A number of health care professionals have moral or ethical objections to dispensing the ‘morning after pill’, so a recent article in The Standard (“Morning-after pill poses moral dilemma for some Mds”, 29 June 2000) is of interest beyond the community served by your paper. I would like to make two points.
First: though the drug in question was described as a ‘contraceptive’ that ‘prevents pregnancy’, many who are familiar with the action of the drug consider it an abortifacient, not a contraceptive, and object to dispensing it for that reason. Moreover, people attempting to understand the issues involved need to be aware that the words ‘abortion’, ‘pregnancy’, ‘conception’ and ‘contraception’ are often assigned completely different meanings by parties in the dispute about Preven.
Second: the good news in the story is almost too obvious for many to see. The woman obtained the drug that she wanted, and the physician was not forced to involve himself in something that he considered to be morally abhorrent. Arrangements at the hospital accommodated both her request for the drug, and his request not to have someone else’s morality imposed upon him.
This is the kind of common-sense accommodation that ought to be more widely practised.
Sean Murphy, Administrator
Protection of Conscience Project
Representatives speaking up for freedom of conscience in pharmacy were told that they should leave the profession by more than one colleague at the Canadian Pharmacists Association Conference in Saskatoon. Frank Archer’s article was cited against them.
Fuáir an Coiste Ill-phairti Oireachtais ar an mBunreacht, pléadáil I scríbhinn on gComhairle Saoirse Choinsiasa, ar an nga oibrithe I gcúrsaí leighis agus daoine nach iad a bheith cosainte ó éigeantalacht agus di-mheas.
Chuir Riarthóir an Phróiseas, Sean ó Murchu, in úil go bhfuil béim an phléadáil o chuile éisteachtai eile an Choiste go dáta. “Ní faoi geinmhilleadh,@ adeir sé, “ach faoi saoirse choinsiasa, chomh fada is a bhaineann sé le cursai leighis faoi lathair, ata na smaointe seo.@
“Mo lean,” a mhinigh sé, “na h-argointi faoi chúrsai léighis go dtí seo-ni raibh siad riamh curtha, ionas go mbeadh, mar deir diad (seal mhachnamh stuamtha), agus mar gheall air sin ni raibh aon mhachnamh deanta ar na rudai tharlaionn dóibh siud ata in aghaidh geinmhilleadh de réir choinsiasa”.
Thagair an t-Uasal ó Murchu don staitistic a rinne iarracht soiléiriú, nuair nach raibh an cúrsa leighis seo sásúil do go leor daoine,nach raibh iachall ar na daoine sin páirt a ghlacadh ann. Rinne an pléadáil I scríbhinn an poinnte nach bhfuil sé sin fíor. Ní dheanann an pléadáil aon phoinnti faoi moltaí spesificiula-fagtar iad seo faoi chúraim an Choiste.
” Má tá nó má bhionn gá le tacaíocht choinsiasa a chur ins an dlí in Éirinn, is faoi Muinntear na H-Éireann a bheas an cúram sin, agus is in Éirinn a chaithfidh na dlíthe agus na polasaithe a bheith déanta-chomh fada is a bhaineann siad le saol na H-Éireann”.
Tá an pléadáil seo ar fáil on Website.
Protection of Conscience Project
The All-Party Oireachtas Committee on the Constitution has received a written submission from Protection of Conscience Project on the need for laws to protect health care workers and others from coercion and discrimination.
Project Administrator Sean Murphy noted that the focus of the submission was different from that of the recent Committee hearings. “This submission is not about abortion,” he wrote, “but about freedom of conscience in relation to morally controversial medical procedures.”
“Unfortunately,” he explained, “discussions about such procedures have not always been accompanied by sufficient reflection about their impact on those who object to them for reasons of conscience.”
Mr. Murphy observed that when the procedure in question is objectionable to large numbers of people, it is usually assumed that no one would be forced to participate in it. The submission cites a number of cases to make the point that, in the long run, this is not the case.
The Project does not recommend specific measures, leaving such questions for the consideration of the Committee: “If there is or will be a need for protection of conscience legislation in Ireland, that need will have to be articulated by Irish citizens, and laws and policies framed according to the circumstances prevailing in Ireland.”
The submission to the Committee is available on-line through the Project Website.
The Toronto Sun published an article by columnist Marianne Meed Ward mocking the position taken by conscientious objectors among pharmacists.
In May, 2000, prior to the decision by Manitoba pharmacists, a letter to the editor of the Pharmacy Practice (an on-line publication) had argued against the idea largely on grounds of economic self interest. (See the response of the Project)
Also in May, the Canadian Pharmaceutical Journal, owned by the Canadian Pharmacists Association, published a column asserting that pharmacists must dispense drugs despite conscientious objection, or refer patients to a pharmacist who will The column was written by Frank Archer, described as a bio-medical ethics tutor at the University of British Columbia, and a member of the ethics committee of the College of Pharmacists of British Columbia. In the same issue, the editor of the Journal declared: “Emergency contraception is here and the majority of Canadians – including most health professionals – are firmly in support. Pharmacists have a professional responsibility to help ensure safe, efficient access to all approved medicines, whatever their personal beliefs.”
Japan, the United States, Canada, Australia, New Zealand and the European Union are reported to be trying to make it illegal for health care workers to decline to perform abortions for reasons of conscience. The negotiations at the Beijing +5 conference are said to have broken down when Nicaragua proposed strong language to protect conscientious objectors. If accurate, these reports indicate that the US, Australia and New Zealand are attempting to impose on third world countries policies that are not acceptable in their own, since all three countries have enacted protection of conscience legislation for their own health care workers.
Reports from South Africa indicate that there is considerable controversy surrounding the operation of abortion facilities. It is said that some medical personnel are being forced to participate in abortions despite conscientious objection, while some medical personnel willingly involved in abortions have been subjected to harassment.
The adoption of a protection of conscience policy not dissimilar to those existing in some pharmacy associations in the United States triggered an attack by the Winnipeg Sun in an editorial titled Pharmological farce. (See Project’s response) Coverage in the National Post and Winnipeg Free Press was more balanced. CBC Radio in Winnipeg hosted an open-line programme on 8 June concerning the issue.
Pharmacists for Life (Canada)
Pharmacists for Life Int’l/Canada (PFLI/Canada) is an educational group concerned with sanctity of human life issues affecting the profession. We appreciate and applaud the noble decision of the Manitoba Pharmaceutical Association to include in their Standards of Practice a statement which allows the professionals that they regulate to follow their conscience in the practice of this health care profession.
Since the statement does not force a pharmacist to dispense or make referrals for products or services “in which they have a medical, ethical, moral or religious objection to, the Association shows its recognition of the pharmacist’s autonomy and integrity. By allowing a freedom of conscience, pharmacists are not impaired in the proper exercise of professional judgment and skills”, said Mr. Michael Izzotti, coordinator of PFLI/Canada.
For many years the profession has been encouraging all pharmacists to become more involved in the practice of “pharmaceutical care”, in which pharmacists provide cognitive services to the public, as well as, supplying products which are intended to achieve specific “health outcomes” for the patient. Mr. Izzotti stated that in the provision of pharmaceutical care, “causing death of a human being is not included in the list of “health outcomes.” He also stated, “that to many pharmacists, the practice of proper pharmaceutical care would exclude the provision of any products that are intended to cause death, including chemicals for assisted suicides, euthanasia and those which can cause abortions.”
Contact: Michael Izzotti, Coordinator PFLI/Canada Tel: (905)528-4828 Fax: (905)528-5593