Development of the Inclination Toward Conscientious Objection Scale for Physicians

KELEŞ Ş., DAĞ O., Aksu M., GÜLPINAR G., Yalım N. Y.

Health Care Analysis, 2022 (SSCI) identifier identifier

  • Publication Type: Article / Article
  • Publication Date: 2022
  • Doi Number: 10.1007/s10728-022-00452-6
  • Journal Name: Health Care Analysis
  • Journal Indexes: Social Sciences Citation Index (SSCI), Scopus, ASSIA, International Bibliography of Social Sciences, CINAHL, EMBASE, MEDLINE, Philosopher's Index
  • Keywords: Conscientious Refusal to Treat, Ethics – Medical, Right to Health
  • Hacettepe University Affiliated: Yes


© 2022, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.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.