was employed to assess scale reliability, and the Spearman-Brown coefficient was calculated. Cronbach’s alpha reliability coefficient was used to estimate the internal consistency of the scale items. The distinctiveness of the items was evaluated using Student’s t-test. The lower and upper 27% groups were compared to assess the distinctiveness of the scale. The items were loaded on four factors that explained 85.46% of the variance: “Conscientious Objection – Medical Profession Relationship,” “Conscientious Objection in Medical Education and Medical Practice,” “Conscientious Objection with regard to the Concept of Rights” and “Conscientious Objection – Physician’s Professional Identity and Role.” The final scale has 40 items, and was found to be valid and reliable with high internal consistency.

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Acknowledgements

This article is based on data obtained from the project titled “Development of the Inclination towards Conscientious Objection Scale for Physicians, Medical Students and Community Pharmacists”. We are thankful the physicians who agreed to contribute to the study.

Funding

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Department of Medical History and Ethics, School of Medicine, Karadeniz Technical University, Trabzon, Turkey

    Şükrü Keleş

  2. Department of Biostatistics, School of Medicine, Hacettepe University, Ankara, Turkey

    Osman Dağ

  3. Department of Medical History and Ethics, School of Medicine, Manisa Celal Bayar University, Manisa, Turkey

    Murat Aksu

  4. Department of Pharmacy Management, Faculty of Pharmacy, Gazi University, Ankara, Turkey

    Gizem Gülpinar

  5. Turkish Bioethics Association, Ankara, Turkey

    Neyyire Yasemin Yalım

Authors
  1. Şükrü Keleş
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  2. Osman Dağ
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  3. Murat Aksu
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  4. Gizem Gülpinar
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  5. Neyyire Yasemin Yalım
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Contributions

All authors contributed to the design of the project. Şükrü KELEŞ, Osman DAĞ and Neyyire Yasemin YALIM were major contributors in writing the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Şükrü Keleş.

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Conflicts of Interest/Competing Interests

The authors declare that they have no competing interests.

Ethics Approval

Ethical approval was obtained from the Ankara University Ethics Committee [Approval Number: 9, dated January 2, 2019].

Consent to Participate

The participants could start filling in the scale only after they read and approved an informed consent form.

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Keleş, Ş., Dağ, O., Aksu, M. et al. Development of the Inclination Toward Conscientious Objection Scale for Physicians. Health Care Anal 31, 81–98 (2023). https://doi.org/10.1007/s10728-022-00452-6

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