Medical marijuana and conscience rights

The Interim

Paula Kosalka

Some Canadian physicians are anxious that regulatory changes will pressure doctors to prescribe marijuana. Dr. William Pope, the registrar of the College of Physicians and Surgeons of Manitoba, told the Winnipeg Free Press in January that the college is worried that federal reforms will lead more patients to ask doctors for marijuana. “As far as most of us are concerned, there is really no appropriate prescribing,” he said.

Physicians are now permitted to dispense marijuana with the approval of the province. Patients applying for marijuana access no longer have to submit personal health information to Health Canada. It is also easier for individuals with less serious conditions to get medical marijuana. Pot users will not be able to grow their own marijuana anymore, but will have to buy it from commercial growers licensed by the federal government. On April 1, the new rules came into effect. According to the Winnipeg Free Press, officials predict that the number of cannabis users across the country could rise from 37,000 to 450,000 by 2024 as a result. – [Full text]

Catholic physicians who want to follow their conscience must ’emigrate,’ UK expert says

LifeSiteNews

Hilary White

LONDON, May 30, 2014  – Physicians who have strong moral objections to prescribing abortifacient drugs, including the morning after pill, should leave England, a meeting of the Catholic Medical Association was told.

This is not due to “discrimination” against conscientious Catholic physicians, but rather is a “total conflict of culture,” in the new post-sexual revolution social order, one that substantially rejects the Christian outlook on sex.

On May 17, the CMA’s annual conference heard Charlie O’Donnell, a consultant in emergency and intensive care medicine, say that “orthodox” Catholics training in obstetrics and gynecology would have such huge obstacles they would have little choice but to “emigrate.” Physicians are routinely faced with requests for artificial contraceptives, artificial procreation treatments or Viagra for “gay couples,” and there is simply no room left in the profession for the Christian worldview in medicine in Britain. . . [Full text]

Top employment strategies for discouraging conscientious objection

Bioedge

Xavier Symons

In a recent Journal of Medical Ethics article, controversial bioethicist Francesca Minerva argues for limiting the number of conscientious objectors in Italian hospitals.

Minerva asserts that conscientious objection “prevents access to certain treatments”, and proposes that we set up disincentives for objectors in hospitals. The proposed solutions include offering higher salaries for non-objectors and establishing ‘conscientious objector quotas’. She concludes:

When conscience-related issues prevent access to a certain treatment, such as abortion in Italy, the public health system, or the Ministry of Health in this case, has to find a solution that safeguards and protects the health of the patients as a priority.

In a response to Minerva, Oxford theologian and ethicist Roger Trigg argues that conscientious objection is a necessary part of the practice of medicine:

Once we discount conscientious moral reasoning, medicine is reduced to a technical issue about procedures, without any regard to their effect on the greater human good.

In the case of abortion, he suggests that high rates of conscientious objection might indicate a need to reconsider the original policy:

One problem with abortion is that for the most part those making the political decision are not those who have to implement the policy. If the latter object in sufficiently high numbers to make the policy hard to implement, that might be a reason for assuming there could be something wrong with what was being proposed.


cclicense-some-rightsThis article is published by Xavier Symons and BioEdge.org under a Creative Commons licence. You may republish it or translate it free of charge with attribution for non-commercial purposes following these guidelines. If you teach at a university we ask that your department make a donation to Bioedge. Commercial media must contact us for permission and fees. Some articles on this site are published under different terms.

Doctors who follow church teaching told to emigrate

The Tablet

Elena Curti

Catholic doctors who follow church teaching on sexual ethics cannot work as gynaecologists in Britain, the Catholic Medical Association (CMA) conference was told.

Charlie O’Donnell, a consultant in emergency and intensive care medicine, said the best advice he could give to an “orthodox” Catholic wishing to specialise in obstetrics and gynaecology would be to “emigrate”.

Dr O’Donnell told the conference at Ealing Abbey, west London, on 17 May that a Catholic training to be a consultant in obstetrics and gynaecology would soon find he or she had conscientious objections to such tasks as prescribing artificial contraceptives, giving unmarried couples fertility treatment or Viagra to gay couples. . . [Full text]

Accommodating conscience in medicine

J Med Ethics doi:10.1136/medethics-2013-101892 Commentary

Roger Trigg

The issue of conscientious objection to agreed public policy is a vexed one. The clearest example is that of conscientious objection to military service. A free and democratic society has to respect the consciences of those who believe that killing in battle is absolutely wrong. Many disagree with the moral stance being taken, but it has been seen as the mark of a mature and civilised society to respect the conscience of pacifists. The freedom to be able to live by what one thinks most important has been seen as a constituent element in the freedoms that others have fought to preserve.

Respect for the conscience of those medical professionals who feel unable to participate in abortion appears to be in the same category (as would be respect for those who refused to participate in assisted suicide or euthanasia). Issues about the value of human life are at stake. Matters are undoubtedly complicated in the case of abortion by arguments over the supposed ‘humanity’ or ‘personhood’ of a fetus. Even so, some sincerely regard abortion as murder. Mutual respect is easy between people who agree. The problem in a democratic society arises when there is significant disagreement, but it is … [Full text]

 

Conscientious objection in Italy

Med Ethics doi:10.1136/medethics-2013-101656

Francesca Minerva

Abstract

The law regulating abortion in Italy gives healthcare practitioners the option to make a conscientious objection to activities that are specific and necessary to an abortive intervention. Conscientious objectors among Italian gynaecologists amount to about 70%. This means that only a few doctors are available to perform abortions, and therefore access to abortion is subject to constraints. In 2012 the International Planned Parenthood Federation European Network (IPPF EN) lodged a complaint against Italy to the European Committee of Social Rights, claiming that the inadequate protection of the right to access abortion implies a violation of the right to health. In this paper I will discuss the Italian situation with respect to conscientious objection to abortion and I will suggest possible solutions to the problem.

[Full text]

Polish physicians and medical students declaration of faith and freedom of conscience

On 5 March, 2014, 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.  It was subsequently signed by over 3,000 people

The Declaration was carved onto two stone tablets and deposited at Jasna Gora on 25 May, 2014, during a pilgrimmage of health care workers to honour the canonization of John Paul II.  It closes with an affirmation that Catholics, including physicians, “have a right to perform their professional activities in accordance with their conscience.”  [Deklaracja Wiary website]

Deklaracja Wiary

Declaration of Faith*

Lekarzy katolickich i studentów medycyny w przedmiocie płciowości i płodności ludzkiej
Of Catholic doctors and students of medicine, on the sexuality and fertility of human beings
Nam – lekarzom – powierzono strzec życie ludzkie od jego początku…  We, doctors, entrusted to protect human life from its conception until its natural end;
1. WIERZĘ w jednego Boga, Pana Wszechświata, który stworzył mężczyznę i niewiastę na obraz swój. 1. BELIEVE in one God, the Lord of the Universe, who created man and woman in his own image.
2. UZNAJĘ, iż ciało ludzkie i życie, będąc darem Boga, jest święte i nietykalne:
– ciało podlega prawom natury, ale naturę stworzył Stwórca, – moment poczęcia człowieka i zejścia z tego świata zależy wyłącznie od decyzji Boga.Jeżeli decyzję taką podejmuje człowiek, to gwałci nie tylko podstawowe przykazania
Dekalogu, popełniając czyny takie jak aborcja, antykoncepcja, sztuczne zapłodnienie, eutanazja, ale poprzez zapłodnienie in vitro odrzuca samego Stwórcę.
2. PROCLAIM that the human body and life, being gifts from God, are sacred and inviolable and that,a. The body is subject to the laws of nature but is formed by The Creator;b. The moments of human conception and dying offer us, by God’s grace, the opportunity to participate in God’s love, creation and passion. If a person acts by their own will to negatively alter conception and bring about death, then he or she not only violates the basic commandments of the Decalogue, committing acts such as abortion, euthanasia, contraception, artificial insemination, and/or in vitro fertilisation, but rejects The Creator as well.
3. PRZYJMUJĘ prawdę, iż płeć człowieka dana przez Boga jest zdeterminowana biologicznie i jest sposobem istnienia osoby ludzkiej. Jest nobilitacją, przywilejem, bo człowiek został wyposażony w narządy, dzięki którym ludzie przez rodzicielstwo stają się współpracownikami Boga Samego w dziele stworzenia – powołanie do rodzicielstwa jest planem Bożym i tylko wybrani przez Boga i związani z Nim świętym sakramentem małżeństwa mają prawo używać tych organów, które stanowią sacrum w ciele ludzkim. 3. ACCEPT the truth that human sexuality is a gift of God and provides the method by which human beings are ennobled with the privilege to become “co-creators with God in the work of creation” through parenthood. The call to parenthood is God’s plan, and only those bound with Him by the holy sacrament of marriage have the ability to rightly use these gifts, which are sacred, in the human body.
4. STWIERDZAM, że podstawą godności i wolności lekarza katolika jest wyłącznie jego sumienie oświecone Duchem świętym i nauką Kościoła i ma on prawo działania zgodnie ze swoim sumieniem i etyką lekarską, która uwzględnia prawo sprzeciwu wobec działań niezgodnych z sumieniem. 4. ACKNOWLEDGE that the foundation for the dignity and freedom of the Catholic doctor is exclusively his or her conscience, enlightened by the Holy Spirit and informed by the teaching of the Church, and that he or she has the right to act according to said conscience and in keeping with medical ethics that have established the doctor’s right to oppose all acts that are against one’s conscience.
5. UZNAJĘ pierwszeństwo prawa Bożego nad prawem ludzkim – aktualną potrzebę przeciwstawiania się narzuconym antyhumanitarnym ideologiom współczesnej cywilizacji, – potrzebę stałego pogłębiania nie tylko wiedzy zawodowej, ale także wiedzy o antropologii chrześcijańskiej i teologii ciała. 5. RECOGNISE the priority of God’s law over the law of nations and,a. The current need for providing alternatives to the anti-human ideologies and dictates imposed by some contemporary societies.b. The need to constantly deepen not only professional knowledge but also the knowledge of Christian anthropology and theology of the body.
6. UWAŻAM, że – nie narzucając nikomu swoich poglądów, przekonań – lekarze katoliccy mają prawo oczekiwać i wymagać szacunku dla swoich poglądów i wolności w wykonywaniu czynności zawodowych zgodnie ze swoim sumieniem. 6. BELIEVE that, while not imposing their beliefs and opinions, Catholics, including doctors and students, have a right to perform their professional activities in accordance with their conscience.
Wysokim uznaniem darzymy tych lekarzy i członków służby zdrowia, którzy w pełnieniu swojego zawodu ponad wszelką ludzką korzyść przenoszą to, czego wymaga od nich szczególny wzgląd na chrześcijańskie powołanie. Niech niezachwianie trwają w zamiarze popierania zawsze tych rozwiązań, które zgadzają się z wiarą i prawym rozumem oraz niech starają się dla tych rozwiązań zjednać uznanie i szacunek ze strony własnego środowiska. Niech ponadto uważają za swój zawodowy obowiązek zdobywanie w tej trudnej dziedzinie niezbędnej wiedzy, aby małżonkom zasięgającym opinii, mogli służyć należytymi radami i wskazywać właściwą drogę, czego słusznie i sprawiedliwie się od nich wymaga. Likewise we hold in the highest esteem those doctors and members of the nursing profession who, in the exercise of their calling, endeavor to fulfill the demands of their Christian vocation before any merely human interest. Let them therefore continue constant in their resolution always to support those lines of action which accord with faith and with right reason. And let them strive to win agreement and support for these policies among their professional colleagues. Moreover, they should regard it as an essential part of their skill to make themselves fully proficient in this difficult field of medical knowledge. For then, when married couples ask for their advice, they may be in a position to give them right counsel and to point them in the proper direction. Married couples have a right to expect this much from them.
Paweł VI, Humanae vitae, 27. Pope Paul VI, Encyclical Humanae Vitae, 27
 *Translation by Matercare International

Should doctors take part in executions?

 Bioedge

 Michael Cook

It is unethical for American physicians to participate in executions, according to a commentary in the Journal of the American Medical Association. Robert D. Truog, a bioethicist, I. Glenn Cohen, a law professor, and Mark A. Rockoff, a doctor, all of Harvard University, assert forcefully that “Regardless of whether execution is justified … it must never be perceived as a medical procedure.” That is almost universally acknowledged around the world, and by all medical associations.

The Harvard academics were responding to a study by the Death Penalty Committee of The Constitution Project, a group of eminent lawyers who oppose capital punishment. Recommendation 39 was that doctors should be involved in those executions which do happen in order to ensure that they are humane as possible – even if medical associations object. This is impossible, the three authors contend. Participation is a violation of the principles of medical ethics. Expecting that some doctors will participate is cynical and shows a “profound disregard” for the integrity of the medical profession. “Medical professionals cannot permit state law and regulation to subvert an ethical commitment that has uniform support across virtually the entire profession around the world.”

Of course, this begs the question of physician involvement in assisted suicide. But the authors appear to look upon this as an altogether different question. They imply that an execution is an “involuntary” taking of life, while assisted suicide is a voluntary taking of life. Dr Truog distinguished between the two in a 2011 article in the Hastings Center Report: “the critical ethical distinction between physician-assisted suicide and capital punishment, which is that the former is focused upon patient-centered goals, whereas the latter serves the goals of the state”. He thought that a doctor might participate as a citizen in a firing squad, but he could not administer a lethal injection as a doctor.


cclicense-some-rightsThis article is published by Michael Cook and BioEdge.org under a Creative Commons licence. You may republish it or translate it free of charge with attribution for non-commercial purposes following these guidelines. If you teach at a university we ask that your department make a donation to Bioedge. Commercial media must contact us for permission and fees. Some articles on this site are published under different terms.

Embargo on lethal drug stops executions and assisted suicides in US

 Bioedge

Michael Cook

A shortage of a lethal drug is stopping both executions and assisted suicide in the United States. The supply of Nembutal, the drug of choice for executing prisoners in many American states and for assisted suicide in Oregon and Washington state, has dried up because its European manufacturer, the Danish company Lundbeck, refuses to supply it for use in executions. This has had an unintended consequence: patients in Oregon who want physician-assisted suicide cannot get it.

In a recent, widely-reported execution, the state of Oklahoma tried a three-drug cocktail as a substitute for Nembutal (also called pentobarbital or sodium thiopental) last month, but the prisoner, Clayton Lockett, appeared to die in great pain. So patients in Oregon are not going to be using that. A second-best drug, secobarbital, costs between US$1,500 and $2,300-more than five times pentobarbital and it is still hard to obtain.

The botched execution has dismayed lobbyists for assisted suicide because it suggests that a satisfactory substitute for Nembutal will be hard to find. According to the Wilamette Week, an Oregon newspaper, “Advocates would like to expand the policy across the country, and their concerns about bad publicity hampering that rollout appear to account for their reluctance to discuss Oregon’s shortage.”

The assisted suicide lobby, therefore, has turned to other solutions. Compassion & Choices (the rebranded Hemlock Society) has asked the Oregon Board of Pharmacy to allow a pharmacy to manufacture the drug from raw materials.

“Providing this service is important to Oregonians, and I’m very concerned about what appears to be a complete lack of availability of the drug we’ve historically used,” State Senator Elizabeth Steiner Hayward (who is also a doctor who dispenses assisted suicide prescriptions) told Wilamette Week. “What I’ve been told by the pharmacists is the drug is completely unavailable, and we should not prescribe it.”

The irony that one group lobbying against death is frustrating the work of another group lobbying for death was not lost on bioethics gadfly Wesley J. Smith. “It seems to me that if the drugs are wrong to use in lawful executions, they are also wrong to prescribe to people who want to kill themselves. Death-causing is death-causing, and that ain’t medicine,” he wrote in the National Review.

There are other ironies. It is widely acknowledged that it is against medical ethics for doctors to participate in executions. However, Oregon is one of the few states that mandates physician participation in an execution. And anticipating objections by a doctor’s colleagues, it has banned sanctions against him (or her) for participating in an execution.


cclicense-some-rightsThis article is published by Michael Cook and BioEdge.org under a Creative Commons licence. You may republish it or translate it free of charge with attribution for non-commercial purposes following these guidelines. If you teach at a university we ask that your department make a donation to Bioedge. Commercial media must contact us for permission and fees. Some articles on this site are published under different terms.

Professor argues for a profound rethinking of conscience rights

Mary Anne Waldron offers three solutions for legal quagmires

The B.C. Catholic

Alistair Burns

An argument in favour of changing how citizens approach freedom of conscience and religion was presented May 2. Mary Anne Waldron, a professor of law at the University of Victoria, spoke to an audience of 80 in Holy Name of Jesus Parish Hall in Vancouver.

Her lecture was the first event co-hosted by the Catholic Physicians’ Guild of the Archdiocese of Vancouver and the St. Thomas More Catholic Lawyers Guild.

She asked the crowd to ponder why “we protect conscientious and religious freedom, when it is so often inconvenient, may seem unfair, and often offends others.”

The law professor declared perhaps many would prefer a world “in which our (specific) view prevailed” on major legal problems: abortion, euthanasia, and sexual moral codes.

Freedom of conscience and religion rights, she asserted, should allow the participation of all citizens in debates on social policies and norms, “protecting the minority against tyranny by the majority.” [Full Text]