January-March, 2005
March
The Labour Committee of the Wisconsin Assembly heard conflicting
testimony regarding
Wisconsin Assembly Bill 207, introduced by Representative Jean
Hundertmark. A previous bill passed by the legislature was vetoed by the
state governnor. R. Alta Charo claimed that the bill would permit health
care workers to mislead patients by failing to give information, and
complained that objectors would not be compelled to refer patients. Dr.
Cynthia Jones-Nosacek, on the other hand, argued that she should not be
compelled to refer patients so that they can be killed by withdrawal of
nutrition and hydration.
The National Abortion Rights Action League is encouraging people to take
'pledge cards' to local pharmacies and have pharmacists sign them to promise
that they will dispense birth control drugs, including those that might act
by preventing implantation, thus causing the death of an early embryo. NARAL
appears to believe that freedom of choice should be limited to its own
supporters.
Professor Chris Higgins, the director of the United Kingdom's Medical
Research Council's clinical sciences centre, supports the creation of
animal-human hybrids by the injection of genetic materials from human
embryos into animal eggs. Dr Calum MacKellar, the director of research of
the Scottish Council on Human Bioethics, rejects the idea. The controversy
illustrates the potential for conflicts of conscience among researchers and
others involved in reproductive technology.
New Jersey
Assembly
Bill 2698 has been signed by the Acting Governor of the state. It forces
all hospitals to provide "medically and factually accurate and objective"
information about the potentially abortifacient morning-after pill to sexual
assault complainants, and the state plans to provide a tract for this
purpose written by the Commissioner of Health and Senior Services, in
collaboration with the Director of the Division on Women in the Department
of Community Affairs and the New Jersey Coalition Against Sexual Assault.
Further, all hospitals will be required to provide the potentially
abortifacient morning-after pill to sexual assault complainants upon
request. The bill is clearly intended to suppress conscientious objection.
Some reports indicated that the requirement to dispense the drug depends
upon a negative pregnancy test, but the bill contains no provision to this
effect. This will be of concern to those who object to the drug because it
can act to cause the death of the early embryo by preventing implantation.
If the tract that will be forced upon the hospitals fails to acknowledge
this mechanism of action, a hospital could legally supplement the tract with
this information in order to comply with the legal requirement for medical
and factual accuracy. For the same reason, a hospital might decline to
distribute the tract if it describes both pre-fertilization and
post-fertilization effects as 'contraceptive.'
The British government's controversial Mental Capacity Bill will be returned
to the House of Commons for review of amendments proposed by the House of
Lords. Concerns that the bill will permit euthanasia have been repeatedly
voiced during the progress of the bill through parliament.
The Independent, a newspaper in the United Kingdom, quotes a consultant
obstetrician to the effect that most late term abortions are done in the
private sector, not the public health system. Peter Bowen Simpkins observed
that "late abortion is not a very pleasant affair. . . Many doctors and
nurses don't do abortions at all." [The Independent, 16 March, 2005]. The
comment illustrates the importance of protective legislation for
conscientious objectors, but also suggests that there is no principled
reason to insist that controversial procedures must be performed in public
institutions.
A Muslim pharmacist in the east of London in the United Kingdom declined to
dispense the potentially abortifacient morning-after pill for religious
reasons. The Sunday Mirror quoted the patient to the effect that the
pharmacist should find another job. The response is, unfortunately, typical
of what passes for 'tolerance' and 'respect for freedom of religion' in many
jurisidictions.
Physicians Eduard Verhagen and Pieter Sauer of the Groningen University
Medical Center continue to advocate the legalization of euthanasia for
infants. In an article in the New England Journal of Medicine they assert
that only about three of 15 to 20 annual cases of infant euthanasia are
reported. Verhagen reviewed 22 cases of infant euthanasia in 1997 and found
that none were prosecuted. Verhagen has proposed guidelines for infant
euthanasia that doctors can follow without fear of prosecution. [British
Medical Journal] If Verhagen's claims are accurate, they demonstrate the
potential for conflicts of conscience among health care workers who may be
asked to facilitate or to cover up an illegal act.
The ethics committee of Stanford University has approved a plan to breed
mice with brains made from cells from aborted infants. [The Telegraph, 6
March, 2005] The experiment illustrates the potential for conflicts of
conscience among researchers.
Administrative Law Judge Colleen Baird has recommended that Wisconsin
pharmacist Neil Noesen be made to attend ethics classes because he refused
to dispense contraceptives for reasons of conscience, and also refused to
refer the patient to another pharmacy. The judge claimed that his action
exposed the patient to a danger to her health, welfare or safety in the form
of pregnancy. Baird's recommendation is to go to the Wisconsin Pharmacy
Examining Board for review and action. [See
Establishment Bioethics and
Referral: A False Compromise]
26 year old Claire Baldwin, who now works in the Body Shop in
Carmarthen, Wales, narrowly escaped death in the Netherlands when she was
born prematurely. Her parents were told that she was dead and she was left
in a kidney dish in a dirty laundry room to die. Her father discovered her
and insisted that she be placed in an incubator, despite resistance and
ridicule from nursing staff. [This Is South Wales, 17 February, 2005] Such
cases illustrate the potential for conflicts of conscience among health care
workers faced with similar situations. [Born
alive, left to die (Chicago, Illinois, U.S.A.) (1999)[ [Baby
left to die at Vancouver General Hospital (Vancouver, British Columbia,
Canada) (1985)]
A judge in Chicago has ruled that an embryo conceived and accidentally
killed in a fertility clinic was a human being whose parents are entitled to
file a wrongful death lawsuit. The judge held that the law in Illinois
recognizes the existence of a human being after conception occurs. Critics
voiced concerns that the ruling, if allowed to stand, will inhibit
reproductive technology. The ruling is of interest to conscientious
objectors among pharmacists because it illustrates the basis for their
concerns about the destruction of human embryos. It also illustrates how
public discourse is significantly impacted by the scientifically incorrect
term 'fertilized egg.'
Sen. Jim Whitehead has proposed a bill to ensure that pharmacists cannot be
sued or disciplined for declining to dispense drugs to which they object for
reasons of conscience. Whitehead said that he was asked to put forward the
legislation by some pharmacists in his district. asked him to push the
legislation. The chairman of the Georgia Pharmacy Association, University of
Georgia Professor Flynn Warren, stated that pharmacists in Georgia may
already refuse to fill prescriptions, but said that they should suggest to a
patient how to get it filled elsewhere. [AP
Story] Many objectors would find this unsatisfactory. [See
Referral: A False Compromise]
A bill to legalize assisted suicide for mentally competent patients who have
six months to live is being drafted in California. State lawmakers and
courts have demonstrated marked hostility towards freedom of conscience in
health care (US
Supreme Court rejects appeal of repressive ruling), so there are grounds
for concern that conscientious objectors and objecting denomination health
care entities may be compelled to participate in or facilitate the
procedure.
In a letter distributed to parishes throughout Ecuador, the Catholic bishops
of the country identified the moral issue of concern to them in the use of
the morning-after pill. They pointed out that one of the acknowledged ways
in which the drug works is to prevent implantation of an early embryo, and
stated that causing the death of an embryonic human individual in this way
is morally unacceptable. [News
item]
Pope John Paul II has reiterated the support of the Catholic Church for
organ transplants, which is conditional upon death having occurred before
transplantation takes place. The
Pope wrote that "the moment of death for each person consists in the
definitive loss of the constitutive unity of body and spirit," a concept
that must be tied to some physical reality in order to be applied in
practice. The concept of "brain death" has been widely used for this
purpose, but practical and philosophical questions remain. [Catholic
World News]
Despite what has been described as a media barrage, a bill that would
protect freedom of conscience for pharmacists was approved by a committee of
the Arizona House by a vote of 6-3. The executive director of the Arizona
Pharmacy Alliance attempted to argued that pharmacists should be forced to
refer if they will not dispense, a position opposed by many conscientious
objectors. A spokesman for the Arizona Catholic Conference rejected the idea
of compulsory referral.
The Dutch Voluntary End to Life Association (NVVE) is complaining that some
Dutch physicians are refusing to facilitate euthanasia requests or delaying
their execution. NVVE director Rob Jonquière has complained that many
doctors "are looking for excuses not to carry out euthanasia." While figures
on the subject are sometimes disputed, government-commissioned research
found that there were 9,700 euthanasia requests in 2001, of which 3,800 were
carried out. Health care workers in other jurisdictions who have hitherto
been unsupportive of protection of conscience laws and policies should take
careful note of this development, since the arguments that are being put
forward to compel physicians to participate in euthanasia are precisely the
same arguments being made to compel objectors to facilitate abortion,
contraception and other morally controversial procedures.
Vaxin, a company in Birmingham, Alabama, plans to use PER C6 in their new
flu vaccine. The CEO of the company that created PER C6 has admitted that
the cell line originated with tissue from an 18 week infant that was
aborted. A group called Children of God for Life has criticized the
decision, pointing out that thousands of people protested the use of aborted
fetal tissue in the manufacture of smallpox vaccine in 2001.
Two doctors declined to inseminate a woman who identifies herself as
lesbian because she was not married. Instead, they referred her to another
doctor who assisted her to achieve a pregnancy, and agreed to to provide
pre- and post-natal care and cover any costs incurred as a result of the
referral. Six months after becoming pregnant with the assistance of the
doctor to whom she was referred, she launched a civil suit against the
clinic. In essence, she claims that the physicians acted wrongfully because
they would not perform the insemination themselves. In November, 2004, the
first ruling went against the clinic. The Alliance Defence Fund has secured
an order from a California appeals court that requires the woman to show why
the lower court order should not be quashed. The Appeal court invited
comment on two issues: (a) whether a doctor has a right to refuse to perform
a procedure for religious reasons, and (b) whether a doctor can accommodate
his beliefs and satisfy anti-discrimination laws by referring a patient
elsewhere and paying the associated costs. [Court
of Appeal Writ]
January
Liberal Democrat Mike Rumbles is demanding that Catholic schools abandon
Catholic teaching in favour of the state's new 'sexual health strategy.' He
argues that the state should withdraw funding if they do not do so. This
kind of argument is typically used against denominational health care
institutions to force them to supply services that contradict their beliefs.
A senate bill that would have forced all health insurance plans to
include coverage for birth control was discussed in a senate committee, but
the committee took no action on the bill. [New
Report]
Professor Allan Templeton, the president of the Royal College of
Obstetricians and Gynaecologists, has urged that the British government
approve the use of mifepristone (RU-486) by women at home. He spoke at a
forum organised by the chairman of the Commons Select Committee on Science.
The use of the drug in South Africa is causing significant problems for
conscientious objectors to abortion, who are in the majority among health
care workers. Women are given the drug and told to go to emergency
departments in hospitals when they start to bleed. Objecting physicians and
staff are then faced with the task of completing an abortion begun by
someone else.
A bill introduced in both houses of the the Arizona Legislature (HB
2541) would prevent health care providers from being forced to dispense
the 'morning-after pill' and prescription contraceptives if they object to
distributing such drugs for reasons of conscience.
Nurse Wilhemien Charles is suing the Gauteng health department, Kopanong
Hospital, Gauteng health MEC Gwen Ramakgopa, and the Minister of Health
Manto Tshabalala-Msimang on the grounds that she was harassed and
intimidated into assisting at abortions. She left the state hospital to work
in the private sector. The Vereeniging Equality Court directed her to the
Labour Court, but she is going to South Africa's High Court instead. She is
seeking an unconditional apology, R50 000 damages, and court orders to
prevent unfair discriminatory practices at South African health facilities.
Charles would have had to pay for proceedings in Labour Court, her
current lawyer would not have been able to act for her, and other parties
could not have joined the action to support her. Nurse Charles and Doctors
for Life plan to submit evidence that intimidation of conscientious
objectors is systemic. [News
Item] [South
African nurse denied position]
An inquest has heard evidence that 11 elderly men at a Derby
hospital were starved to death. Inquest chairman Sir Richard Rougier has
stated that if food and fluids were withheld "in good faith' to bring about
patient deaths as "the lesser of two evils" (continued life apparently being
the greater) "it would be grossly unfair to record a verdict other than that
of death by natural causes" [The Telegraph]. His statement demonstrates the probability that conflicts of conscience are likely to
arise for health care workers in such circumstances.
In testimony before a House of Lords Select Committee the Catholic
Bishops' Conference of England and Wales has criticized Lord Joffe's
euthanasia bill because it weakens protection for the vulnerable. [Catholic
Communications Service, 18 January] On the other hand, Canon Professor Robin
Gill, an advisor to the Anglican Archbishop of Canterbury, testified that
Anglican were divided on whether or not the law should be changed, noting
that Anglican bishops were against it but churchgoers were in favour. The
Archbishop later stated that the Anglican church remains opposed to
euthanasia. [The Independent, 16 January] The different positions adopted
suggest the likelihood of conflicts of conscience arising among health care
workers should the bill pass, and underline the importance of protective
legislation for conscientious objectors.
A bill introduced in the New Jersey legislature would force pharmacists to
dispense medication despite philosophical, moral or religious objections. [Bill]
A report from the Royal Dutch Medical association asserts that doctors
may provide euthanasia for patients who are suffering "hopelessly and
unbearably," even if they are not physically or mentally ill. Such persons
are said to be "suffering through living." [British
Medical Journal] The gradual expansion of the circumstances under which
euthanasia is socially or ethically acceptable indicates the need for
protection of conscience legislation, without which objectors are likely to
face increasing pressure and even coercion to facilitate or participate in
the procedure.
A bill proposed in California by Assemblyman Lloyd Levine would require
pharmacists to supply contraceptives and potentially abortifacient drugs,
even if it were against their conscientious convictions. Levine considers it
a pharmacist's job to fill prescriptions. He is also working on a bill to
legalize assisted suicide by doctors. It would be consistent with his
position to force doctors to participate in assisted suicide. The bill is
opposed by Assembly Leader Kevin McCarthy on the grounds. [EWTN]