July-September, 2003
September
29 September, 2003
North Carolina Governor Mike Easley has approved recommendations that will
provide compensation to thousands of North Carolina residents who were
involuntarily sterilized by the state over a period of 50 years. The
sterilizations were consistent with the "ethics of the profession" at the
time. This should remind those who insist that conscientious objectors must
conform to the "ethics of the profession" that there are other legitimate
ethical standards.
The killing of Frenchman with a drug overdose administered by his mother has
led François Fillon, French social affairs minister, to suggest a debate
about legalizing euthanasia in such cases. This is not the first time
prominent French officials have made such suggestions. [French
Health Minister considers change to euthanasia law]
Professor Helmuth Nyborg, who teaches psychology professor at the University
of Aarhus, Denmark, has suggested that the state should take steps to create
a better Danish society by encouraging childbearing among the 'intelligent'
and discouraging it among the 'unintelligent' to prevent 'degenerates' from
being born. Although his comments were rejected by Integration
Minister Bertel Haarder, it appears that the unfavourable response was
evoked by the professor's focus on intelligence and reference to
'degenerates'. Pre-natal screening to identify and eliminate physically
'defective' infants by abortion is so routine that it is, in many places, a
'standard of care' that causes conflicts of conscience among health care
workers opposed to eugenic practices.
27 September, 2003
Senate Bill 1397, which would prevent health care institutions entities
from being forced to participate in abortions, is not expected to reach the
floor of the US Senate until 2004.
The Fondation Science et Conscience
and the Association for the
Promotion ofScientific Accountable Behaviour (APSAB)
held a conference in Geneva, Switzerland on 25-26 September to discuss the
problems faced by scientists who have spoken out about the dangers of
products produced by their employers. Members or representatives of UNESCO,
OECD, the EU and numerous other agencies were slated to attend.
The groups are proposing an
international convention to recognized and protect the conscience of
salaried scientists and engineers.
An Australian hospital is asking patients to complete a form on which they
state whether life-prolonging treatment can be withheld from them and
whether they are to be resuscitated. They can also use the form to send a
final message to those who survive them. Dr Eric Fairbank of South West
Healthcare, Warrnambool, Victoria, says that the forms are to do with
palliative care, not euthanasia. [Warrnambool Standard, 24 September]
Dr. John Fleming, director of the Southern Cross Bioethics Institute,
Adelaide, South Australia, said: "In the light of a recent case in Victoria,
Australia, [Nutrition
and hydration to be withdrawn from Australian woman] doctors may now
regard artificially delivered food and fluids as medical treatment which may
be withdrawn from a non-dying patient. Dr Fairbank's assurance that his
forms are 'not about euthanasia' has to be measured against the judge-made
law which seems to permit, in the state of Victoria, euthanasia by omission
of life-sustaining measures such as food and fluids." [SPUC]
Researchers in Auckland, New Zealand, have found a simple, inexpensive
treatment for some cases of human infertility. They found that they could
significantly increase the chance of conception among women with
"unexplained infertility" or mild endometriosis by flushing a special liquid
through the reproductive organs. The treatment avoids the ethical concerns
about in vitro fertilization. [CNS
News]
19 September, 2003
A member of the Council of Disabled People, Bill Albert, has denounced
prenatal screening and abortion "state sanctified eugenics". The practices
are exposed in a BBC programme in which reporters found that some women are
pressured to have abortions if the infants they are carrying have even
correctable physical defects. Bioethicist John Harris of Manchester
University argues in favour of eugenic screening, suggesting that parents
opposed to it are misguided. The controversy illustrates the potential for
moral conflicts among health care workers. [BBC]
James Bogle, a leading medical barrister in the United Kingdom, gave
evidence against the draft Mental Incapacity Bill now before a parliamentary
committee. He warned that the bill would make incapacitated patients
vulnerable to attorneys who would have "power without responsibility". Dr.
Philip Howard of St George's Hospital Medical School, London, stated that
the bill would make suicide notes legally binding advance directives. The
committee has received an "unprecedented" number of letters expressing
similar concerns. This suggests that many health care professionals would
find themselves in conflicts of conscience if the bill passes. [See
Group argues for withdrawal of nutrition and hydration in UK]
Pharmaceutical companies in Australia must now label products developed or
tested with human embryonic stem cells. This will facilitate ethical
decision making by those opposed to embryonic stem cell research.
A circuit court judge has ordered the feeding tube removed from Terri
Schiavo, a disabled Florida woman. It appears that the case will continue in
a federal court. [See previous report:
Case for
withdrawal of feeding continues in Florida]
August in Nairobi saw a silent procession by thousands of Kenyan Christians
demonstrating against abortion. According to a recent poll, legalized
abortion is rejected by 81% of Kenyans, but health minister Charity Ngiluo
complains that denying abortion to women is unfair. The Christian Medical
Fellowship has raised concerns that the wording of the proposed constitution
now being discussed may permit abortion. [See
Abortion demanded in Kenya]
In evidence given to the parliamentary committee reviewing the draft Mental
Incapacity Bill, the Making Decisions Alliance (MDA) argued that advanced
directives would permit the withdrawal of sustenance, and would be in the
best interests of patients suffering some some conditions, like advanced
dementia. It recommended that 'quality of life criteria' be used to make
such decisions. [For a contrary view, see
Euthanasia
prevention bill in United Kingdom;
Draft Mental Incapacity
Bill criticized]
The House of Lords has passed a private member's bill to prohibit euthanasia
by denial of sustenance. The Patients' Protection Bill will be considered in
the House of Commons. The bill addresses the problem caused by legal rulings
to the effect that proxies can deny nutrition and hydration to incapacitated
patients. [For related items, see
Draft Mental Incapacity
Bill criticized; Food and fluids
controversy;
Case for
withdrawal of feeding continues in Florida;
Nutrition and hydration to be withdrawn from Australian woman;
Comatose woman can be starved;
UK attempt to ban euthanasia by starvation and dehydration]
The Merck pharmaceutical company is making available single dose
vaccines for measles and mumps that have not been derived from fetal tissue.
The company is now taking limited orders (three boxes per physician, each
with ten doses), the minimum order being one box. Physicians may order by
calling Merck at 1-800-9675 or 1-800-637-2579.
Children of God for Life will assist
physicians concerned that they may not be able to use all ten doses.
The Law Society of Scotland warned a parliamentary committee that a
draft bill would expose incapacitated patients to abuse and was incompatible
with the European Convention on Human Rights. "People First", representing
people with learning disabilities, also spoke against the bill, and Dr
Donald Lyons, medical adviser for elderly services to the Greater Glasgow
Primary Care Trust, said that he would not want to work under the bill if it
became law. Other critics have charged that the bill would legalize
euthanasia by starvation and dehydration.
Russian doctors are reported to be removing kidneys from homeless people who
are still alive, but who, in the words of an anonymous surgeon, "are done
for anyway". The organs may be worth as much as $40,000 US each. [The
Courier Mail] The operations are not legal, but the ethical outlook of
those involved may be a source of difficulty for objecting health care
workers.
A Polara survey of 1,263 Canadians conducted in August found that 49%
favoured euthanasia and 37% were opposed. A 1997 poll by the same firm
showed 60% of respondents supported assisted suicide. The numbers are
worrisome for health care professionals who do not want to be involved with
these practices. [Ottawa
Citizen]
Dr. Pu Liansheng, who gave a terminally ill woman a lethal injection 17
years ago and was later acquitted of murder, now argues that euthanasia
should be legalized. [The People Daily]
Paulina Ramirez was raped in 1999 when she was 13 years old and now has a
three year old child, fathered by the rapist. An obstetrician refused to
perform an abortion, and she was persuaded not to have an abortion by
doctors, social workers and a priest. She was given $10,000.00 by the
government to assist in rearing the child, but is now suing the government
for more compensation, claiming that her life has been completely destroyed.
While it seems reasonable to seek additional financial assistance, a
troubling aspect of the case is that activists want legal action against
those who persuaded her not to have an abortion, which presumably includes
the objecting obstetrician. [Yahoo]
3 September, 2003
Evidence from doctors and nurses indicates that Terri Schiavo is responsive
to her environment and not in a persistent 'vegetative' state. One nurse
also reported that her husband, who is attempting to have her tube feeding
halted, often asked when she was going to die, became 'visibly excited' when
her condition worsened, and talked about how he would use the money he
expected to receive following her death. The next hearing has been set for
September 11th. [See
previous report]
Belgium legalized euthanasia in September, 2002. 170 cases of euthanasia
have been reported since, but the Belgian Medial Journal claims that the
actual number is two or three times higher.
A bill based on Oregon's assisted suicide law has been introduced in
Vermont. It would allow patients who are expected to die within six months
to ask for drugs to commit suicide. Some doctors in the state have formed
the Vermont Alliance for Ethical Healthcare to oppose the legislation.
August
29 August, 2003
The case of Terri Schiavo, a disabled women who is unconscious but
dependent upon artificial nutrition and hydration provided by a tube to her
abdomen, continues to attract comment. Her husband wishes to withdraw her
feeding tube, but the Catholic Bishops of Florida have added their protest
to that of her family, whose lawyer has drawn attention to the fact that it
would be illegal to starve one's dog to death. Video evidence showing
Schiavo responding to doctors and family members has been rejected by the
judge hearing the case as "inconsistent". The problem is one faced all over
the world because the provision of nutrition and hydration has frequently
been defined as medical
treatment - which can be withdrawn - rather than
care- which cannot. Situations like this can present significant
conflicts of conscience for health care providers.[For previous report, see
Food and fluids controversy. For
other cases and comment, see
Nutrition and hydration to be withdrawn from Australian woman;
Comatose woman can be starved;
UK attempt to ban euthanasia by starvation and dehydration]
The National Institute for Clinical Excellence (NICE) has recommended that
women between 23 and 39 40 should be entitled to up to six state-funded IVF
cycles. The proposal would create an expectation of service that would
adversely impact conscientious objectors. Politicians have expressed concern
that it would reduce funds available for other medical treatment.
Describing the lawsuits as reminiscent of Nazi Germany, two judges of
the Supreme Court of Kentucky have dismissed claims filed against doctors by
parents of children with physical disabilities. The parents argued that they
would have sought abortions had they been aware of the disabilities. The
threat of such civil suits is used to coerce physicians who would, for
reasons of conscience, reject eugenic practices.
In the Isle of Man, where politicians are expected to deal with a bill to
legalise euthanasia, bishop-elect Reverend Graeme Knowles has encouraged
debate on the subject but has declined to state his views on assisted
suicide. Such a position can be of concern to conscientious objectors of the
same faith, inasmuch as they may look to their religious leaders for support
when faced with demands that they compromise their convictions. [See
Importance of backing from religious leaders emphasized]
The American College of Pediatricians
"applauds and supports"
Senate Bill 1397, which would clarify existing law to ensure that
physicians, hospitals, and health care facilities can decline to provide
abortions. The College firmly supports the optimum working environment for
physicians and other health care professionals enabling them to have the
freedom to provide the best care for all patients, especially children.
6 August, 2003
The Center for Bioethics and Human Dignity has arranged with the Ethics
Institute at the American Medical Association to post responses to clinical
ethics cases posted on the AMA's "Virtual Mentor" web page. The first case
study and commentary is
Faith-Based
Decisions: Parents Who Refuse Appropriate Care for Their Child.
Those who would use the 'ethics of the profession' to coerce conscientious
objectors in health care should note that states are considering how to
compensate victims of the eugenics programmes that imposed compulsory
sterilization on those considered to be 'unfit'. Those programmes functioned
with the suppThe American Medical Association's official policy stipulates
that "information about emergency contraception is part of the comprehensive
information to be provided as part of the emergency treatment of sexual
assault victims." However, a recent study found that only 28 percent of the
hospitals surveyed routinely offer and provide emergency contraception to
victims of sexual assault. The problem of availability of emergency
contraception is made even more difficult by a recent wave of hospital
closings and mergers, where private and community hospitals are being taken
over by religious-based owners who are opposed to including birth control
and emergency contraception in their treatment regimen.
Every member of Congress, especially those who say they care about stopping
violence against girls and women and helping victims of rape and sexual
assault, should support this legislation. Providing emergency contraception
is not the same as performing an abortion.ort of the 'ethics of the
profession' that prevailed at the time. Recordnet.com tells the story of 73
year old Charlie Follet of California, who was sterilized when he was 15
years old, one of 20,000 people victimized by California's eugenics
programme.
A bill introduced in the U.S. House of Representatives (Compassionate
Assistance for Rape Emergencies Act: CARE Act) would force hospitals to
dispense the potentially abortifacient 'morning-after pill' to patients
complaining of sexual assault. This is just one of a continuing series of
attempts to override freedom of conscience in denominational institutions.
July
The Death with Dignity Bill, which would have legalized assisted suicide,
has been defeated 60-57 in the New Zealand Parliament, with one abstention.
The narrowness of the vote will likely provide some impetus to continued
lobbying for the procedure, which would have serious consequences for health
care workers. [See
Assisted Suicide: What Role for Nurses? ]
Dr Michael Neary has been struck from the medical register for having
performed unnecessary hysterectomies on more than 60 women at Our Lady of
Lourdes Hospital in Drogheda. The Irish minister of health is now being
pressured to conduct an inquiry into the obstetric unit at the hospital. It
does not appear that enquiries have been made to determine whether or not
health care workers were pressured to participate in the procedures.
India's Supreme Court has ruled that punitive legal measures against people
who have more than two children do not violate constitutional rights to life
and liberty. At issue was a law passed in the northern state of Haryana
making it illegal for parents to hold public office if they have more than
two children. The central government is considering laws that would prohibit
people with more than two children from holding government jobs or running
for office. [Times
of India] Other punitive measures are being discussed in the media. [Financial
Express] It is difficult to see how such a regime would respect freedom
of conscience among health care workers who do not support the 'two child'
policy difficult when people not connected with health care are treated in
this fashion.
Manx 4 Death with Dignity is sending postcards to all households calling for
legalization of assisted suicide. A similar campaign was organized earlier
this year in Guernsey. (Pro-euthanasia
postcard campaign in Guernsey)
The British Pregnancy Advisory Service has asked the Department of Health to
approve a trial of abortifacient drugs like Mifepristone or Misoprostol
(Cytotec). Women could take the drugs to induce an abortion at home. A
problem that arises for conscientious objectors is that women whose
abortions are incomplete arrive at hospital expecting on-duty staff to
complete the procedure.
70% of 800 respondents surveyed by Bristol's University Centre for
Reproductive Medicine favoured in vitro fertilization. This level of
support indicates that health care workers who object to the procedure for
reasons of conscience may find themselves pressured to participate,
especially if it is part of a state health care plan.
Miss Teresa Innes, hospitalized in West Yorkshire, is in a coma caused by an
allergic reaction to penicillin. The Bradford Health Trust has obtained a
high court judgement that allows it to stop providing her food and fluids.
If the Trust acts on the judgement the woman is likely to die within two
weeks. In its decision, the high court cited the 1993 House of Lords ruling
in the case of Anthony Bland. The ruling is consistent with those in many
other jurisdictions that have defined food and fluids as 'treatment'
which can be withdrawn, rather than 'care',
which must always be provided. Health care workers who consider nourishment
to be care rather than treatment may find themselves in difficulty in
jurisdictions that take the opposite view in law.
Those wanting to present evidence to Britain's Joint Select Committee on the
Draft Mental Incapacity Bill must do so before 1 September, 2003. The bill
would allow patients, not necessarily terminally ill, to be starved and
dehydrated in order to cause their deaths, a process that has been described
as "euthanasia by neglect". (See Food
and fluids controversy)
Trials are underway to test a new form of pre-natal screening that can be
used as early as the fifth week of gestation to detect conditions like Down
Syndrome and cystic fibrosis. Such tests are ordinarily used to identify
'defective' infants for 'genetic termination' (i.e, abortion. See
Foothills Hospital Now Forces Nurses To Participate In Genetic Terminations
) Conscientious objectors to eugenics and abortion come under
considerable pressure when such tests are adopted as a 'standard of care'.
A member of a Kenyan parliamentary health committee has called for the
legalization of abortion; Christian and Muslim leaders are opposed. Failure
to consider the opposition of health care workers to the the procedure will
likely have serious consequences. (See
previous report on Kenya, with remarks on the situation in South
Africa).
The European Council for Fatwa and Research (ECFR), which met in Stockholm
during the first week of July, has ruled that euthanasia and assisted
suicide are forbidden by Islam. The Council distinguished such acts from the
removal of life-support from patients who are clinically dead.
American Senators Gregg and Nelson and six others have introduced the
Abortion Non-discrimination Act introduced in the US Senate. It is
identified as
S. 1397. The bill passed the US House of Representatives after being
examined at committee hearings at which Project advisor Prof. Lynn Wardle
testified. [Testimony
of Lynn D. Wardle, J.D.]
Florida Governor Jeb Bush is being asked to intervene in the case of Terri
Schiavo, who is unconscious but dependent upon artificial nutrition and
hydration. A court has ruled that her husband can order her feeding stopped
in order to cause her death, but other family members have appealed to the
governor, claiming that the husband is motivated by $700,000.00 life
insurance policy and an interest in another woman. The case illustrates the
problem that arises when food and fluids are legally defined as 'treatment'
which can be withdrawn, rather than 'care',
which must always be provided. Health care workers who consider nourishment
to be care rather than treatment may find themselves in difficulty in
jurisdictions that take the opposite view in law.
At its annual meeting the British Medical Association expressed support for
the Hashmi judgement, which allowed the artificial production of a baby so
that the brother could be treated using blood from its umbilical cord. A
dissenting physician called the procedure "eugenics with a vengeance."
The compromise reached by the New York Catholic Conference (See
Compromise worked out in New York) concerning the 'morning-after pill'
is being criticized in some quarters on the grounds that the drug is 'abortifacient'.
The drug may prevent implantation of a human embryo, thus causing its death,
which conscientious objectors view as morally equivalent to
abortion. On the other hand, if ovulation has not occurred, the drug may
suppress ovulation and inhibit sperm transport and survival, thus acting as
a
contraceptive. The NYCC agreed that the drug could be dispensed to a
woman complaining of rape in the latter situation, assuming the drug is not
otherwise contraindicated. [NYCC
statement] Some criticism seems directed at practical difficulties that
may arise in applying the guideline; other critics may not appreciate the
distinction between the mechanism of
contraception and that of contra-implantation.
Costa Rica's Minister on the Condition of Women, Esemeralda Britton
Gonzalez, has promised that the influence of the Catholic Church in Costa
Rican society will be eliminated in order to facilitate abortion and
contraception. Her remarks were made to the UN Committee on the Elimination
of All Forms of Discrimination Against Women (CEDAW). One of the committee
members asked what steps that government had taken to that end. It should be
noted that a policy that would suppress the freedom of a church from
speaking out on such issues would also suppress the freedom of any citizen
or group motivated by religious, moral or ethical concerns. [See
There Are No Secular Unbelievers]
Embryos may now be screened for deafness using a test developed by
Australian doctors and approved by Victoria's Infertility Treatment
Authority. A report concerning the successful screening of seven embryos
conceived in vitro was presented at the International Genetics
Congress in Melbourne. All seven embryos screened in the reported case died;
six failed to implant in the womb and one was apparently killed because it
carried two genes for deafness. [News
report] The death of the embryos indicates the reason why some health
care workers object to such procedures; others reject eugenic screening
altogether.
Embryos 'left over' from fertility treatments may be used for research,
according to funding guidelines published by the European Union Commission.
This means that such research will be funded by tax money from countries and
individuals opposed to it. At the same time, the dynamic likely to follow
from the guidelines may make it more difficult for conscientious objectors
among researchers and health care workers to avoid participation in the
process, whether at the 'production' stage in research or when the products
of such research are demanded by patients.
Lapeer County Judge Michael Higgins of Michigan ordered a woman addicted to
drugs to use birth control in order to stop her from having babies that she
could not care for. The woman is fighting the order with the help of the
American Civil Liberties Union. The court order could cause problems for
health care workers required to facilitate the imposition of contraceptive
measures who may morally oppose the imposition of such an order, even if
they do not oppose contraception. [Detroit Free Press, 9 July]
Papers presented at the European Society of Human reproduction and
Embryology's conference in Madrid, Spain, suggested a growing interest in
the use of ova obtained from aborted foetuses in research and in vitro
fertilization. Ovarian follicles from second and third trimester
foetuses were kept alive by Dutch and Israeli scientists in the laboratory,
and some follicles began to develop. Researches from Copenhagen, Denmark,
reported that no health or developmental problems had been noted among
children conceived using eggs that had been matured in the laboratory prior
to fertilization. Apparently the interest in this area arises from claims
that not enough women are willing to donate eggs for artificial reproductive
techniques like IVF. At the same conference, Dr. Norbert Gleicher of the
Foundation for Reproductive Medicine in Chicago reported that he had
injected male cells into female embryos during research into single cell
gene disorders, generating denunciations from those opposed to making human
"she-males". [CNN]
In the United Kingdom, Baroness Warnock, who drafted the
legislation that now governs reproductive technology in the U.K., stated
that she had no objections to the use of eggs obtained from aborted girls
for artificial reproduction. Though she acknowledged that some women might
not want eggs obtained in that manner, she did not understand their
objections. On the other hand, the Archbishop of Cardiff compared the
enthusiasm for such procedures to "the Nazi experiments performed during the
Second World War." [Yorkshire Post, 2 July, ICN, 1 July]
Also in England, a lesbian couple awaits the birth of a child
produced by in vitro fertilization using sperm purchased over the
internet from a donor selected for his physical characteristics. [The
Age]
The procedures and research being pursued in the field of
reproductive technology illustrate the potential for conflicts of conscience
to arise among researchers and health care workers who may be called upon to
facilitate the work.