BACKGROUND Ritual circumcision of infant boys is controversial in Norway, as in many other countries. The procedure became a part of Norwegian public health services in 2015. A new law opened for conscientious objection to the procedure. We have studied physicians' refusals to perform ritual circumcision as an issue of professional ethics. METHOD Qualitative interview study with 10 urologists who refused to perform ritual circumcision from six Norwegian public hospitals. Interviews were recorded and transcribed, then analysed with systematic text condensation, a qualitative analysis framework. RESULTS The physicians are unanimous in grounding their opposition to the procedure in professional standards and norms, based on fundamental tenets of professional ethics. While there is homogeneity in the group when it comes to this reasoning, there are significant variations as to how deeply the matter touches the urologists on a personal level. About half of them connect their stance to their personal integrity, and state that performing the procedure would go against their conscience and lead to pangs of conscience. CONCLUSIONS It is argued that professional moral norms sometimes might become more or less 'integrated' in the professional's core moral values and moral identity. If this is the case, then the distinction between conscience-based and professional refusals to certain healthcare services cannot be drawn as sharply as it has been.

中文翻译：

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拒绝执行割礼包皮环切术：对医生专业和道德推理的定性研究。

背景技术与许多其他国家一样，在挪威，对男婴进行的割礼是有争议的。该程序于2015年成为挪威公共卫生服务的一部分。针对该程序，出于良心拒服兵役的新法律已经开放。我们已经研究了医生拒绝执行礼节性割礼作为职业道德问题的问题。方法对10家拒绝从六家挪威公立医院进行包皮环切术的泌尿科医师进行定性访谈研究。访谈被记录和记录下来，然后通过系统的文本压缩（定性分析框架）进行分析。结果医师一致反对基于专业道德的基本原则反对专业标准和规范中的程序。虽然在这种推理方面，小组中有同质性，关于此事，个人接触泌尿科医师的深度有很大的不同。他们中大约有一半将自己的立场与个人品格相联系，并指出，执行该程序将违背他们的良心，并导致良心的痛苦。结论有人认为，职业道德规范有时可能或多或少地“融合”在职业道德的核心价值观和道德认同中。如果是这种情况，那么就无法像以往那样清晰地区分基于良心和专业拒绝某些医疗保健服务的区别。并指出执行程序会违背他们的良心，并导致良心不安。结论有人认为，职业道德规范有时可能或多或少地“融合”在职业道德的核心价值观和道德认同中。如果是这种情况，那么就无法像以往那样清晰地区分基于良心和专业拒绝某些医疗保健服务的区别。并指出执行程序会违背他们的良心，并导致良心不安。结论有人认为，职业道德规范有时可能或多或少地“融合”在职业道德的核心价值观和道德认同中。如果是这种情况，那么就无法像以往那样清晰地区分基于良心和专业拒绝某些医疗保健服务的区别。