Protection of Conscience in an Earthquake Zone
Presented at the Catholic Women's League Archdiocesan Convention
Vancouver, British Columbia, Canada: 8 May, 2002
Thank you for extending the invitation to speak at your Archdiocesan
convention. My wife is a member of the League, and I am told by the husband
of a long-standing CWL member, a man of great experience and wisdom in such
things, that this makes me a member of the CWL auxiliary.
Now, I am not here today in my capacity as a member of the CWL auxiliary,
but to introduce you to the Protection of Conscience Project, and, more
important, to the problem that brought it into existence.
Let's begin with the problem. Imagine following situations:
- You are an operating room nurse. You are repeatedly refused a job
because you don't want to assist in abortions.1
- You are a physician with strong moral objections to extramarital
sex. You refuse to provide Viagra or birth control pills to single
patients. You are charged for professional misconduct, and may lose your
licence to practice medicine.2
- You are a probationary welfare worker. You are fired because you
refused to authorize payment for an illegal abortion.3
- You are a student nurse, and your preceptor has strongly indicated
that your refusal to dispense the potentially abortifacient 'morning
after pill' may result in a failing grade.4
- You are a pharmacist. A woman who knows that you will not
dispense contraceptives for moral reasons deliberately approaches
you and demands to be given birth control pills. You refuse. Your
employer suspends you, and the woman lodges a complaint of professional
misconduct. A year later, you still aren't working.5
- You are a health care professional who doesn't want to be involved
in activity that contradicts your moral or religious convictions.
Colleagues and newspaper columnists tell you to find another job. A
University of Toronto professor says that people like you are "scum."6
These are actual incidents, involving real people.
This is tolerance, Canadian style. This is what brought the Protection of
Conscience Project into existence in December, 1999.
The Project is just that - a project. It is not a society or
organization, but a non-profit, non-denominational initiative that is the
work of a project team and advisory board.
The team consists of an administrator, who maintains the website and
manages day-to-day operations, and a human rights specialist. I am the
Project Administrator. The human rights specialist is Michael Markwick, of
West Vancouver, former executive assistant to the Chief Commissioner of the
Ontario Human Rights Commission, and past President of the British Columbia
Chapter of the Catholic Civil Rights League (Canada).
The Project advisory board includes seven advisors from different
disciplines and from different faith traditions:
- Janet Ajzenstat, B.A.,
M.A., Ph.d; Associate Professor, Department of Political Science,
McMaster University, Hamilton, Ontario, Canada
Dr. Shahid Athar, M.D., F.A.C.E.; Clinical Associate Professor of
Internal Medicine and Endocrinology, Indiana School of Medicine,
Indianapolis, Indiana, U.S.A. Dr. Athar is currently the elected
vice_president of the Islamic Medical Association of North America and
the Chair of its Medical Ethics Committee.
J. Budziszewski, Ph.D; Associate Professor, Departments of
Government and Political Philosophy, University of Texas (Austin),
Dr. John Fleming, B.A., Th.L. (Hons), Ph.D.; Director, Southern
Cross Bioethics Institute, Adelaide, Australia
Henk Jochemsen, PhD; Director, Prof.dr. G.A. Lindeboom Institute,
David Novak, A.B., M.H.L., Ph.d.; Professor of the Study of Religion
at the University of Toronto, and also Professor of Philosophy, with
appointments in University College, the Faculty of Law, the Joint Centre
for Bioethics, and the Institute of Medical Science. University of
Toronto, Ontario, Canada.
Lynn D. Wardle, J.D.; Professor of Law, J. Reuben Clark Law School,
Brigham Young University, Salt Lake City, Utah, U.S.A.
The general policy of the Project is that the people best placed to deal
with a problem are those who are most directly involved. Thus, the Project
does not direct or manage protection of conscience initiatives. It is not
"Conscience Central Control". Instead, it provides information, offers
suggestions, encourages co-operation and facilitates communication. In
addition, on specific issues, other activities are undertaken that are
intended to encourage respect for freedom of conscience in health care. To
date, these activities have included:
- editors of newspapers and professional journals7
- regulatory authorities
- Media interviews
- Ad hoc meetings
The Project website (http://www.consciencelaws.org) includes a variety of
material that is intended to assist conscientious objectors and people
working for freedom of conscience in health care. Among other things, on the
website you will find:
Statistics on visitors to the website indicate a continuing interest in
the subject. The number of user sessions per month has climbed from about
1,500 in July, 2001 to over 3,100 in April, 2002. On average, there were
over 100 user sessions per day in April, with an average visit time of a
little over 11 minutes.
The Home Page and site Map are posted in English, French and Spanish;
translation of these pages into Italian has begun, courtesy a CWL member.
Links on other pages provide access to a web translation service. The
intention is to provide 'protection of conscience' with a minimum Internet
presence in other languages, in the hope that this will encourage similar
projects in the non-English speaking world.
The Project's focus is fairly specific. In the first place, we
concentrate on health care and bioethics, even though there are grave
reasons for concern about freedom of conscience and religion in other fields
as well. This policy follows a realistic appraisal of limitations on
resources and time, and reflects a prudential judgement about how the
Project can be most effective.
The Project does not engage in debate on the morality of controversial
procedures. Articulation of the reasons behind conscientious objection often
requires discussion of moral decision making, but this is always done
only for the purpose of illuminating an objector's position. The goal is
not to prove that the objector is correct, but to demonstrate that
the objector's position cannot be dismissed as unreasonable. Definitive
arguments against abortion, euthanasia, or other controversial procedures
are left to pro-life advocates.
The reason for avoiding pro-life argument is that many so-called
'pro-choice' people dismiss conscience advocates as 'closet pro-lifers'
whose real aim is to deny access to abortion. These specious claims
about a 'hidden agenda' are a smear tactic that imputes dishonest motives to
conscientious objectors. Mixing pro-life arguments with freedom of
conscience advocacy lends credence to this, and makes it easier for
opponents to avoid embarrassing questions, like, "Why do you call yourself
'pro-choice' if you deny freedom of choice to those who don't agree with
Not all pro-lifers are comfortable with this approach. Some, for whom I
have great respect, disagree with it. I think that this is quite natural,
and I don't consider it a problem.
Scope of concern
I have frequently mentioned conscientious objection to abortion. The
legalization of abortion was, in fact, what triggered the passage of the
earliest protection of conscience laws. Abortion remains a significant cause
of concern because it is both morally controversial and widely
Nonetheless, it would be a serious mistake to associate the need for
protection of conscience legislation only with abortion. Consider the
problems posed by assisted suicide and euthanasia.
You are aware that Oregon legalized assisted suicide in 1997. Although
often called by the acronym "PAS"- physician assisted suicide - one hospice
administrator has noted that it is usually nurses who are on the 'front
In fact, an article in a professional medical journal in the United States
suggested that it would be better for nurses to take the lead in assisted
suicide, because helping patients to kill themselves violates a physician's
11, One wonders what opinion the authors have of nurses.
What is particularly interesting is the result of a survey of nursing
teams employed by an Oregon hospice. While most of the nurses strongly
supported the notion that patients should be able to choose physician
assisted suicide, most did not want to participate in it.12
What does the future hold for them?
For one answer, we might look to the Netherlands, where euthanasia has
been practised for years, though officially legalized only this year.
Dr. Peter Hildering of the Dutch Physicians Guild has received reports of
discrimination against physicians who won't participate in euthanasia. The
extent of the problem depends upon the specialty; nursing home physicians
and general practitioners who won't participate in euthanasia report
difficulties in finding practices. Medical students who admit that they
would refuse to assist with euthanasia are unwelcome in some places. Dr.
Hildering tells two stories to illustrate the situation:
A general practitioner I know of says he doesn't want to work
with doctors who don't perform euthanasia. He worries that the
patients of the [conscientious objector] doctor will all come to him
for euthanasia-and he's not happy with that. One of the groups in a
rural area had a visit by the inspector for health because one of
the doctors wouldn't perform euthanasia in that group. And he put it
to that group of doctors that they had to look for a way for their
patients to get euthanasia because he felt it was a normal medical
practice to offer.13
That, in Holland.
You may not be aware that Belgium has begun the process of legalizing
euthanasia, and that the Belgian Free University is already making plans to
instruct medical students in euthanasia techniques. You may not be aware
that an assisted suicide bill was just narrowly defeated in Hawaii. But you
surely are familiar with the continuing lobby for the legalization of
assisted suicide and euthanasia in North America. I suggest that it would be
most unrealistic to believe that this will not continue, or to think that
what is happening in the Netherlands cannot happen here.
On the contrary: the personal integrity of health care workers who want
to practise in conformity with their conscientious convictions is already
seriously at risk. I have cited some particular cases, but these are like
sudden fractures that occur here or there along fault lines in the earth's
crust. To be caught by an ethical earthquake triggered by one's
conscientious convictions can be both frightening and damaging, but such
quakes are actually caused by enormous pressures that continue to
build, slowly and quietly, deep in the foundations of our society. The
wealthy western world has become a vast moral earthquake zone, and the
controversies shaking it concern far more than abortion, assisted suicide
- Artificial reproductive technologies are a constant source of moral
controversy, not the least because human embryos produced artificially
become raw material for various kinds of research.14.
- Eugenics, practised by means of pre-natal screening and
pre-implantation genetic diagnosis, is a daily reality,15
encouraged by 'wrongful birth' and 'wrongful life' suits.16
- Trafficking in human organs and fetal tissue has become a world-wide
- People for the Ethical Treatment of Animals provides grants to
companies developing human embryo testing as one of the alternatives to
the use of lab rats or other research animals.18
- Some prominent ethicists have suggested that animals used in
research could be replaced by infants, the mentally retarded and
Protection of conscience concerns in the 1960's were largely
related to abortion. We've come a long way since then.
What does the future hold?
These developments suggest that conflicts of conscience experienced by
health care workers are likely to become increasingly frequent as time goes
on, at least among those who are principled moralists or religious
believers. Specific legislation exists in some countries - notably in most
of the American states - that provides some protection for such people.
However, in most cases, existing laws are inadequate, for a number of
reasons. And no protection of conscience laws exist in Canada.
Canadian politicians are generally uninterested in the problem. This may
have something to do with our political traditions, which include rigid
party discipline, enforced by 'whips' and the threat of reprisal. Government
members who vote against their party for reasons of conscience may be
deprived of influential positions, excluded from nomination in the next
election, and see their constituents denied government money and programmes
for the rest of their terms. Similar sanctions can be applied to members of
opposition parties. Note that "free votes" or "conscience votes" in
parliament and provincial legislatures are so unusual that they make
headlines. A political environment in which freedom of conscience is treated
as a rare privilege is not well suited to the development of protection of
One generally meets with one of two responses from politicians at the
provincial or federal level. The first is that adequate protection is
already available under existing human rights law.20
If this is true - I suggest that it is not - it is available only to people
who have the good health and emotional stamina to endure months or even
years of litigation, and who can pay thousands upon thousands of dollars in
legal costs, perhaps after having been deprived of their income by
suspension or dismissal.
For example, it took five years for eight nurses to grind through the
human rights process in Ontario to reach the point at which a hearing was to
begin - five years before their case was even to be heard. The
hospital settled at the last moment, but the economic and emotional toll on
the nurses was significant. All had lost their full_time employment at the
hospital, one had died, and others had suffered stress-related illness.21
A second response from politicians is that workers should seek protection
of conscience provisions in their collective agreements.22
Well, many workers are not covered by collective agreements. But there is a
more important point. What is the 'market value' to be put on freedom of
conscience and religion when it is thrown onto the bargaining table? Should
it be bartered for thirty dollars a week? Shall we trade it for an extra
week's vacation pay? That workers should be forced to bargain for freedoms
that are supposed to be their birthright ought to be repugnant to the
citizens of a free country, and politicians who suggest it should be ashamed
I have reviewed the problems that led to the formation of the Protection
of Conscience Project, introduced you to the Project and outlined the scope
of its concern, and touched upon the political situation in Canada . . .
What can the CWL do?
The suggestions I have are all intended for parish consorts of the CWL
rather than the diocesan, provincial or national levels of the League.
Speaking as the Administrator of the Protection of Conscience Project,
with respect to protection of conscience in health care:
- Translate the Home Page and Map into Portuguese, Dutch, German or
- Make sure that health care workers in your parishes know that they
have your support.
- Sponsor an essay competition among high school students on the theme
of freedom of conscience in a secular society.
- If you become aware of a conscientious objector who needs financial
support to cover legal costs, undertake fundraising to assist, and
encourage other groups to do the same.
4. Private communications between the Administrator and
student nurse (2001).
5. Private communications between the Administrator and
pharmacist. Case still not resolved.
8. A conference in Rome organized by
Matercare International in June,
2001, heard from obstetricians and gynaecologists from around the world who
face discrimination because they are morally opposed to abortion.
11. Faber_Langendoen K, Karlawish J. Should assisted
suicide be only physician assisted? Ann Intern Med. 132:483, 21
Abstract (Accessed 12 May, 2002)
14. A Canadian Ministry of Health spokesman described
embryo 'adoption' as "just the donation of reproductive material". Ko,
"Would You Like Fries with that Embryo? It's Not Adoption, Just 'Material'.
Ottawa Wrestles Once Again With Embryo Ownership And Experimentation."Alberta
Report Newsmagazine (now The Report_ www.report.ca) May 31, 1999.
Project Submission re: Assisted Human Reproduction Act
15. Richard Lynn, emeritus professor of psychology at
the University of Ulster, asserts that eugenics is being practised in the
form of pre_implantation genetic diagnosis, and that there is nothing wrong
with the notion that the "genetic quality of the population" can be improved
by eugenic practices.
17. Doctors are suggesting that governments should pay
living donors who offer kidneys for transplantation. The kidneys would
become part of a pool that could be screened and offered to recipients. The
proposed scheme would continue to prohibit the purchase of organs by
individuals. It is being suggested as a way of dealing with black market
trade in human organs. (Article)
(Accessed 9 April, 2002)
18. Farah, Joseph,
"Sacrificing human beings to save animals? PETA gives grants to develop use
of embryos, alternative to rat tests" (Accessed 18 January, 2000)
19. Singer, Peter, The Animal Liberation Movement.
Nottingham, England: Old Hammond Press, 1987, P. 8; Neimark, Jill, "Living
and Dying with Peter Singer," Psychology Today, January-February,
1999, P. 58. Both quoted in Smith, Wesley J., supra, P. 210-211
20. Letter from Stan Woloshyn, Minister of Community
Development (Alberta), to Peggy Anderson, 4 December, 2000
22. Letter from Paul Ramsey, Minister for Health and
Minister Responsible for Seniors (B.C.) to Sean Murphy, 28 July, 1995
Letter from John Jansen, Ministry of Health (B.C.) to Kathleen M. Toth, 26