Doctors divided over voluntary assisted dying legislation in Victoria

Australian Broadcasting Corporation

Lauren Day

You may think you have to make some pretty tough decisions at work, but it doesn’t get much tougher than choosing whether to help someone die.

Doctors are grappling with their personal and professional beliefs about death and their role in it as politicians in Victoria consider assisted dying laws.

Opinion polls show the majority of people support voluntary assisted dying, but those who would have to administer it are divided.

Polls suggest around 75 per cent of people support assisted dying for the terminally ill, but only 40 per cent of doctors agreed in a recent survey by the Australian Medical Association. . . [Full text]

 

Bioethicist calls for a ban on doctors’ conscientious objection

The Sydney Morning Herald

Cameron Atfield

Doctors working in the public system should be banned from refusing to perform certain procedures, such as abortions, because of their religious beliefs, a leading bioethicist will argue in Brisbane next week.

Oxford-based Australian bioethicist Julian Savulescu will make the argument at a public lecture at the Queensland University of Technology’s Australian Centre for Health Law Research next Tuesday.

In his lecture, Professor Savulescu will also argue doctors and health professionals should only enter medical specialities in which their values would not be in conflict with routine legal medical procedures. . . [Full text]

Anti-vaccination group ‘encouraging parents to join fake church’ for religious loophole

 9news.com.au

An anti-vaccination group is reportedly encouraging parents to sign up to a fake church so they can bypass immunisation requirements for childcare.

Under a NSW government’s 2013 law and the Victorian government’s proposed law due to start next year, children who are not fully immunized cannot enroll in childcare.

But parents can get around these laws if they declare a conscientious objection on a Medicare form and have it signed by a GP, who first counsels them about the risks and benefits of immunisation, Fairfax Media reports. . . [Full text]

 

Proposed Australian euthanasia bill may return in 2015

Medical Services (Dying with Dignity) Exposure Draft Bill 2014

The six member Legal and Constitutional Affairs Committee of the Australian Senate has issued a report recommending that Greens senator Richard di Natale reflect and consult further with experts concerning his euthanasia and assisted suicide bill.  The Committee also recommended that, if a revised bill is formally introduced, senators should be allowed a “conscience vote” on it. The bill has some provisions that provide some protection for objecting physicians, but they are problematic in some respects.

Victorian Premier and Opposition Leader pledge to allow conscience vote on forcing doctors to participate in abortion

News Release

Australian Christian Lobby

The Victorian Premier and Opposition Leader will allow a conscience vote if a private members’ bill is introduced to restore freedom to doctors to decline to participate in abortion.

Denis Napthine and Daniel Andrews were responding to questions from Christian leaders at the Australian Christian Lobby’s Make it Count forum at Queens’ Hall, Parliament House last night.

Their commitments come following sanctions imposed on Melbourne Doctor Mark Hobart, who declined to assist a couple who wanted their baby girl aborted so they could try again for a boy.

“If a private members’ bill was introduced then we would certainly allow a conscience vote,” Dr. Napthine said.

“My position would be to afford a conscience vote,” Mr Andrews said.

ACL Victorian Director Dan Flynn welcomed the leaders’ commitments to allow a parliamentary vote on whether or not doctors should be forced to participate in abortion by making a referral for an abortion.

“No one should be forced to go against their conscience on an issue which involves the taking of a human life,” Mr Flynn said.

The leaders were asked about a range of issues including domestic violence, freedom of religion, poker machine reform and the ice epidemic.

Asked whether “your Government (would) commission independent research into whether there are features in poker machines that lead to gambling addiction”, Mr Andrews committed to examining “the best research, the best evidence”.

On family violence, Dr. Napthine said: “Men particularly need to stand up”.

Mr. Andrews said family violence was the leading cause of death or disability for women aged 45 and under and was “national disgrace”.

On religious freedom, Mr Flynn expressed disappointment about Labor’s election policy, reiterated last night by Mr Andrews, to amend Equal Opportunity laws to diminish the freedom of faith-based schools to employ staff who share their ethos.

Dr. Napthine was called away from the forum to deal with last night’s terrorism-related shooting of an Islamic extremist just moments before Mr Andrews concluded taking questions.

The pre-election Make it Count event was attended by 150 Christian leaders from a wide cross-section of denominations and churches.

Assisted suicide and euthanasia bill proposed in Australian Senate

Medical Services (Dying with Dignity) Exposure Draft Bill 2014

A bill to legalize physician assisted suicide and euthanasia has been proposed to the Australian Senate by Green Party Senator Richard di Natale.  Since it is an “exposure draft” it is not in the queue for passage. It includes provisions that provide protection for medical practitioners who refuse to provide the services for “any reason.”  However:

  • The objects of the Act set out in Section 3 do not include the protection of conscientious objectors;
  • The definition of “dying with dignity medical service” in Section 5 includes
    • euthanasia
    •  assisted suicide
    • providing information
  • Since Section 5 is broadly written, it appears that the attending medical practitioner can delegate the act of euthanasia to someone else.
  • Section 11(2)a states that a medical practitioner may refuse to provide euthanasia or assisted suicide “for any reason,” which would include reasons of conscience or religion, but
    • the section pertains only to medical practitioners
      • so it does not protect objecting pharmacists or other health care workers
    • Section 11(2)a does not state that medical practitioners may refuse to facilitate euthanasia or assisted suicide throught referral
  • Section 21 precludes coercion of objecting medical practitioners, but
    • does not preclude coercion of other objecting health care workers, and
    • can be understood to prevent hospices or denominational hospitals from enacting policies against euthanasia and assisted suicide
  • Section 24 provides protection from civil and criminal liability and disciplinary proceedings for medical practitioners who refuse to provide euthanasia and assisted suicide, but
    •  does not clearly offer similar protection to objecting practitioners, since refusing to provide euthanasia or assisted suicide cannot be said to be an omission “for the purposes of the Act,” which are specified in Section 3, and
    • offers no protection at all for other objecting health care workers.
  • There is no provision to protect persons who object to euthanasia for reasons of conscience from discrimination in education or employment.

Fundamental freedoms

 Why the right to conscientious objection must be restored

Presentation to the Life Dinner
Melbourne, Australia

David van Gend*

I feel a little out of place coming from Queensland to speak about the wretched situation in Victoria: coming from a State where it is always sunny, where the people are always nice, and where we don’t have oppressive laws that try to compel the conscience of free citizens.

But we are all in this together: an assault on fundamental freedoms in one State will become a precedent for similar abuses in other States.

Uncivil society

It was a Melbourne man, Julian Savulescu, now an ethics professor at Oxford, who declared that doctors who will not provide abortion should be “punished through removal of license to practice”. He wrote in the British Medical Journal in 2006:

A doctors’ conscience has little place in the delivery of modern medical care. What should be provided to patients is defined by the law… If people are not prepared to offer legally permitted, efficient, and beneficial care to a patient because it conflicts with their values, they should not be doctors.1

Crucial to his argument is that, “when society has already decided that a service is legal”, it is not for doctors to “compromise the delivery of services”. When Savulescu’s article was discussed in 2006 in the medical newspaper Australian Doctor, I was given as an example of the sort of doctor who, in his view, “should either get out of the specialty or the profession altogether.”2  I gave a different angle to Australian Doctor: that abortion as commonly practiced is not a medical service; it is a “medical abuse” which doctors are bound by their Hippocratic principles and humane conscience not to commit.

And no law, no professional board, has the authority to compel any doctor to violate the principles of their vocation or mutilate their own conscience by collaborating in intentional killing.

Yet in Victoria, under section 8 of the Abortion Law Reform Act 2008,3 that compulsion by the authorities is exactly what doctors and nurses face.

Not long ago society was a little more civil and did not contemplate using the force of law to compel the conscience of fellow citizens. . . [Full text]

Refusals of vaccinations in Australia

A controversy has developed in Queensland, Australia, over the refusal of some parents to have their children vaccinated.  Although media reports refer to “conscientious objection,” it appears that the term is being applied much more broadly to encompass those who refuse vaccinations because they are concerned about side effects or doubtful about their efficacy.  Queensland Health Minister Lawrence Springborg told a reporter, “I think the whole issue of conscientious objection has been abused and misused and really we are dealing here with people who are vaccine refusers.” [news.com.au]

Protection of conscience provision in new Tasmanian abortion law

The Reproductive Health (Access to Terminations) Bill 2013 passed the Tasmanian  Legislative Council 9-5 on 21 November [ The Examiner] and received Royal Assent today.  Abortions after 16 weeks will require the approval of two physicians.  The new Act includes a protection of conscience provision that exempts those who object to the procedure from participating in it, except when necessary to save the life of a woman or prevent serious physical injury.  There is no requirement for referral, but an objecting physician must provide a woman “seeking a termination or advice regarding the full range of pregnancy options” a “list of prescribed health services” from which she may seek advice.  Since, subject to the content of the list, this does not seem to be the equivalent of referral for abortion, the requirement may not be problematic for those concerned about indirect moral complicity.

What is not clear is whether or not the Act actually prohibits an objecting physician from providing information or advice about pregnancy options beyond the “prescribed” list.  Section 7(4) states that an objecting physician may continue to “provide treatment, advice or counselling, in respect of matters other than a termination or advice regarding the full range of pregnancy options” (emphasis added) which could be taken to imply that an objecting physician is not permitted to offer a woman anything other than the prescribed list.