October-December, 2001
December
The Chicago Sun-Times reports that hospitals that do not want to be
involved with dispensing the potentially abortifacient 'morning-after-pill'
are being pressured by a new Illinois law to inform rape complainants where
to get the drugs.
Five couples have applied to Victoria's Infertility Treatment Authority
to conceive babies using in vitro fertilisation and then to use
pre-implantation genetic diagnosis (PGD) to cull those not suitable as
tissue donors for terminally ill siblings. A similar procedure was approved
earlier in the United
Kingdom.
In Washington D.C., abortion advocates united to prevent passage of a
bill funding medical centres because a protection of conscience amendment
had been added to protect conscientious objectors from discrimination or
coercion.
Parliamentarians were recalled from Christmas break to legalize abortion
in Tasmania after a medical student complained to police that abortionists
were falsifying documents in order to skirt the 75-year-old abortion law.
Doctors stopped performing abortions after the complaint was made. The bill
was amended to include
protection for those who do not want to participate in abortion. [News
Story]
While Quebec pharmacists are being trained to dispense the 'morning after
pill' without a prescription, Normand Cadieux, managing director of the
Association Québécoise des Pharmaciens-Propriétaires (Association of Quebec
Pharmacists) stated that those who have religious objections to the pill do
not have to be certified to dispense it. It is reported that four thousand
of the province's 5,700 pharmacists have already had the required training.
[The
Gazette]
It is reported that the Swiss National Council rejected restrictive and
permissive bills on euthanasia. However, two forms of euthanasia: "indirect
active" euthanasia, and "passive" euthanasia, are said to be recognized by
the Swiss academy of medical sciences. [News
Story]
The Observer (U.K.) appears to have resurrected a two year old
news
release on the subject of "tokophobia" - a pathological dread of
childbirth. The original news release refers to a study published in the
British Journal of Psychiatry. Two of the 26 women who participated in the
the study had abortions, even though their children were 'wanted'. The
release described abortion as possibly the only choice in extreme cases "in
the absence of an empathic professional listener or access to relevant
medical literature." The suggestion that abortion might sometimes be "the
only choice" may lead some people to conclude that health care workers have
an obligation to assist.
The federal court in Karlsruhe, Germany has dismissed a suit brought by
parents of identical twin girls against gynaecologists who had failed to
inform them that one of the twins was physically handicapped. The parents,
who said that they would have aborted the handicapped twin, had sought
financial damages. The judges ruling on the basis that the abortion would
have been illegal because it risked the life of the other twin, did not rule
against 'wrongful birth' suits on principle. [British
Medical Journal] (See
previous news item.)
Maryland's Catholic bishops expect that a bill intended to suppress
freedom of conscience in Catholic institutions will be re-introduced in the
state legislature in January. The bill would repeal existing protection and
force Catholic hospitals to dispense or refer patients for abortifacient
drugs if the patients presented as rape victims. [Catholic
News Service]
The Human Fertilisation and Embryology Authority (HFEA) will allow
parents use pre-implantation genetic diagnosis not only to screen in
vitro embryos for the disease, but to identify an embryo whose umbilical
cord blood can be used as a source of bone marrow or stem cells for an older
sibling. A special licence would be required. Among the conditions for the
procedure are requirements that the older sibling suffer from a "severe or
life-threatening" condition, other possibilities of treatment and sources of
tissue are not available, and tissue matching not be accomplished by genetic
modification of embryos. [HFEA
news]
Health care professionals who would deny their colleagues freedom of
conscience usually do not expect to be required to perform morally
controversial procedures. The case of a 16 year old boy in England
illustrates how existing technology and fluid moral outlooks can give rise
to unusual expectations of medical treatment.
Jamie Cooper of Birmingham, England, wants to have his sperm frozen
before a sex-change operation, so that it can be used to conceive a child
in vitro. Cooper appears to want to be both 'mother' and biological
father of a child. Having turned 16, he is eligible for a tax-funded
sex-change operation from the National Health Service.
It is reported that Michigan
House Bill 5158, which was originally drafted to provide protection of
conscience for all people working in health care, will be amended to exclude
protection for those with moral objections to contraception. It appears that
the proposed exclusion reflects political rather than principled
considerations. A vote is scheduled in the Michigan House of Representatives
for 11 December, 2001.
Japanese Prime Minister Junichiro Koizumi, who chairs the government's
council for science and technology policy, has announced that Japan will
allow combined human-animal embryos to be produced through cloning. The
research is advocated in the hope that transplant organs can eventually be
produced in animals. As is commonly the case when morally controversial
procedures are officially approved, no thought appears to have been given to
problems arising from conflicts of conscience among workers in the field.(
Daily Yomiuri)
Representative Neal Kedzie has proposed Wisconsin Assembly Bill 360, a
bill that would prohibit wrongful life and wrongful birth lawsuits.
Wrongful birth lawsuits are civil actions brought by parents seeking
monetary compensation for the birth of a child with disabilities. They
usually assert that they would have aborted the child had the disabilities
been diagnosed, and ask for money to pay for emotional distress and child
care expenses.
Wrongful life lawsuits are brought by or on behalf of a child born with
disabilities. It is argued that the existence of the child is a legal wrong,
and that it would have been better had the child been aborted. In these
cases the child seeks monetary compensation for pain, suffering and medical
and educational expenses.
In contrast to malpractice suits for negligent or incompetent medical
treatment, wrongful life/birth actions are brought against doctors who have
not contributed to a the child's disability. They are sued because they are
alleged to have failed to offer eugenic screening services, misdiagnosed the
results of such screening, or otherwise dissuaded or prevented mothers from
having abortions.
Assembly Bill 360 does not affect normal medical malpractice suits,
including failure to properly diagnose and treat conditions that can be
treated in utero or at birth.
At least nine American states prohibit wrongful life and wrongful birth
lawsuits, and courts in several others have disallowed them. (See
Supreme
Court of Canada to hear 'wrongful birth' case ;Eugenic
screening expected by French courts;No
Christian gynaecologists and neonatologists in Netherlands ;
Catholics and Pro-lifers Being Forced Out of Ob/Gyn Profession;
Doctor sued for birth of Down Syndrome child;
French doctors fear suits, threaten to stop eugenic screening)
In a letter to the French daily, Le Monde, 11 top prenatal
specialists from eight hospitals in France have stated that they will refuse
perform diagnostic tests on unborn children. The doctors were reacting to a
French high court ruling in a wrongful life suit that awarded substantial
monetary compensation to a child with Downs syndrome. The specialists did
not object to eugenic screening per se, but expressed concern that
the court had set a precedent that would penalize even doctors who
practising competently. It appears that they are willing to continue the
screening if they are adequately insured against civil suits. However, that
solution would likely be of no help to health care professionals who have
moral objections to eugenic screening and eugenic abortions. (See
Supreme
Court of Canada to hear 'wrongful birth' case ;Eugenic
screening expected by French courts;No
Christian gynaecologists and neonatologists in Netherlands ;
Catholics and Pro-lifers Being Forced Out of Ob/Gyn Profession;
Doctor sued for birth of Down Syndrome child )
By a vote of 74 to 71, the Dáil passed the 25th Amendment to the
Constitution (Protection of Human Life in Pregnancy) Bill after the
Taoiseach (Irish prime minister) cut off debate. The measure will now go to
the Seanad. The title of the bill suggests that it is intended to protect
the developing infant during pregnancy, but does not provide protection to
the early embryo between
fertilization and implantation.
Legal or policy definitions of pregnancy as beginning at implantation
have elsewhere had an adverse impact on conscientious objectors who do not
want to dispense the 'morning after pill', or who do not want to be involved
with early embryo experimentation, artificial reproduction, etc. (See
Contradicting state policy may lead to jail in the U.K.;
U.K.
authority moves to suppress freedom of expression;
Irish Medicine Board declares 'morning-after-pill' non-abortifacient;
College of Pharmacists still opposed to freedom of conscience;
Project Report 2001-01;
Award for essay
against freedom of conscience ;
Demands for 'morning after pill' a problem for Catholic health care;
Planned
Parenthood attacks freedom of conscience;
Medical Students for Choice oppose freedom of choice in health care;
New terminology for cloned embryos)
Since Ireland does have a limited
protection of conscience law that covers both contraception and
abortion, it is not clear what impact the law will have. While its legal
effect may be limited, its educative and normative influence might well
prove significant.
The
World Net Daily reports that Acambis PLC of Great Britain, which has
been awarded a contract to manufacture additional smallpox vaccine by the
U.S. Department of Health and Human Services, will not use a stem-cell line
from an aborted fetus in the manufacturing process. A previous report from
the Daily indicated that Acambis planned to make the new vaccine using MRC-5
cells, a line that originated in 1966 from a 14-week fetus aborted for
psychiatric reasons. That such cells might be used in vaccines had given
rise to concerns that anti-terrorism measures might impact those with
conscientious objections to abortion. (See
Smallpox vaccine may
pose moral problems ;
Anti-terrorism
measures and medical practice)
The Saskatchewan Association of Licensed Practical Nurses (SALPN)
(Canada) attempted to prohibit a Christian nurse from practising his
profession because of his public protests against abortion and opposition to
homosexual activism. The SALPN buttressed its claim that Bill Whatcott was
guilty of professional misconduct by referring to a 20 year old criminal
record, dating from a troubled period in his pre-Christian youth, and to
more recent convictions for civil disobedience. The adjudicator ruled that
the criminal record was irrelevant, commenting that it was to his credit
"that he endured such a youth and then had the strength and wisdom to seek a
new lifestyle and a new profession." With respect to Whatcott's civil
disobedience, the adjudicator concluded that it was peaceful, and not
unusual in a society where illegal protests about a variety of issues are
common.
Whatcott has been a nurse for 12 years. That he should have been put to
the expense of defending himself before a disciplinary tribunal for
exercising freedom of conscience and expression is not unusual in Canada.
(See, for example,
Worker fired for refusing payment for illegal abortion;
Nurses triumphant! Human rights case ends in settlement
)
November
Mark Evans, chairman of obstetrics and gynaecology at MCP Hahnemann
university in Philadelphia, states that it is becoming increasingly common
for women pregnant with twins, either as a result of artificial reproductive
technology or natural twinning, to have one of the infants killed in
utero by lethal injection. [Report]
Professor Evans told a fertility congress in Melbourne, Australia, that all
parents of twins should consider aborting one in order to reduce the risk of
prematurity and complications at birth.
The Melbourne (Australia) Advertiser reports an example of such a case
involving a woman pregnant with twins by IVF. Professor Gab Kovacs said the
Melbourne woman was "under psychological stress" and "decided she couldn't
cope" with twins. About 12 women a year in Victoria alone are said to abort
one twin.
The growing frequency of the practice is likely to have increasing impact
on conscientious objectors.
A panel of five law lords ruled unanimously that human rights legislation
exists to protect
life, rejecting the application of an English woman for permission for
assisted suicide. Dianne Pretty has indicated that she will appeal to the
European Court of Human Rights. [BBC
Report] [See
British House of Lords accepts appeal of assisted suicide case]
Dr. Robert Walley, medical director of
MaterCare International (MCI), asserts that the United Nations is more
interested in stopping births through contraception and abortion than
helping women who suffer complications in childbirth. This bias causes the
UN to ignore obstetricians and gynaecologists willing to help desperate
women in some of the world's poorest countries. He notes that billions of
dollars are spent on abortion and birth control programmes, but only a
fraction of that amount is dedicated to providing emergency obstetrical
care.
Of particular concern to MCI is a condition known as obstetric fistulae,
which occurs when a woman's bladder or rectum become damaged during
obstructed labor. MCI trains traditional birth attendants to prevent
obstetric fistulae and performs surgery on women who suffer from the
condition. The UN is hampering MCI's efforts to provide essential
obstetrical care in East Timor, even though, according to Dr. Walley, "there
are no obstetricians in this country with a population of 700,000 and one of
the highest maternal mortality rates in Asia." This suggests to Walley that
the UN believes it is better for East Timor to have no obstetrician than to
have a pro-life obstetrician.
Dr. Walley has
previously criticized UN officials in East Timor because of aggressive
imposition of their values on the people. [Catholic Family & Human Rights
Institute]
Donna Mitchell of the Committee for Advertising Practice has suggested
that those who continue to publish ads that contradict the official
government position on the "morning after pill" could be fined or
imprisoned. (See
U.K.
authority moves to suppress freedom of expression)
A
study conducted by Newcastle university and reported in the Medical
Journal of Australia reports that one in 25 Australian surgeons has given a
lethal injection to a patient who requested it. One third admitted to having
hastened a patient's death by prescribing excessive doses of pain killers,
but the interpretation of this figure is problematic. The study surveyed two
thirds of Australia's surgeons.
The Bioethics Advisory Committee in Singapore has approved
experimentation on human embryos aged up to 14 days on the grounds that the
personhood of the early embryo is "far from being realized". As usual, the
possibility of conscientious objection by researchers or others does not
appear to have been considered.
Lawrence Gostin, director of a centre on public-health law at Georgetown
and Johns Hopkins universities, has drafted legislation that would permit
mandatory examination, vaccination or treatment, including mandatory
vaccinations for children entering school if a state governor declared an
emergency and invoked the law. Refusal to submit to vaccination, quarantine
or treatment would be be offences. The proposed legislation is a response to
the threat of bioterrorism. It is unclear what impact it might have on
people who object to vaccines that have been obtained from morally
controversial sources. [Washington Post]
Columbian pharmacists and other health care workers who object to the
"morning after pill" for reasons of conscience will likely come under
pressure as a result of a decision by the Colombian Health Ministry to
approve its sale. [See previous
news item from Columbia]
The Korea Herald reports that the Korean Medical Association (South
Korea's largest group of medical doctors) issued new ethical guidelines that
prohibit involvement in euthanasia and advise caution when deciding to
perform abortions. However, it is said that they should accept the request
of the family to suspend "life-sustaining treatment" in the case of a
patient who has no chances of reviving. It is not clear from the report
whether or not "life-sustaining treatment" includes artificial nutrition and
hydration, and it is significant that the article refers to "revival" rather
than "survival", suggesting that the guidelines are meant to apply to
patients who are not terminally ill.
North American jurisprudence has adopted the view that assisted nutrition
and hydration is a form of
treatment that can be refused by a patient or surrogate decision maker.
This has allowed patients to be legally starved to death. Those who consider
nutrition and hydration (assisted or not) to be part of basic
care that is always to be provided believe that bringing about the death
of patients by starvation or dehydration is euthanasia, whether or not the
fact is acknowledged in law. Depending upon the interpretation of the
guidelines, Korean health care workers who are morally opposed to euthanasia
may find themselves pressured to participate by their professional
organizations.
In October, 2001, the European Court of Human Rights dismissed an appeal
by French pharmacists Bruno Pichon and Mrs Marie-Line Sajous. They had
argued that they should not be forced to dispense a drug marketed as a
contraceptive that sometimes had an abortifacient effect, as they were
opposed to abortion on religious grounds.
The court ignored the argument about the nature of the drug, and instead
interpreted Article 9 of the European Convention on Human Rights to mean
that the practice of religious belief "does not cover each and every kind of
public act or behaviour, motivated or inspired by a religion or a belief."
It appears that the court interprets practice or expression of religion or
belief to mean narrowly religious worship, teaching, and ritual observance.
In effect, the Court has ruled that religious believers who actually attempt
to live by their faiths may be forced out of civic and professional life.
Reversing a decision made about 18 months ago, the Irish Medical Board
has aligned itself with the position of the Irish Government, which states
that the drug Levonelle does not fall within the definition of abortion set
out in the Protection of Human Life in Pregnancy bill, now before the
Dáil. A cabinet sub-committee recommended last month that legal
uncertainties about the drug should be removed. The IMB consulted the
Institute of Obstetricians and Gynaecolgists and a senior lawyer.
Irish
Times
The change may not impact conscientious objectors directly because
Ireland's protection of conscience law
prevents them from being forced
to participate in the distribution of contraceptives. However, the law does
not prohibit discrimination against them, so they may find themselves
excluded from educational programmes and from employment.
The Advertising Standards Authority in the United Kingdom has ordered the
Society for the Protection of Unborn Children to stop describing
'morning-after-pills' as "abortion-inducing", apparently because official
government policy is to deny that the drug has an abortifacient mechanism.
The development is of interest for two reasons. First: citizens in a
democratic country are being forbidden to express opinions that contradict
government policy. Second: conscientious objection to the drug can be
suppressed on the ground, not that the reasons for objection (in most cases,
that the 'morning-after-pill' may have an abortifacient effect) are
erroneous, but because they are contrary to state policy. [Guardian, 14
November]
The Annual General Meeting of the BC College of Pharmacists meeting was
held in Burnaby on 3 November, 2001. The only resolution presented at the
meeting proposed an amendment to the College Code of Ethics to respect
freedom of conscience. The resolution was defeated 24-14, but the degree of
support for the motion was a surprise to at a least one experienced
pharmacist. A member of the College's Ethics Committee found himself
challenged by a young pharmacist for attempting to impose his own views as a
kind of religion.
Freedom of conscience advocates met a number of supporting colleagues,
including one who prescribes the 'morning after pill' but understands and
respects those who do not. Some support came from unexpected quarters, and
it appears that some members of the College Council are becoming sensitive
to the problem. The Registrar allowed those supporting the resolution to
display material and offered to announce that it would be available.
For background on the situation in British Columbia, see
"Autonomy", "Justice"and the Legal Requirement to Accommodate;
In Defence of the New Heretics;
Project Report 2001-01
Le Monde reports that French Health Minister Bernard Kouchner now
believes the law prohibiting euthanasia should be changed. (See
previous breaking news item.) It does not appear that the effects of
such a change on those in the medical profession who object to euthanasia
are being taken into account. Recent changes to the French abortion law have
led to conflicts of conscience and
resignations of some
hospital medical staff.
Law Professor Lynn Wardle of Brigham Young University delivered a paper
at the Fall Institute of the Pharmacy Law Institute in Columbus, Ohio on 9
November, 2001. The title of the paper was Why A New Law? Model
Conscience Clause Legislation. Professor Wardle will be speaking
February 1-2, 2002 at the American Association of Pro-Life Obstetricians &
Gynecologists midwinter symposium in Ft.Lauderdale, Florida about freedom of
conscience. Professor Wardle is an advisor to the Protection of Conscience
Project.
The grand prize in the 2001 student literary challenge sponsored by the
Canadian Pharmaceutical Journal has been awarded to a University of Alberta
student whose essay, The Conscience Clause: A Threat to Pharmaceutical
Care, was published in the Journal's September supplement. The author
argues that it is unethical for pharmacists to refuse to dispense legal
medication on moral grounds, and concludes that freedom of conscience should
not be allowed because it might hinder access to legal drugs.
A study by the Jérôme Lejeune Foundation has found doctors uneasy about
legal amendments that have liberalized France's abortion law. The July
amendments raised the gestational time limit for abortion from 10 to 12
weeks and allowed minors to obtain abortions without parental consent. Many
doctors are reported to be uncomfortable about later term abortions, and
some hospitals find it almost impossible to recruit doctors willing to
perform them. Doctors at the Edouard Herriot hospital in Lyons resigned when
administrators told medical staff in the gynaecology department to implement
the new law. [Zenit, 7 November]
According to a BBC report, girls as young as nine years old are being
subjected to secret pregnancy tests by emergency room nurses in the United
Kingdom. The news agency states that one in five emergency nurses in UK
hospitals are performing such tests without the knowledge of the parent or
child, on the grounds that the tests are necessary before the girls are
X-rayed. Since this violates the principle of informed consent, a
conscientious objector would likely be supported by the ethics establishment
in refusing to participate, but might well come under pressure from
colleagues, especially if refusal to participate would bring the practice to
the attention of critics. [BBC
News]
Problems have arisen in negotiations that would have seen a "hospital
within a hospital" established to avoid conflict with the requirements of
Catholic health care (See
Compromise
proposed in hospital reorganization).
The Seton Health Care Network has advised the mayor and council of
Austin, Texas, that, even in a separately licensed facility within the
hospital, rape victims must be tested to see if they are ovulating before
potentially abortifacient drugs can be dispensed.
Bishop Gregory Aymond of the Catholic Diocese of Austin will be speaking
with Seton representatives and Catholic ethicists about the situation. While
noting that the church condemns rape as a terrible evil and responds
compassionately to rape victims, "a Catholic institution cannot act or
cooperate in an action that destroys human life."
The proposed protocol is said to be still under review, but the
development caught the mayor by surprise. Annoyed, he withdrawn the item
from the City Council agenda, cancelled a public hearing on the matter and
"postponed indefinitely" any further action by the council. He suggested
that dispensing the controversial drugs was "fundamental . . . and not
negotiable."
The problem arose in June, 2001, when Seton, announced sterilizations and
contraceptive services could no longer be provided at Brackenridge Hospital
due to revised religious directives that banned participation in such
activities. At that time, Seton officials did not expect to make changes in
provision of the potentially abortifacient 'morning after pill'. The present
change of approach is said to originate in issues raised in 1994, prior to
the revised directives.
Seton proposed to continue providing the bulk of the maternity services,
but an oversight council and women's health organizations objected. The
council recommended that the city take control of all maternity and
reproductive services and contract with a company to manage the operation.
[American-Statesman Staff, October 26, 2001]
Children of God For Life, a group that opposes the use of tissue from
deliberately aborted babies in research or therapy, is concerned that a new
smallpox vaccine, apparently being proposed in response to fears of
biological terrorism, may use aborted fetal cell lines.
The contract for developing the vaccine was awarded to the Oravax/Acambis
Corporation. Children of God for Life states that its research shows that
the company intends to use aborted fetal cell line MRC-5 as the cell
substrate for growing the virus. A Centers for Disease Control
document
verifies that "Recently, MRC-5 was used as a cell substrate for the
preparation of an experimental smallpox vaccine under a Phase 1 trial."
Children of God for Life notes that smallpox vaccine can be made using
animal substitutes. A requirement to participate in an inoculation programme
using vaccines derived from fetal cell tissue would likely result in
controversy.
(See update No fetal
cells in new smallpox vaccines)
An ethics committee at Kyoto university has approved embryonic research
due to start in March. Final approval must come from the Japanese
government. [Ananova,
5 November]
The House of Lords has agreed to hear a right-to-die case after a panel
of three High Court judges ruled unanimously against a request for assisted
suicide made by Dianne Pretty, a 47-year-old British woman who suffers from
motor neurone disease.
(See UK Woman loses right-to-die
case)
October
Consistent with Health Canada's admission earlier this year that it had
no evidence to support its claim that abortion is a medically necessary
procedure, the Executive Director of the Canadian Abortion Rights Action
League (CARAL) has told the Canadian House of Commons Finance Committee that
women seeking abortions "... do so for socio-economic reasons. Sometimes it
is a desire to complete their education and become financially independent.
In many cases, couples with children wish to restrict their family size in
order to provide adequate financial support. Often, choosing abortion is a
conscious decision not to become a socio- economic burden on society."
When asked by Member of Parliament Jason Kenney how a procedure done for
"socio-economic" reasons could be medically necessary, Wilson replied that
if the provinces determine it to be necessary, then it is.
The submission is of interest because those who would force health care
workers to participate in abortions usually justify their demand with the
assertion that the procedure is medically necessary. (See also
Canadian health minister advised to demand payment for private abortions)
In a measure that will adversely impact health care workers opposed to
euthanasia and assisted suicide, the Belgian Senate approved a bill allowing
terminally ill patients to seek assistance from a doctor in committing
suicide. The bill, which passed the Senate by a vote of 44-23 division (with
2 abstentions), must pass the House of Representatives.
Diane Pretty, who is dying from motor neurone disease, has lost a High
Court challenge to laws against assisted suicide. She plans to take the case
to the House of Lords. [BBC
News]
(See English
woman argues for right to assisted suicide)
A 22-year-old female employee is suing Wal Mart, claiming that the
failure to include contraceptive coverage in its insurance plan amounts to
discrimination against women. The case does not appear to deal with the
issue of conscientious objection by an employer, but may have an impact in
such cases. [USA
Today]
House Bill 5158, superseding an earlier bill that died in committee,
offers protection to health care workers and facilities. An unusual feature
of the bill is a "5%" rule that permits termination of an employee if the
service to which he objects occupies more than 5% of his daily work. The
bill's chief sponsor has indicated that he would consider making
referral a requirement for conscientious objectors, which a number of
conscientious objectors would be unwilling to accept. [Holland Sentinel]
A federal court judge has agreed to allow Planned Parenthood to intervene
in a lawsuit to support KMart, who fired a pharmacist for refusing to
dispense abortifacient drugs. The ruling will likely result in postponement
of a November 5th trial date for a case that began in 1996. This illustrates
the need for legislation to protect individuals who may be forced into
bankruptcy or significant debt in legal battles with major corporations and
powerful, moneyed interests.
The case began when Kmart fired
Karen Brauer, an Indiana pharmacist, after she refused to dispense
Micronor, a progestin-only contraceptive that works in a significant number
of patients by preventing the implantation of an early embryo.
In a 7-0 decision, the Kansas Supreme Court ruled that, "as a matter of
law. . . a physician who has a doctor-patient relationship with a pregnant
woman who intends to carry her fetus to term and deliver a healthy baby also
has a doctor-patient relationship with the fetus."
By implication, the ruling makes the existence of the relationship
conditional upon the intention of the mother. While this presents a number
of logical and practical difficulties (notably the problem that arises
should a mother change her mind during the pregnancy), the ruling does
suggest that physicians do not act unreasonably when they recognize a
physician-patient relationship with a child in utero. [Washington
Times]
The English high court has authorised doctors to withdraw food and fluids
from an unconscious patient ruled to be in a "persistent vegetative state".
Dame Elizabeth Butler-Sloss, president of the high court's family division,
stated: "She would want to die in peace and not to persist in the twilight
limbo in which she exists at the moment." The legally established practice
of causing death by starvation and dehydration requires the participation of
health care personnel, some of whom may decline to assist for reasons of
conscience. [BBC
News]
A group identifying itself as pro-choice circulated an e-mail to
New Jersey students in support of legislation intended to suppress freedom
of choice and freedom of conscience. It appears that the Equity in
Prescription Insurance and Contraceptive Coverage (EPICC) Act force even
those with moral objections to contraception to provide contraceptive
coverage in health insurance. The e-mail indicated that the measure was also
supported by Planned Parenthood.
The ACOG has issued guidelines requiring that every pregnant white woman
in the United States be offered a test for the gene mutation that causes
cystic fibrosis. The test will also be offered to every couple planning to
have a baby if one of the partners is white. The gene for cystic fibrosis is
carried by one in every 29 white Americans. It appears that a positive
pre-conception test will result in referral for in vitro
fertilisation and pre-implantation genetic diagnosis, while a positive
post-conception test will result in abortion. The guidelines will likely
make practice more difficulty for physicians who oppose eugenic practices
for reasons of conscience. (See
Supreme
Court of Canada to hear 'wrongful birth' case ;Eugenic
screening expected by French courts;No
Christian gynaecologists and neonatologists in Netherlands ;
Catholics and Pro-lifers Being Forced Out of Ob/Gyn Profession;
Doctor sued for birth of Down Syndrome child )
The Project Administrator's computer was infected by a virus, probably
some time during the last half of September, 2001. The virus disabled the
anti-virus programme and destroyed all information on the hard drive. It
also mailed itself to contacts in the Project address book.
New York Assembly Bill 675 is reported to require every individual and
group health insurance policy that offers maternity coverage to provide
abortion coverage. Bill A.4397 may be interpreted to mean that the state
Public Health Council could demand that abortions be provided as a condition
for the issue of certificates or other approvals. Similarly, bill A. 2674
could be interpreted by the state Public Health Council to authorize it to
force hospitals to include abortion in their mission statements.
The Human Fertilisation and Embryology Authority in the United Kingdom
has been asked to approve the artificial conception of a child to provide a
two year old boy with compatible bone marrow donor. In vitro
fertilisation and pre-implantation genetic diagnosis would be used to select
the donor embryo to be brought to term; unsuitable embryos would probably be
destroyed. The case illustrates how people who object to such procedures
will likely face increasing pressure as new technologies become more
popular. [BBC
News]
There is some disagreement at the American Society for Reproductive
Medicine (ASRM), which was recently reported to have allowed clinics to use
pre-implantation genetic diagnosis (PGD) for sex selection for non-medical
reasons. It had already approved sex selection by means of sperm sorting.
PGD involves the screening of embryos created in vitro for the
desired sex, with the probable destruction of embryos found to be of the
wrong sex. This is consistent with suggestions being made by some people in
England, and problematic for some conscientious objectors.
A later report indicates that John A Robertson, chairman of the Society's
ethics committee supports in vitro sex selection of embryos for
non-medical reasons, but Dr. Robert Rebar, associate executive director of
the ASRM, insists that the committee stands by its previous policy of
discouraging sex selection. [Buffalo
News, 4 November] [Austin360.com]
(See British
philosopher advocates in vitro sex selection)
The Canadian Supreme Court will consider whether payments from a doctor's
insurance company should continue indefinitely or whether a 10 year old Down
syndrome child should receive state welfare support. He is reported to
require lifetime care. His mother says that her doctor did not advise her to
take an amniocentesis test, and she would have aborted her son had she been
made aware of his condition before birth. 'Wrongful birth' suits have a
serious impact on doctors who do not wish to be associated with eugenic
screening. [National
Post] (See also
Eugenic screening expected by French courts;No
Christian gynaecologists and neonatologists in Netherlands ;
Catholics and Pro-lifers Being Forced Out of Ob/Gyn Profession;
American College of Obstetricians and Gynecologists requires eugenic
screening;
Doctor sued for birth of Down Syndrome child )
Date 17 September, 2001: House of Representatives of the Australian
Parliament [Report]
Writing in the Journal of Medical Ethics, Dr David McCarthy of the
university of Bristol advocates a legal right for parents to select the sex
of their child using in vitro fertilisation (IVF) technology. He asserted
that IVF and pre-implantation genetic diagnosis (PGD) could be used to allow
people to have balanced families and legalisation would therefore be
unlikely to have much impact on the overall sex ratio. As usual, the
potential impact on those who do not wish to participate in sex selection
was not considered. [BBC
News online, 1 October]