1 July, 2014
Covering the period from 1 May, 2014 to 30 June, 2014
1. By Region/Country
Visit the Project News/Blog for details.
It has been disclosed that researchers at the Hoff Clinic, at the Vienna
University Clinic for Psychiatry and Neurology deliberately
infected hospitalised orphaned children with malaria in the hope of finding a cure
for syphilis. The incident is being studied by an historical
A bill to legalize physician assisted suicide and euthanasia has been
proposed to the Australian Senate, though it is not slated for debate and
that provide protection for medical practitioners who refuse to provide the
services for "any reason." However, there are a number of problems
with the text. Among them, there is no protection for non-physicians
and no protection against discrimination in employment.
Dr. Thomas Schirrmacher is the Rector of Martin Bucer Seminary, Executive
Director of the International Institute for Religious Freedom, and
Ambassador for Human Rights of the World Evangelical Alliance. He delivered
a lecture at Brazil's Supreme Court on the subject of religious freedom that
was attended by about 400 congressmen, members of the government, government
staff, representatives of public authorities, heads of Christian churches,
leaders of other religions, and the leadership of the Christian legal
Some Canadian physicians are concerned that regulatory changes will
generate pressure on doctors to prescribe marijuana. Dr. William Pope, the registrar of
the College of Physicians and Surgeons of Manitoba, said, "As far as most of us are
concerned, there is really no appropriate prescribing."
The Quebec legislature has passed An Act Respecting
End-of-Life Care ("ARELC") is intended to legalize euthanasia by
physicians in the province of Quebec. It replaces the original Bill
52, the subject of a previous
commentary by the Project. ARELC allows Quebec physicians to
provide euthanasia under the Medically Assisted Dying (MAD) protocol.
In addition, substitute decision makers can order legally incompetent
patients who are not dying to be starved and dehydrated to death. This
practice is completely unrestricted and is not even reportable.
The law will not take effect until December, 2015. However, the introduction of euthanasia will require the complicity of thousands
of health care workers and administrators. Many are likely to
comply, but palliative care physicians, hospices and an
undetermined number of other physicians and health care workers are opposed
to euthanasia and assisted suicide.
Physicians may refuse to provide euthanasia if the patient is legally
ineligible, and for other reasons, including conscientious objection.
ARELC requires physicians who refuse to provide euthanasia for any reason
other than non-eligibility to notify a designated administrator, who then
becomes responsible for finding a MAD physician. The idea is to have
the institution or health care system completely relieve the physician of
responsibility for facilitating the procedure.
The protection of conscience provision in ARELC distinguishes physicians
from other health professionals, providing less protection for
physicians than for others. Physicians may refuse only "to
administer" euthanasia - a very specific action - which seems to
suggest that they are expected to participate in other ways. A serious
problem is presented by the Code of Ethics of the Collège des médecins, because it
requires that physicians who are unwilling to provide a service for reasons
of conscience help the patient obtain the service elsewhere.
Palliative care hospices and a single Quebec hospital may permit
euthanasia under the MAD protocol on their premises, but they do not have to
do so. Patients must be advised of their policy before admission.
A prominent hospice spokesman predicted that hospices refusing to provide
euthanasia will operate in an increasingly hostile climate.
Project commentary on the original draft statute has been revised and
republished to reflect the law passed by the legislature.
Three physicians and a lawyer have written an article published in the
May issue of the Canadian Medical Association Journal. The authors warn that the medical profession must
prepare for the legalization of assisted suicide and euthanasia, and must be
ready to answer questions like,"Will physicians who are conscientious objectors be obliged to present
physician-assisted death as an option to patients and facilitate
transfers of patients to other physicians or facilities?"
The College of Physicians and Surgeons of Ontario (CPSO) has announced a public
consultation as part of its review of
Physicians and the Ontario Human Rights Code. The policy
was adopted amidst considerable controversy in 2008 because of an
unsuccessful attempt by the College and the Ontario Human Rights Commission
to suppress freedom of conscience in the medical profession.
The CPSO review follows a province-wide
crusade earlier this
year against three Ottawa physicians who provide support for natural family
planning but refuse to prescribe or refer for contraception or abortion.
In June, a Calgary doctor who also refuses to prescribe contraceptives was
vehemently denounced, a number of people repeating the increasingly frequent
refrain that such people should not be allowed to practise medicine.
A French court has acquitted a physician charged with lethally injecting
seven terminally ill patients. Dr. Nicolas Bonnemaison claimed that he was
acting properly as a physician. Another French court ordered the
cessation of assisted nutrition and hydration for Vincent Lambert, who is
comatose, but not dying. The application was brought by his wife, but
is being opposed by his parents, who successfully petitioned the European
Court of Human Rights to intervene.
A bill to permit physician-assisted suicide has been approved by the Ministerial Committee on Legislative Affairs,
but is being strongly opposed by rabbinical authorities in the country.
Francesca Minerva argues that Italy should offer higher salaries to
physicians willing to perform abortions and should establish limits on the
number of physicians allowed to exercise freedom of conscience in Italian hospitals.
The Green Party of New Zealand has published a
position paper that appears to admit that 99% of abortions are
not, in fact, necessary to ensure mental or physical health. The
paper incorrectly implies that a physician willing to provide an abortion is
"neutral" with respect to the procedure, while a physician unwilling to do
so is not. The party states that it will force objecting physicians to
refer for abortions, even though, according to its own paper, no medical
grounds exist for "99%" of abortions now taking place in the country.
The management of a private Polish hospital, the Hospital Pro-Familia in
Rzeszów, is now suing anti-abortion activists who are publicly protesting
abortions that are being performed at the facility. It appears that
the hospital is attempting to prevent the activists from describing abortion
as "killing." Such a restriction on expression would make it
impossible for many health care workers who object to abortion to
explain the basis for their objections.
A Declaration of Faith for Catholic doctors and medical
students was published in a letter by
Dr. Wanda Półtawska, a friend of Pope John Paul II, and
subsequently signed by over 3,000 people. The Declaration insists that Catholics, including physicians, "have a right to perform their professional
activities in accordance with their conscience." [Deklaracja
A prominent Polish physician is at the centre of a controversy about
abortion. Dr. Bogdan Chazan, director of Holy Family Children's
Hospital in Warsaw, refused to authorize an abortion for a woman whose baby
had been diagnosed with severe brain damage, and did not refer her elsewhere
for the procedure. The Polish Prime Minister has weighed in, insisting
that physicians who refuse to provide abortions for reasons of conscience
must refer patients to someone who will do so.
Those attending an annual conference of the Catholic Medical Association
were told that physicians who adhere to the teaching of the Catholic Church
should seriously consider emigrating, since there is no room for such a
worldview in medical practice in the country.
Britain's National Health Service will provide drugs to suppress puberty
to children as young as nine if they believe that they are they wrong sex.
The treatment is intended to make sex change surgery easier should they
later opt for it. This could eventually give rise to conflicts of
conscience among physicians or other health care workers who may be expected
to participate or facilitate it, though the treatment is now managed by
specialists who do not have moral or ethical concerns about it.
Niall Dickson, the head of the General Medical Council (GMC), has
admitted that more than 60 doctors signed forms to authorize abortions
without knowing anything about the women who were seeking them. They
acted illegally, and Dickson described it as unacceptable, but no
disciplinary action or prosecution was recommended. According to
Dickson, no patients were harmed and the practice has ended. Since the
GMC declines to act against physicians who deliberately do what they know to
be wrong in order to facilitate abortion, it remains to be seen whether or
not it will act against physcians who refuse to do what they believe to be
wrong - such as facilitating abortion.
As a result of a boycott by European manufacturers opposed to capital
punishment, a shortage of a lethal drug, Nembutal, is stopping both
executions and assisted suicide in the United States. Meanwhile, a
private group, the
Death Penalty Committee of The Constitution Project, has recommended
that executions be carried out using a single lethal drug, as is the case
with legal assisted suicides. The group also recommended that every
exectuion by lethal injection be carried out under the supervision of
medical professionals in order to minimize unnecessary pain or suffering.
The second recommendation contradicts the position of the American Medical
Association and has been criticized by professors from Harvard University.
The Supreme Court of the United States has ruled 5/4 in
favour of Hobby Lobby, a Christian business seeking exemption from the
controversial Health and Human Services birth control mandate. The
ruling is likely to affect the outcome of numerous other civil suits brought
against the federal government by employers who object to providing employee
insurance for contraceptives, embryocides and sterilization for reasons of
conscience. The HHS birth control mandate and surrounding controversy,
while not directly affecting health care workers, has become part of the
social environment that affects discussion of freedom of conscience in
A court in Virginia has imposed a sentence that includes
mandatory vasectomy on a 27 year old male. The sentence was part of a
plea bargain. It appears to have been suggested because the accused
had fathered numerous children out of wedlock.
A clinic in Toledo, Ohio, has advised parents that,
after June 1, 2015, clinic paediatricians will not accept or treat children
whose parents refuse to have them vaccinated. The decision is not
related to the moral or religious beliefs of physicians, but reflects their
concern that unvaccinated children present a health risk to others attending
2. News Items
You can search news items by date, country and topic in the
Calgary doctor refuses to prescribe birth control due to
The doctors’ declaration of faith
Should doctors have the right to refuse to treat a patient?
Assisted suicide and euthanasia bill proposed in Australian
Doctor on duty ‘will not prescribe the birth control pill,’
reads sign at Calgary walk-in clinic
Euthanasia rulings in Europe stir right-to-die debate
Virginia’s compulsory vasectomy
Right-to-die already weighing on Quebec’s conscience
New Zealand Green Party will force referral for abortion for
Director of IIRF Speaks at Brazil’s Superior Court of Justice on
Freedom of Expression and Conscientious Objection
Polish Prime Minister says doctors must do abortions despite
Chief Rabbi Strongly Condemns Assisted Suicide
Lawmakers clash over euthanasia bill
Doctor group declines care to unvaccinated
Medical marijuana and conscience rights
Catholic physicians who want to follow their conscience must
‘emigrate,’ UK expert says
Top employment strategies for discouraging conscientious
Doctors who follow church teaching told to emigrate
Should doctors take part in executions?
Embargo on lethal drug stops executions and assisted suicides in
Professor argues for a profound rethinking of conscience rights
NHS to give sex change drugs to nine-year-olds: Clinic accused
of ‘playing God’ with treatment that stops puberty
Doctors reluctant to give young women permanent birth control
Canadian physicians warned to get ready for euthanasia and
Austrian historians studying another informed consent debacle
from the 50s
New execution protocol similar to doctor-assisted suicide
Pre-signing abortion forms is illegal, General Medical Council
Polish “Family” Hospital Doing Abortions Sues Pro-Life Activists
3. Recent Postings
CMA doctors hail Supreme Court mandate ruling, decry ongoing
targeting of faith community
ACLJ: Supreme Court Issues “Landmark Decision Protecting
Religious Freedom and Freedom of Conscience”
Services (Dying with Dignity) Exposure Draft Bill 2014
Polish physicians and medical students declaration of faith and
freedom of conscience
freedoms: Why the right to conscientious objection must be
International stands firmly behind Dr. Bogdan Chazan
West Island Palliative Care Residence clarifies care it offers
following passage of Quebec's end-of-life legislation
Physicians and the Ontario Human Rights Code
Redefining the Practice of Medicine: Euthanasia in Quebec.
An Act Respecting End-of-Life Care (June, 2014)
4. Action Items
The Project will post notices of conferences
that are explore and support the principle freedom of conscience, including the
legitimate role of moral or religious conviction in shaping law and public
policy in pluralist states or societies.
6. Publications of Interest
Downar J, Bailey TM, Kagan J, Librach SL.
Physician-assisted death: time to move beyond Yes or No. CMAJ
2014 May 13;186(8):567-8. doi: 10.1503/cmaj.140204. Epub 2014 Apr 7.
Conscientious objection in Italy. Med Ethics doi:10.1136/medethics-2013-101656
Nordstrand SJ, Nordstrandagnus MA, Nortvedt P,
Magelssen. Medical students'attitudes towards conscientious objection: a survey J Med Ethics
Accommodating conscience in medicine.
J Med Ethics doi:10.1136/medethics-2013-101892 Commentary
Truog RD, Cohen IG, Rockoff MA. Physicians,
Medical Ethics, and Execution by Lethal Injection.
JAMA. 2014;311(23):2375-2376. doi:10.1001/jama.2014.6425.