January-March, 2003
March
Dr Kay Mitchell of Auckland university anonymously surveyed 2,600 family
doctors by mail and found 225 cases in which treatment had been withheld or
painkillers used with at least a partial intention to cause an earlier
death. Rev. Dr. Michael McCabe, director of the Nathaniel (Catholic
bioethics) Centre, expressed concern that the findings could undermine trust
in physicians. Dr John Adams, chairman of the New Zealand medical
association, commented that the preservation of life is one of a doctor's
primary obligations.
Meanwhile, Peter Brown's "Death with Dignity Bill" is to be debated in
parliament. Among those opposed to it are Kaikoura M.P. Dr. Lynda Scott, the
Maxim Institute and the country's Catholic bishop's conference. Proponents
of the legislation include Dr. Philip Nitschke, an Australian euthanasia
advocate who is in New Zealand marketing his 'exit bags'. He is also
speaking in defence of assisted suicide advocate Lesley Martin, charged with
attempting to murder her terminally-ill mother by drug overdose and
suffocation.
Continued pressure for legalization of euthanasia and assisted suicide,
particularly in the absence of protective legislation, is a matter of
concern for those who do not wish to participate in such procedures.
The president of a legislative committee that is to investigate the
legalization of euthanasia/assisted suicide has admitted that the work group
has not met in the six months since Guernsey's parliament voted to begin the
enquiry.[See
Pro-euthanasia postcard campaign in Guernsey ].
Children and God for Life and Human Life International are involved in a
struggle with the board of directors of Merck & Co. Inc., a pharmaceutical
company that had a net income of $7.2billion in 2002, $34.6 million of which
came from viral vaccine sales. The dispute involves a shareholder's
resolution put forward by Rev. Thomas J. Euteneuer of Human Life
International, but highlights the moral controversy involved in the
production and use of some vaccines.
A survey of England and Wales conducted by the Department of Health in
2001/02 has been released by the Office for National Statistics. It suggest
that 7% of female respondents aged 16-49 and 21% of women aged 18-19 had
used the potentially abortifacient morning-after pill during the preceding
12 months. About a million packs of the drug are provided annually in the
United Kingdom. The widespread use of the product is likely to make it
increasingly difficult for health care workers who, for reasons of
conscience, object to dispensing it.
The UN Emergency Unit for Ethiopia is pushing for aggressive population
control measures enforced by "reward and punishment" in order to make the
country less dependent on foreign food aid. The suggestion may bring
Ethiopian health care workers who do not share the United Nations moral
outlook into conflict with those who want to impose the UN policy. [Africa.com]
[See
No Place for Abortion in African Traditional Life - Some Reflections (2002)]
The Lancet reports that a new quadruple blood test has halved the 14% false
positive rate associated to current pre-natal screening tests. The tests are
used to identify Down's Syndrome and other conditions in order to facilitate
abortions, thus presenting a problem for health care workers who object to
eugenic practices and/or abortion. [BBC]
The Taiwanese legislature, considering an appeal for euthanasia from a
leukemia patient, has been told by physicians that better palliative care is
the appropriate response to such requests.
Mayor Michael Bloomberg of New York City, has vetoed a bill that would have
required all city hospitals to provide the potentially abortifacient
morning-after pill to patients complaining of rape. He asserted that the
bill was unnecessary.[New York Post]
A Filipina woman employed as a live-in caregiver, has been fired and
threatened with deportation because she refused to have an abortion.
Eurasian Homecare Services and the man who employed her had sent her to
Notre Dame Hospital after they learned she was pregnant. The conversation
with the there doctor was conducted on her behalf in French, a language she
did not understand. When she learned that they were discussing arrangements
for an abortion, she refused. [Montreal
Gazette]
Assisted suicide legislation has been proposed by New Zealand First MP Peter
Brown. The bill requires two medical opinions, consultation with a
psychologist or psychiatrist, and a waiting period. Only those 18 years or
older would be allowed to request assisted suicide. Dr Philip Nitschke, a
well-known euthanasia advocate from Australia, is on a speaking tour of New
Zealand, and has come to the support of a woman charged for attempting to
murder her sick mother. Continued advocacy of euthanasia and assisted
suicide illustrates the importance of protection of conscience legislation.
32 members of the National People's Congress moved that euthanasia should be
legalized in China, initially in Beijing and Shanghai. China's coercive
population control policies, which already adversely affect health care
workers who object to abortion [Chinese
health care workers and the 'one-child' policy] provide a particularly
troubling backdrop for the proposal.
The Patients' Protection Bill, which would ban the deliberate withdrawal of
nutrition and hydration as a means of causing the death of patients, has
received a second reading in the House of Lords and been sent to committee.
[Hansard]
The 58,000 residents of the Channel Island of Guernsey will be receiving
postcards from a local group, which they will be asked to sign and return to
support legalization of euthanasia. In September of last year the States,
Guernsey's parliament, voted to investigate the legalization of euthanasia.
Guernsey is not part of the United Kingdom. It is subject directly to the
British sovereign, and is not subject to laws passed by the British
Parliament unless the laws specifically include such a provision. The Privy
Council must approve Guernsey's statutes.
A hospital ethics committee in Melbourne, Australia, has approved the
production of a baby by means of IVF, guided by eugenic screening and tissue
matching. The child's parents plan to use blood from the umbilical cord for
transfusion to a sick sibling. The case illustrates how artificial
reproductive technologies can be used for unforeseen ends which may, in such
circumstances, give rise to conflicts of conscience among participating
health care workers.
A measure that would have forced hospital emergency rooms to dispense the
potentially abortifacient morning-after pill to rape complainants failed to
muster enough votes in the Senate to pass.
Wisconsin's Senate Labor Committee has approved
Senate Bill 21, which would protect pharmacists who, for reasons of
conscience, refuse to dispense drugs or devices that would cause death
through abortion, euthanasia, physician assisted suicide, etc. Testimony
from three pharmacists supporting the bill is available on the Project
website.[Testimony
of Pharmacist Klubertanz Re: Wisconsin Senate Bill 21]
In the state of Victoria, Australia, a Civil and Administrative Tribunal
ruling that a feeding tube could be removed from a woman suffering from
dementia will not be challenged. A Right to Life group had appealed the
ruling to the Supreme Court, but has since withdrawn from the case. It
appears that the woman will be starved to death on the grounds that the
assisted feeding constitutes medical treatment rather than care.
The BBC reports that 49 infants in utero were killed by lethal
injection in 2001. Most were normal and healthy, but were culled because the
mother did not want to bear all of the children she was carrying. The
procedure has become more common because of in vitro fertilization,
with implantation of more than one of the resulting embryos. [BBC
report] Lethal injections of potassium chloride are used in the province
of Alberta to ensure that infants scheduled for late term eugenic abortions
are dead when they emerge. The practice developed after it was revealed that
some infants had survived late term abortions and had been left to die at
Foothills Hospital in Calgary. [Nurses
At Foothills Hospital Rebel Over The Horrifying Results Of Late-Term
'Genetic Terminations']
International Planned Parenthood Federation (IPPF) hosted a conference on
'unsafe abortion' in Kenya in the first week of March, attended by health
ministers from Ghana, Mozambique and Namibia. The head of the African
Alliance for Women's Reproductive Health and Rights claimed that thousands
of African women die annually from unsafe abortions, blaming restrictive
abortion laws inherited from former colonial powers. Mrs Charity Ngilu, the
Kenyan health minister, has stated that "the denial of women to make free
choice on their reproductive
health life is wrong," but bishops of the Catholic, Anglican and Independent
Pentecostal churches denounced the statement; Muslim leaders in Kenya are
also opposed to abortion. Aside from the fact that reliable statistics
cannot be had, the notion that suppression of abortion is an artifact of the
colonial period is disputed. [See
No Place for Abortion in African Traditional Life - Some Reflections (2002)].
Conference attendees do not appear to have been advised that the failure to
take into account the position of conscientious objectors in South Africa
was a significant omission in the legalization of abortion in that country.
[See
Traumatised Health Care Professionals Forced to Take Part in Abortion
Procedures].
A 'wrongful life' suit will proceed in the Court of Queen's Bench of
Alberta. Acting on behalf of her disabled daughter, a woman is suing her
obstetrician because the child was born with serious physical and mental
disabilities. The threat of 'wrongful birth' and 'wrongful life' suits can
be used to pressure physicians and others to become involved in eugenic
practices, which some find morally objectionable. [News
report]
A joint
statement, issued after a first meeting between delegations of the Chief
Rabbinate of Israel and the Holy See, a statement was issued that included
the following assertion:
4.1. Human life is of unique and highest value in our world. Any
attempt to destroy human life must be rejected, and every common effort
should be made, in order to promote human rights, solidarity among all
human beings, respect for freedom of conscience.
Official statistics published by the Oregon Department of Human Services
reveal that 38 people died by physician assisted suicide in the state, which
legalized the practice in 1998. 58 people had been given prescriptions for
lethal medication. Among the reasons for seeking assisted suicide, concern
about "losing autonomy" was expressed by 85% of the patients. [See
Assissted Suicide- What Role for Nurses?]
In the South African town of Rietvlei near Umzimkhulu in Eastern Cape, a
controversy has arisen because women were refused abortions at the local
hospital. Accusations of misconduct have been leveled at the staff, who are
reported to object to the procedure for religious or moral reasons. Those
who want to force the staff to provide abortions claim that this is required
by the South African Termination of Pregnancy Act. [See
South Africa Changes Abortion Law;
Are State Doctors in the Western Cape willing to implement the Choice of
Termination of Pregnancy Act of 1996? An opinion survey conducted in the
Western Cape in November 1997.;
No Place for Abortion in African Traditional Life - Some Reflections (2002))
Legislators in Wisconsin and Missouri have introduced bills that would
ensure freedom of conscience for pharmacists with moral objections to
dispensing certain drugs. See Wisconsin
SB21 and Missouri
AB480, and the
Project Letter to the Editor.
Consistent with some notable judicial decisions, the Civil and
Administrative Tribunal in the Australian state of Victoria has decided that
artificial nutrition and hydration are forms of medical
treatment rather than
care. The decision paves the way for a proxy decision maker to cause the
death of a patient by withdrawing food and fluids, a procedure which is
likely to give rise to conflicts of conscience for some health care workers.
February
The 'Reporter' , a Dutch television programme, has broadcast claims that the
actual euthanasia rate in the Netherlands is higher than officially reported
because many doctors find the reporting requirements too time-consuming. The
programme asserted that many administer lethal doses of morphine on the
pretext that they are intended to control pain, or sedate patients and let
them die of dehydration and starvation.
A new document being drafted by the Vatican and Slovakia will acknowledge
that, for reasons of conscience, Slovakians are free to refuse to carry out
obligations that the state would otherwise impose. The document will include
reference to conscientious objection to military service, parental authority
to withdraw their children from sex-education classes, recognition of Sunday
observance, and protection for doctors who refuse to perform abortions.
Hammersmith Hospitals Trust in London is asking patients to provide advance
directives about
care and
treatment should they develop diseases like advanced dementia or cancer,
or problems like confinement to bed after a stroke or double incontinence.
The forms include reference not only to ordinary treatment for illness, but
to artificial nutrition and hydration. The provision of nourishment is
looked upon by many conscientious objectors as basic care, not treatment,
despite legal rulings to the contrary. Conflicts may arise if health care
workers are required to starve and dehydrate patients in conformity with the
directives sought by the Trust.
Hawaiian Senate Bill 658 would require all hospitals to provide the
potentially abortifacient morning-after pill to rape complainants. The bill
provides fines of $5000 each time a hospitals decline to provide the drugs.
After a second violation, the state will revoke the hospital's certificate
of authority. The bill appears similar to one just passed in New Mexico.
(See
previous report)
Lord Joel Joffe has put forward the Assisted Dying Bill, which would permit
people suffering from terminal or serious and incurable illnesses to obtain
'medical assistance to die'. The fill is not thought likely to become law.
[BBC] The
continuing efforts of pro-euthanasia advocates ought to alert health care
professionals to the importance of solidarity in defending freedom of
conscience. Those who demand that colleagues be made to facilitate or
participate in morally controversial procedures should realize that they
themselves could become victims of their own policy objectives.
Compassion in Dying, an assisted suicide lobby group in Oregon, reports that
30 of their clients killed themselves in 2002, compared to 17 in 2001. The
group believes that the number amounts to about 80 percent of the assisted
suicide deaths in the state, where the practice is legal. Official
statistics will be released next month. The executive director of the group
believes that publicity about a lawsuit intended to hamstring the law
actually increased interest in assisted suicide. He also suggested that
physicians had become more comfortable with it. Conflicts of conscience are
more likely to arise as the practice becomes more common. [For another view
of the situation in Oregon, see
Assisted Suicide: What Role for Nurses?] An assisted suicide bill is now
before the Arizona state legislature.
Australian Labour Party member John Hogg, deputy president of the Senate in
Queensland, has asked Catholic Church leaders to become "more aggressive" in
public support of Catholic teaching. He complained that Catholic politicians
who defend Church teaching are often left to fend for themselves when Church
authorities fail to support them, especially when they are attacked by
nominally Catholic groups opposed to Catholic teaching. [Zenit
interview] Conscientious objectors not infrequently encounter the same
problem, which is not unique to the Catholic Church.
An obstetrician who refused to perform artificial insemination on a lesbian
patient is before the 4th District California Court of Appeal in San Diego
defending herself against a civil suit. The doctor, a Christian, offered to
provide fertility treatments and to care for her after she became pregnant,
but would not provide artificial insemination because to inseminate a
homosexual would conflict with her religious beliefs. For 11 months the
doctor provided drug and hormone therapies as the patient tried
self-insemination with sperm from a sperm bank. The obstetrician also
performed diagnostic surgery on the patient to determine her suitability for
artificial insemination, and referred her to another doctor to perform the
procedure. However, the obstetrician and her colleagues declined to have the
insemination occur in their clinic. [News
report]
Senate Bill 21, a protection of conscience bill for pharmacists, has
been introduced in Wisconsin. It is reported to have broad support in both
houses. Advocates for freedom of conscience in Wisconsin request support for
SB 21 and opposition to LRB-1983/1 and LRB-1984/1, two bills that would
force hospitals to provide the potentially abortifacient morning-after pill
to rape complainants.
Christopher McManus, Professor of Psychology and Medical Education at
University College London, has produced research that suggests that
applicants to medical schools from ethnic minorities have less than half the
chance of acceptance as whites. Even so, the proportion of medical students
from minorities has risen from 10 to 33 per cent over the last twenty years,
and it is now being suggested that medical schools are restricting the
admission of Muslim applicants. The restriction is said to result from the
refusal of Muslims to participate in courses that are contrary to their
faith. Many, for example, will not perform abortions. An executive member of
the Muslim Doctors' and Dentists' Association also identified artificial
reproductive procedures and euthanasia as contentious issues.[The Times]
House Bill 1741, passed by the House in January, has been killed by a
committee of the state senate.
Half of 1,000 nurses in the United Kingdom surveyed by Nursing Times
magazine are reported to believe that assisted suicide should be legalized;
1 in 20 "believe" that their colleagues are already involved in euthanasia
or assisted suicide. However, the wording of the statement yielding the 1 in
20 result was ambiguous. "Health professionals already quietly help patients
to die" does not specify that the "help" provided is, in fact, deliberate
killing, nor does it indicate the origin of the respondent's "belief". The
result is further complicated by responses suggesting confusion about the
moral significance of providing a last dose of morphine, or an increasing
frequency of doses, intended to relieve pain but not to kill. The Royal
College of Nursing noted that the survey sample was relatively small, and
reiterated support for better palliative care rather than legalization of
euthanasia. [See
Assisted Suicide: What Role for Nurses?;
Consensus Guidelines on Analgesia and Sedation in Dying Intensive Care Unit
Patients ]
House Bill 119, passed by New Mexico's House of Representatives, would force
all hospitals in New Mexico to offer the potentially abortifcacient
morning-after pill to rape complainants. It now goes to the state Senate. As
a form of preamble to the main text of the statute, the bill offers a series
of purported "findings", including the statement, "Emergency contraception
cannot and does not cause abortion." It appears that this was included in
order to circumvent the state's
protection of conscience statute, which prevents health care workers
from being forced to participate in abortions.
The bill demands that hospitals not only counsel rape complainants about
the use of the morning-after pill, but also provide the potentially
abortifacient pill upon request. A hospital that does not comply may be
fined $5,000.00 for each complainant who is not given information and/or the
pills, and $5,000.00 for each month that it provides emergency services
without having trained its personnel to impart "medically and factually
accurate and objective information" about the drug. After a second fine, the
hospital's licence may be revoked. There is no exemption for denominational
hospitals or institutions founded upon principles that preclude the
provision of potentially abortifacient drugs.
The state Assembly in New York has passed a similar bill. Bill A19
demands that all hospitals provide the 'morning-after pill' upon request by
a rape complainant, as well as information that has been 'approved' by a
state official. The latter requirement is even more restrictive than the New
Mexican law, which at least requires that the information provided be
medically and factually accurate. There is no provision for conscientious
objection. The bill has now been referred to the state Senate. It is
possible that hospitals may defend themselves by relying upon New York's
Civil Rights Law, but the application of the saving provisions of that
statute depends upon judicial interpretation and is far from certain.
Madam Justice Carolyn Layden-Stevenson of the Federal Court of Canada has
ordered Correctional Services Canada to pay for sex change operations that
'medical opinion' deems to be an "essential service for a particular
inmate." Her ruling was apparently influenced by the fact that such
operations are covered by the state medicare system in most provinces. The
inmate who initiated the action was a man convicted for the murder of a
transvestite associate. The notion that such surgery could be considered an
"essential medical service" may prove to be a troubling precedent if it is
applied in cases involving conscientious objection. [National
Post]
Pope John Paul II's
message for the World Day of the Sick included a reminder that
"Catholics working in the field of health care have the urgent task of doing
all they can to defend life when it is most seriously threatened and to act
with a conscience correctly formed according to the teaching of the Church."
January
Kansas State University has found that Wharton's Jelly, a matrix within
the umbilical cord, can provide a ready supply of stem cells for research
without the ethical concerns associated with destroying embryos to obtain
them. The cells obtained from Wharton's Jelly can be propogated for over a
year, frozen, and made to express foreign proteins. They can also be induced
to form nerve cells. [Study]
The report is one of many that indicate that conflicts of conscience among
researchers can readily be avoided by using stem cells from
non-controversial sources.
Plans to widen the grounds for abortion in Indonesia have been opposed in a
joint declaration signed by Buddhist, Catholic, Muslim, Hindu and Protestant
religious leaders. The statement was issued after a meeting of the leaders
at Jakarta's Istiqlal Mosque. It indicates that, without exemptions for
conscientious objection, legalization will lead to conflicts of conscience
among the adherents of these religions who are health care workers. [UCAN]
A team at the Doheny Eye Institute in Los Angeles, California, which
transplanted tissue from the retinas of aborted infants into four patients,
noted improvement in two of them. At least one expert has suggested that
more common eye ailments might be treated in the same way. Use of tissue
obtained through abortion can give rise to conscientious objection. The
likelihood of such conflict increases when experiments of this kind raise
expectations that such tissue may or should be used.
A wrongful birth case in Vancouver, B.C. that has attracted considerable
criticism did not deal with the issue of conscientious objection, nor did it
concern a physician who could be described as 'pro-life'. There was no
evidence that the physician generally discouraged patients from having
amniocentesis, nor does the judge's summary of the evidence suggest that he
objected to abortion. The case turned on a conversation between a physician
and a pregnant patient described as " a sophisticated and experienced
businesswoman woman," who told him that she wanted to have a "perfect baby."
He testified that he had told the patient that she should seriously
consider having an abortion if amniocentesis revealed an abnormality, but
she responded that she would not consider having one. In addition, he
asserted that the patient's travel plans complicated arrangements for the
test and followup. The physician claimed that he would have arranged for the
test if it had not been "too late."
The trial judge rejected the doctor's testimony that the patient said she
would not have an abortion. The judge concluded that the physician had added
"self-serving notes" to his clinical record after the fact "in order to
bolster his case" once he became aware of the possibility of the suit
against him. He ruled that the physician ought to have expedited the test,
and that had he made the attempt to do so he probably would have been
successful.
The finding against the physician was that his failure to arrange for an
amniocentesis "fell below the accepted standard of care and was negligent."
The result of this negligence was the birth of a child with Down Syndrome,
who would have been aborted had the condition been detected by the test.
However, the judge ruled that the parents were also negligent, assessing
their contribution to the outcome at 50%. Damages assessed against the
physician mainly reflected an assessment of costs that would be incurred by
the parents during their lifetimes to reasonably "promote the mental and
physical health" of the child. The judge calculated the amount at $193,771
(USD). The judgement is of concern from the perspective of freedom of
conscience in health care because it indicates that eugenic practices are
now considered a legally enforceable 'standard of care'.
A recent Alan
Guttmacher Institute study notes that almost one quarter of hospitals
providing abortions performed fewer than six abortions. The study's authors
explain that they "were most likely performing abortions only in cases of
fetal anomaly or serious risk to the woman's life or health". Even at face
value, this is a tacit admission that refusal to provide abortions for
reasons of conscience could not be said to present a threat to women's
health. Although the number of abortion providers declined, the decline was
slightly lower than that recorded between 1992 and 1996. This does not
suggest a catastrophic reduction sometimes claimed by those who oppose
freedom of conscience in health care.
The study also reported that 1,819 physicians performed at least one
abortion in 2000 - a decrease of 11% since 1996. An
article by Sydney Smith, a family physician, notes that most of these
providers were probably obstetrician-gynecologists, and would amount to only
about 5% of the total number of obstetricians in the United States. Smith
suggests that personal convictions rather than external constraints are
responsible for the low rate of participation.
A committee of the Virginia legislature has approved
House Bill 1741, that would protect pharmacists, doctors and other
health professionals who refuse to dispense abortifacient drugs. The bill
was amended to delete a requirement for referral by conscientious objectors.
ITV1, a British national television channel, has broadcast a programme which
followed Reginald Crew on his trip to Switzerland, where he died by assisted
suicide. More Britons are believed to be planning similar excursions.
Responding to news of Crew's death, Chris Davies, a British Liberal Democrat
in the European parliament, now argues for the legalization of euthanasia.
An anonymous person has contacted a London newspaper and claimed to be a
Scottish doctor who has assisted eight terminally ill patients to commit
suicide. He also asserted that six other physicians had told him that they
had also assisted in causing the deaths of patients. The chairman of the
UK's Voluntary Euthanasia Society, Dr Michael Irwin, a former general
practitioner, maintains that physicians contribute to a third of all deaths
in Britain, and congratulated those whom he said had administered lethal
injections. The VES conducted an internet poll that purported to show that
half of Britain's physicians believe that people should be able to obtain
medical help to facilitate their deaths, but only a third supported
legalization of assisted suicide.
The Ontario Ministry of Culture will provide a grant of over $177,000.00 to
the pro-euthanasia group 'Dying with Dignity' to develop a counselling
programme in Toronto. The founder of the group, who claimed to have been
present at over 350 suicides, killed herself in 1999. Her book, A Gentle
Death, is advertised on the group website. The grant was approved by the
Trillium Foundation, which is an agency of the ministry. Approval of such
initiatives from government agencies is likely to lead to normalization of
assisted suicide and euthanasia, generating pressure for legalization.
Lu Guangxiu, who works at a laboratory in Changsha, Hunan province, claims
to have cloned more than 80 human embryos. Four had been allowed to develop
to the stage when they could have been implanted in a womb. [Sunday Times,
26 January]
A report in the Medical Post dated 24 July, 2002, alleged that the new Swiss
abortion law would force Catholic hospitals to perform abortions. A letter
to the Project from the Swiss Embassy in Canada, now confirmed as "99% true"
by a spokesman for the Swiss Conference of Catholic Bishops, confirms that
this is not the case. The letter states that "there are no more hospitals
existing in Switzerland that are based on a catholic foundation; all of them
are now managed by secular directors. There are, of course, medical staff
with religious inclinations. . . their number, however, is constantly
declining. The only remaining indication today of some hospitals' former
catholic orientation are their names such as St. Anna . . . there is no more
hospital in Switzerland that would truly qualify for the adjective
'catholic'. . .". (Project
letter to The Medical Post)
Germany's National Committee on Ethics has approved pre-implantation genetic
diagnosis (PGD) h to screen embryos for genetic defects. The committee
included limitations that would limit the destruction of embryos to those
that would be aborted under the current rules for eugenic abortions. Making
eugenic screening a standard practice can create problems for those who have
moral objections to the procedure.
The British Pregnancy Advisory Service (BPAS), England's largest private
abortion provider, has criticized Scots medical professionals who decline to
provide late term abortions. BPAS chief executive Ian Jones claimed that
women in Scotland usually travel to England for abortions after 15 weeks'
gestation. The Sunday Herald report quotes Jones as saying, "if these
doctors do not want to treat women for a late abortion then we do not want
them treating women." BPAS plans to open an abortion clinic at a Scots
National Health Service hospital.
The Roman Catholic Congregation for the Doctrine of the Faith Church has
issued an important document tht focuses on the application of Catholic
belief in political life.
Doctrinal Note on Some Questions Regarding the Participation of Catholics in
Political Life challenges widespread attitude that would see "a
large number of citizens, Catholics among them, are asked not to base their
contribution to society and political life - through the legitimate means
available to everyone in a democracy - on their particular understanding of
the human person and the common good."
The board of the United Hospital Center (UHC) in Clarksburg,West Virginia,
which voted last month to permit eugenic abortions, has reversed its
decision as a result of complaints from the public. The hospital's president
explained that the board had decided to "respect the community's values . .
. from a religious and philosophical standpoint." [Clarksburg Exponent
Telegram, 15 January, 2003]
The Standard, China's business newspaper, reports that the government
intends to continue the one-child policy. The policy has resulted in forced
abortions and infanticide and the coercion of some health care workers. [See
Chinese health care workers and the
'one-child' policy]
When the Alan Guttmacher Institute (AGI) survey concerning partial birth
abortion was released in 1996, there were questions about the accuracy of
its claim that about 650 procedures were performed annually in the US. Two
years later a spokesman for the Institute stated that he was "pretty sure"
the number was between 500 and 1,000. A survey just released by the
Institute, using the same method, places the number at 2,200. If the survey
is accurate, the increase suggests a greater likelihood that health care
workers who object to the procedure may come under pressure to participate
in it.
In November, 2002, the New Brunswick College of Physicians and Surgeons
published a practice comment that acknowledges that doctors do not have to
participate in procedures that they find morally objectionable. More
important, the comment also acknowledges that they do not have to refer a
patient to another physician. In a
bulletin a year earlier, the College requested feedback on the question
of whether or not a greater onus ought to be placed on conscientious
objectors to facilitate morally controversial procedures.
The comment directs physicians to advise patients when their
recommendations or practices are influenced by their moral judgement, so
that patients are aware of why a physician is declining to provide a
requested service or treatment. It identifies referral or the provision of
information about alternative means of access as "preferred" but not
obligatory practices. The College Registrar, Dr. Ed Schollenberg, explained
that the comment is carefully worded because the subject is inescapably
controversial. The College wishes to assist physicians in providing care to
patients while respecting their own moral integrity.
The Project was among those who responded to the College request for
feedback, and also contributed a
letter to the editor on the subject following media reports on the
bulletin.
A declaration by the Muslim National Fatwa Council of Malaysia illustrates
how different views within a religious group may make it more difficult for
those associated with the group to explain the basis for their religious
objection to morally controversial procedures. The Council agreed that
cloning of human embryos was acceptable as long as the embryo is destroyed
before it reaches 120 days of age; it held that abortion was morally
acceptable during the same period. Such opinions are not universally shared
among Muslims. (See, for example,
Islamic Medical Ethics: Some Questions and Concerns. Such differences of
opinion also exist among other religious denominations, and are sometimes
cited as a reason for disregarding religious conviction as a legitimate
basis for conscientious objection.
The Ontario College of Physicians and
Surgeons has accepted a suggestion from Dr. Stephen Dawson that has resolved
complaints lodged against him. Dr. Dawson, a Christian physician who
practises in Barrie, Ontario, was charged for professional misconduct
because he refused to prescribe birth control pills to four unmarried
women.
Dr. Dawson now posts a policy statement in his waiting room that includes
a statement that he will not prescribe birth control pills to unmarried
women nor Viagra to unmarried men, nor will he arrange for abortions. He
will not offer further information about his religious convictions except in
response to queries from patients.
The resolution reflects the fact that there were two different issues at
play in the case: the exercise of freedom of conscience, and the manner in
which it was exercised. College spokesman Kathryn Clarke explained that the
focus of the College was on the latter. "We simply wish to be assured that
when he explains to his patientswhy he does not provide these services that
he does so in a professional and respectful manner."
Dr. John Williams, director of ethics for the Canadian Medical
Association, confirmed that physicians are not obliged "to do something that
they feel is wrong", and do not have to refer patients in such cases. Dr.
Williams made a similar statement in conversation with the Project
Administrator in the spring of 2000. [CMAJ]
[For details of the case, see the story from
The Barrie Examiner, and letters to the editor from the Project to
The Barrie Examiner and the
National Post. Comments from the Christian Medical and Dental Society
and the Catholic Civil Rights League (Canada) appear in a
Lifesite News story. Journalist Michael Coren offers a Real Audio
commentary. The Project also responded to an editorial broadcast
by the CBC criticizing Dawson; the CBC did not broadcast the
Project response.]
The National Population Council of Mexico, which is supported by the United
Nations Population Fund (UNFPA), is reported to have set national quotas for
"family planning" that are to be met by regional hospitals and local family
planning teams. The National Human Rights Commission has protested that the
programme involves threats, bribes, and the imposition of procedures and
drugs without the informed consent of the patients. In such circumstances
there is reason to be concerned that health care worker who object to
morally controversial procedures will also be victimized.
The Medical Research Council in the United Kingdom is attempting to increase
the number of embryos donated for destructive research. It is giving money
to some IVF clinics so that they can find ways to encourage donation,
perhaps by hiring employees to "aid consenting potential donors" in deciding
to donate their embryonic offspring.
500 human embryos at the Rabin Medical Centre - Hasharon Campus in Petah
Tikva near Tel Aviv died when a container in which they were stored was
accidentally left unsealed. The news report stated that every hospital in
Israel has an IVF unit, and that the treatment is offered free as part of
the national health insurance scheme. State supported procedures,
particularly on this scale, may create a dynamic of expectation that all
health care workers will co-operate with what has become a matter of public
policy. Making no claims with respect to the situation in Israel, this can
generate considerable opposition to conscientious objection within the
medical profession.
Utah's Wrongful Life Act was passed in 1983 to prevent 'wrongful
birth' or 'wrongful life' lawsuits. It prevents physicians from being sued
by a woman who claims that she would have had an abortion had she known that
her child was going to suffer from some form of birth defect. Parents of a
Down Syndrome child sued the University of Utah Medical Center because of
what they claimed were faulty prenatal tests. The majority of the court
ruled that that act protects health care professionals who withhold
information, but that this does not create a substantial obstacle for a
woman who might want to obtain an abortion. The court held that an aggrieved
party could pursue other forms of action, such as breach of contract.
Plaintiffs in breach of contract cases are limited to collecting for actual
financial losses, whereas the case before the court included a claim for
punitive damages.
It appears that parents in Utah who might want to abort a child for
eugenic reasons can seek a physician who explicitly agrees with their
outlook, thus ensuring that they will be given the information they desire.
If the information proves to be inaccurate, they cannot sue for wrongful
birth or wrongful life, but can sue for breach of contract. Since eugenic
screening is not 100% accurate, it would presumably be necessary to prove
that the physician was negligent or incompetent in order to succeed in an
action against him.
The effect of the Act, as applied in this case, is to make wrongful birth
and wrongful life suits contrary to public policy in Utah, while preserving
the remedy of breach of contract. This ensures the protection of health care
professionals who do not want to participate in eugenic screening, but it
does not prevent parents who have made explicit eugenic screening agreements
with health care professionals from holding them to account.