Balancing parental conscientious objection and the best interests of the child in neonatal screening in spain

REVIEW ARTICLE

Balancing Parental Conscientious Objection and the Best Interests of the Child in Neonatal Screening in Spain

Manuel Antonio Rodríguez Lanza^1,2, José Luis Aparicio Sánchez^1,2.

¹Servicio de Pediatría, Hospital Universitario Dr. José Molina Orosa, Arrecife, Lanzarote, España, Spain,
²Comité de Ética Asistencial del área de salud de Lanzarote, Arrecife, España, Spain.

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Abstract
Neonatal screening is a cornerstone of public health, allowing early detection of treatable congenital diseases. However, in some contexts, parents may refuse this intervention on ideological or religious grounds. This opposition raises a conflict between parental autonomy and the child’s best interests. In Spain, this conflict arises within a universal healthcare system guided by principles of equity and solidarity. This review analyzes the ethical and legal frameworks governing neonatal screening in Spain, with special attention to parental objection and child protection mechanisms.

Why this article important?

This manuscript addresses a crucial ethical dilemma increasingly faced in pediatric care: the conflict between parental ideological objection and the child’s right to health, specifically within the framework of neonatal screening in Spain. As screening programs expand and include more conditions, occasional parental refusals challenge clinical teams and raise unresolved legal and ethical questions. This article fills a critical gap by synthesizing the Spanish legal framework, bioethical principles, and regional disparities in access, offering a clear, structured analysis that is both academically rigorous and clinically applicable. It highlights the absence of a formal right to conscientious objection in preventive pediatric care and examines real judicial precedents where courts have prioritized child welfare. By proposing a balanced, dialogue-based approach, the article equips healthcare professionals with ethical tools to manage refusals while respecting diversity. In the context of ongoing legislative efforts to harmonize neonatal screening nationwide, this work provides timely and actionable insights to guide policy, improve professional practice, and safeguard children’s rights.

Summary of article

This manuscript explores the ethical and legal conflict between parental conscientious objection and the child’s best interests in the context of neonatal screening in Spain. Grounded in Spanish law and bioethics, it provides an in-depth analysis of how public health priorities, child rights, and family autonomy interact within a universal healthcare system. The article is highly relevant for clinicians, bioethicists, and policymakers, as it addresses a growing concern in pediatric practice: parental refusal of preventive care based on ideological or religious beliefs. By reviewing legal precedents, institutional guidelines, and regional disparities in screening programs, the paper offers both theoretical insights and practical recommendations for conflict resolution. The discussion promotes a model of informed dialogue that respects ideological diversity while affirming the primacy of the child’s right to health. Given recent parliamentary initiatives to standardize neonatal screening, this work is both timely and impactful.

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