Doctors who oppose morning-after pill on conscience grounds face qualifications bar

Guidelines confirm that doctors and nurses who oppose controversial emergency contraception on ‘moral or religious’ grounds cannot receive key specialist qualifications

The Telegraph

John Bingham

Doctors and nurses who object to providing controversial emergency contraception on moral or religious grounds are being barred from specialist professional qualifications under official guidelines.

They class Roman Catholics and others motivated by pro-life beliefs as “ineligible” for important qualifications provided by the Royal College of Obstetricians and Gynaecologists (RCOG) even if they complete the training programme.

It led to accusations that the Faculty of Sexual and Reproductive Healthcare, a branch of the RCOG, is unfairly discriminating against medical staff who act on grounds of conscience. [Full Text]

The Hippocratic “oath” (Some further reasonable hypotheses)

Research 2014; 1:733

Sergio Musitelli*, Ilaria Bossi*

Abstract

Although 65 treatises – either preserved or lost, but quoted by ancient authors like Bacchius (3rd century B.C.), Erotian (1st century A.D.) and Galen (c. 129-199 A.D.) – are ascribed to Hippocrates (c. 469-c. 399 B.C.) and consist of nearly 83 books, nonetheless there is no doubt that none of them was written by Hippocrates himself. This being the fact, we cannot help agreeing with Ulrich von Wilamowitz Möllendorf (1848-1931), who maintained that Hippocrates is a name without writings!

Indeed the most of the treatises of the “Corpus hippocraticum” are not the collection of Hippocrates’ works, but were likely the “library” of the Medical School of Kos. The fact that it contains some treatises that represent the theories of the Medical school of Cnidos (most probably founded by a certain Euryphon, almost contemporary with Hippocrates), with which it seems that Hippocrates entered into a relentless debate, is an absolute evidence.

Moreover, we must confess that, although Celsus (1st century B.C.-1st century A.D.) (De medicina, I, Prooemium) writes that “Hippocrates of Kos…separated this branch of learning (i.e. Medicine) from the study of philosophy”, we have nothing to learn from the hippocratic treatises under the scientific point of view.

However, whatever its origin, the “Oath” is a real landmark in the ethics of medicine and we can say – with Thuchydides (460/455-400 B.C.) (Histories, I, 22, 4) – that it is “an achievement for eternity”.

Suffice it to remember that every graduand in Medicine is generally still bound to take an oath that is a more or less modified and more or less updated text of the “Hippocratic oath” and that even the modern concept of bioethics has its very roots in the Hippocratic medical ethics.

“The art is long; life is short; opportunity fleeting; experiment treacherous; judgment difficult: The physician must be ready, not only to do his duty himself, but also to secure the co-operation of the patient, of the attendants and of externals, ” says the first “Aphorism” and the latest author of “Precepts” (chapter VI) writes: “where there is love of man, there is also love of the art”, and the “art” par excellence is medicine! These precepts go surely back to Hippocrates’s moral teaching.

Nonetheless, the preserved text of the marvellous “Oath” raises many problems. Namely:

1) which is the date of it”?

2) Is it mutilated or interpolated?

3) Who took the oath, i.e. all the practitioners or only those belonging to a guild?

4) What binding force had it beyond its moral sanction”?

5) Last but not least: was it a reality or merely a “counsel of perfection”?

In this article we have gathered and discussed all the available and most important sources, but do not presume to have solved all these problems and confine ourselves to proposing some reasonable hypotheses and letting the readers evaluate the positive and negative points of our proposals. [Full Text]

Why religion deserves a place in secular medicine.

Journal of Medical Ethics, 41: 229-233

Nigel Biggar

Abstract:

As a science and practice transcending metaphysical and ethical disagreements, ‘secular’ medicine should not exist. ‘Secularity’ should be understood in an Augustinian sense, not a secularist one: not as a space that is universally rational because it is religion-free, but as a forum for the negotiation of rival reasonings. Religion deserves a place here, because it is not simply or uniquely irrational. However, in assuming his rightful place, the religious believer commits himself to eschewing sheer appeals to religious authorities, and to adopting reasonable means of persuasion. This can come quite naturally. For example, Christianity (theo)logically obliges liberal manners in negotiating ethical controversies in medicine. It also offers reasoned views of human being and ethics that bear upon medicine and are not universally held – for example, a humanist view of human dignity, the bounding of individual autonomy by social obligation, and a special concern for the weak.[Full text]

 

American veterans dying while on secret wait list: a question of integrity

CNN has reported that at least 40 American veterans at the Phoenix Veterans Affairs Health Care system have died because they did not receive timely medical care.  The report exposes the duplicitous practice of maintaining a “secret” list of patients with actual wait times, and an “official” wait list used to make it appear that all veterans are receiving treatment within 14 to 30 days.  In reality, about 1,400 to 1,600 veterans have been waiting months for treatment.  According to a physician interviewed by CNN and emails obtained by the news agency, staff at Phoenix Veterans Affairs were aware that the practice is unethical.   The physician interviewed described them as “frustrated” and “upset,” but afraid to “speak out or say anything”  because they know they will be fired if they do. [CNN]

RCOG faculty bars prolife doctors from receiving its degrees and diplomas

 Dr. Peter Saunders*

Doctors and nurses who have a moral objection to prescribing ‘contraceptives’ which act by killing human embryos are to be barred from receiving diplomas in sexual and reproductive health even if they undertake the necessary training according to new guidelines.

Under new rules issued by the Faculty of Sexual and Reproductive Health (FSRH) earlier this year these doctors and nurses are also to be barred from membership of the faculty and from specialty training.

The FSRH is a faculty of the Royal College of Obstetricians and Gynaecologists established on the 26th March 1993 as the Faculty of Family Planning and Reproductive Health Care. In 2007 it changed its name to the Faculty of Sexual and Reproductive Healthcare. [Full Text]

 

Scandal of the doctors who were let off after approving abortions for women they’d never even met

67 doctors were identified in an investigation by NHS watchdog
Care Quality Commission said they illegally signed blank abortion forms
But none of them will be brought before a fitness to practise hearing

Daily Mail

Simon Caldwell

Dozens of doctors found to be signing off abortions for women they had never met will not face any disciplinary action, it was revealed yesterday.

The 67 doctors were identified in an investigation by NHS watchdog the Care Quality Commission as having illegally signed blank abortion forms, which should be filled in only once they have a thorough understanding of a woman’s circumstances.

One of the doctors had signed so many blank forms that they were still being used by the abortion clinic four years after he left.

All 67 were referred to the General Medical Council but a Freedom of Information request has now established that none of them will be brought before a fitness to practise hearing, where they could be disciplined, suspended, or struck off.

The GMC has also refused to pass the names to the police, even though the offence can merit a jail sentence. [Full Text]

Totipotency: What It Is and What It Is Not

Stem Cells and Development. April 15, 2014, 23(8): 796-812. doi:10.1089/scd.2013.0364.

Maureen L. Condic

Abstract

There is surprising confusion surrounding the concept of biological totipotency, both within the scientific community and in society at large. Increasingly, ethical objections to scientific research have both practical and political implications. Ethical controversy surrounding an area of research can have a chilling effect on investors and industry, which in turn slows the development of novel medical therapies. In this context, clarifying precisely what is meant by “totipotency” and how it is experimentally determined will both avoid unnecessary controversy and potentially reduce inappropriate barriers to research. Here, the concept of totipotency is discussed, and the confusions surrounding this term in the scientific and nonscientific literature are considered. A new term, “plenipotent,” is proposed to resolve this confusion. The requirement for specific, oocyte-derived cytoplasm as a component of totipotency is outlined. Finally, the implications of twinning for our understanding of totipotency are discussed.

Highlights

  • Inaccurate use of the term “totipotent” by scientists creates unnecessary ethical controversy.
  • Public concern over producing embryos by reprogramming reflects confusion over totipotency.
  • Twinning by blastocyst splitting does not provide scientific evidence for totipotency.

[Full Text]

Swedish midwives must provide abortions even if they object

Smålandsnytt

Caution: machine assisted translation

Ellinor Grimmark denied job – was not discriminated against

It was not discriminatory of Jönköping County Council to deny Ellinor Grimmark the job of midwife when she refused to perform abortions. Thus says the Equality Ombudsman in dismissing the case.

The midwife Ellinor Grimmark felt discriminated against because of her faith, but after investigation the Discrimination Ombudsman (DO) felt that not to be the case.

“It was quite expected, I did not think the Swedish Equality Ombudsman would dare bring it up,”  Ellinor Grimmark told Smålandsnytt.

According to the DO, the County Council of Jönköping did not deny Ellinor Grimmark employment because of her beliefs in themselves, but because she was not prepared to carry out a task which is part of midwifery.

Although this had serious consequences for Ellinor Grimmark, this was proportionate to the aim of guaranteeing the rights and freedoms of others, thought the DO.

Today,  Ellinor Grimmark is working as a nurse in California, but will soon start working as a midwife in Norway, where it is possible for a midwife to refrain from participating in abortions.

But I intend to pursue this further.  We are just a short way down this  road,” she says.

However, the DO’s decision cannot be appealed, and the case is closed. [Original Swedish text]

Washington State hospitals identify policies on access to health care

washington-doh-hospitalsThe Washington State Department of Health has posted a web page that lists all of the hospitals in the state, together with their policies on admission, non-discrimination, end of life care, and reproductive health care.  The page makes it possible for those seeking morally contested procedures to locate hospitals willing to provide them, while allowing hospitals that do not provide them to provide notice of that fact.  This should help to minimize inconvenience and conflict.

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]