Elizabeth Sepper of Washington University in St. Louis is among those now claiming that protection of conscience laws and policies are neglecting those who provide morally contentious services despite opposition from employers or other authorities. The forthcoming issue of the Virginia Law Review will include a paper by Sepper, “Taking Conscience Seriously,” that makes this argument. Last month, the New England Journal of Medicine published a column by an abortion provider taking the same position (see Physicians who provide abortion, assisted suicide need conscience protection.) Of particular note, citing Catholic hospitals and contraception, she asserts that individual health care workers at denominational hospitals may be denied freedom of conscience by their employers. [ScienceDaily]
An opinion piece in the New England Journal of Medicine asserts that “momentum is building” in favour of assisted suicide and euthanasia, citing activism in various jurisdictions and a recent Canadian court ruling that struck down the law against physician assisted suicide. The authors support assisted suicide and euthanasia, but do not see the need for physician assistance. They suggest that the physician role be limited to providing a written summary of a patient’s condition, prognosis and alternative treatments. Patients would then obtain lethal prescriptions from some state authority.
Redefining Physicians’ Role in Assisted Dying. Julian J.Z. Prokopetz, B.A., and Lisa Soleymani Lehmann, M.D., Ph.D. N Engl J Med 2012; 367:97-99 July 12, 2012
The American Journal of Bioethics has published a article by a surgeon recommending that organs be harvested from patients suffering severe irreversible brain injury prior to their deaths. [ABC News]
A study published in the New England Journal of Medicine reports that intra-uterine devices, DMPA injections and contraceptive implants are significantly more effective than birth control pills, patches or rings.
Brooke Winner, M.D., et al, Effectiveness of Long-Acting Reversible Contraception. N Engl J Med 2012; 366:1998-2007
A paper published in the Journal of Medical Ethics argues that accommodation of freedom of conscience by exempting students from performing morally contested activities is not possible in at least some circumstances. The example given is that of male Muslim students who are unwilling to perform physical examinations on female subjects.
A number of bioethicists argue that some parents who use in vitro fertilization- those believed to be at risk for transmitting serious genetic disorders – should be compelled by law to use pre-implantation genetic diagnosis (PGD) to produce unimpaired offspring: even to use only artificial reproduction and PGD.[Bioedge][American Journal of Bioethics]
Catherine Constable of the New York University School of Medicine has published a journal article advocating that patients diagnosed as being in a permanent vegetative state (PVS) should be killed by starvation and dehydration unless their families insist that they receive assisted nutrition and hydration.
There appears to be an increase in the number of parents in the United States refusing vaccinations for their children, and a significant number of paediatricians are responding by refusing to continue with the families in their practices. More than 30% of Connecticut paediatricians responding to a survey reported that they had asked families to leave their practices because of a refusal to immunize. The study did not attempt to ascertain the reason for this.
Walter Sinnott-Armstrong (Duke University) and Franklin G. Miller (National Institutes of Health) have published a paper titled, “What makes killing wrong?” Their conclusion is that killing is wrong because it causes total disability, and that the moral rule against killing is superfluous. After asserting that current organ transplant practice involves taking vital organs from people who are still alive (as they understand that term) they suggest that more organs could be made available for transplant if the requirement for donor death were dropped and replaced with the criterion of total disability. In the course of the paper they suggest that religious beliefs should not inform medical ethics “in any religiously diverse society,” which would appear to imply that medical professionals should be expected to adopt the views they propose. The paper illustrates, at several points, how conflicts of conscience may arise during end-of-life decision making and organ transplantation.
Anna Smajdor, an ethicist in the United Kingdom, is defending the proposition that artificial wombs should be developed so that women no longer have to bear children. The most recent article continues a discussion begun in 2007, when she asserted that only by this means is it possible to remedy “the natural or physical injustices involved in the unequal gender roles of reproduction” and the alleged “social injustices that arise from them.” [LifeSite News]
Smajdor A. The Moral Imperative for Ectogenesis. Cambridge Quarterly of Healthcare Ethics (2007), 16, 336–345; In Defense of Ectogenesis. Cambridge Quarterly of Healthcare Ethics (2012) 21 , pp 90-103