April-June, 2006
June
Despite a promise to hold a referendum on the subject, Portugal's new
government has announced plans to legalize abortion in the fall. Currently,
abortion is legal only in the first trimester in cases of rape or to save the
life of the mother. Reports do not indicate whether or not the government is
giving any consideration to the willingness of health care workers to
participate in abortion.
65% of 500 doctors at the annual meeting of the British Medical Association
overturned last year's decision by the Association to adopt a neutral position
toward assisted suicide. The BMA has thus resumed its previous position against
the procedure. [LifeSiteNews.com]
The California Senate Judiciary Committee has voted to block a bill that would
have permitted physician asisted suicide for the terminally ill. [Reuters 28
June, 2006]
A Canadian pro-life organization has objected to the a procedure known as
donation after cardiac death (DCD), in which organs are removed from a patient
whose heart as stopped beating for five minutes, even if the patient continues
to have measurable brain function, if the patient is diagnosed to have no hope
of recovery. The concern is that by failing to adhere to the criteria for brain
death, it is possible that the patient is killed by the removal of organs.
Objections were raised following a press conference in Ottawa in which it was
announced that the first such procedure had been performed in Canada. There
appears to be a factual dispute between proponents of the new procedure and
those who have concerns about it. Dr. Cameron B. Guest, Chief Medical Officer
for Trillium Gift of Life Network, stated that all cases of auto-resuscitation
(spontaneous re-starting of the heart) had occurred within one minute of cardiac
arrest. Dr. Moira McQueen, President of the Canadian Catholic Bioethics Centre,
said that cases of auto-resuscitation had occurred after more than five minutes.
In any case, the key issue for objectors is that death has been established
before organs are removed. [LifeSiteNews.com]
Ralph's Thriftway, a grocery store in Olympia, Washington, has refused to
carry the morning after pill because of concerns about its mechanism of action.
A local woman plans to organize a boycott of the store on the grounds that the
community is "very liberal" and concerned about "women's rights." If so, it is
ironic to find the liberalism of the community reflected in intolerance for
dissenting views about the morality of a product. Nonetheless, a boycott
continues to respect the freedom of conscience of the store's owners as well as
the freedom of customers to shop where they choose. This is to be distinguished
from legislation or professional regulations that are intended to suppress
freedom of conscience.
The Voluntary Euthanasia Society and the sponsor of a bill to legalize
euthanasia are attempting to exclude religious believers from public discourse
about legalization of the procedure, implying that they are irrational. [ABC
News, 19 June, 2006]
Preimplantation genetic haplotyping is a new eugenic screening technique
developed by Saudi Arabian fertility specialist Ali al-Hellani in 2004 and
perfected by British researchers. In theory, at least, it can increase the
number of detectable genetic defects in human embryos from 200 to nearly 6,000.
Concerns among conscientious objectors to eugenic screening will be
proportionate to the extent that the new technique is used to identify embryos
for destruction rather than treatment. [LifeSiteNews.com]
Len Doyal, a professor of ethics at Queen Mary, University of London, argues
that "involuntary euthanasia" is occurring in Britain and ought to be legalized
and regulated. Writing in the Royal Society of Medicine journal Clinical Ethics,
Professor Doyal asserted that withdrawal of life-sustaining 'treatment',
including assisted nutrition and hydration, is equivalent to euthanasia, and
that a lethal injection would be preferable to the "slow, painful and
incomprehensible deaths" inflicted by current practice. Doyal is a consultant to
the General Medical Council, the Department of Health, the Royal Colleges of
Surgery and Medicine and the Medical Research Council and a member of the ethics
committee of the British Medical Association (BMA). Doyal's article supports the
assertions of conscientious objectors that withdrawal of food and fluids to
cause death is euthanasia, and demonstrates the potential for conflicts of
conscience among health care personnel either in such cases, or in the event
that euthanasia were legalized. [Timesonline,
8 June, 2006]
The Canadian branch of Amnesty International has become the third branch of AI
to decide that the international organisation should advocate for abortion as a
human right. A final decision will be made by Amnesty International next year.
Recognition of abortion as a human right would have profound adverse
consequences for health care workers who object to the procedure.[Life Site, 30
May, 2006]
It is reported that over 90% of infants diagnosed in utero with Down's
syndrome are aborted. Eugenic testing is said to identify over 60% of these
infants. [The Telegraph, 21 May, 2006] More than 24 women had abortions after
the 20th week of gestation between 1996 and 2004 because of diagnoses that their
infants had club feet, extra digits or webbed feet. The statistics were provided
by the Office for National Statistics [The Times 29 May, 2006]
Almost one third of 32,000 abortions had by British women in the first nine
weeks of pregnancy were medical abortions induced by mifepristone (RU486). bpas
(formerly the British Pregnancy Advisory Service) states that the drug has
become increasingly popular. [The Times 29 May, 2006]
A three day convention with the theme "Called to be His Healing Hands" was held
in Bangalore, capital of Karnataka state, India. It was the first convention of
Catholic nurses in the country, and was attended by about 1,200. Participants
reported that nurses are being forced to participate in abortions and that some
who have refused have been forced to resign. (Spero
News)
Citing a
Vatican document on the subject, the Catholic Medical Association in the
United States noted that several vaccines are morally objectionable because they
originated in tissue obtained in voluntary abortions. The organization made
specific reference to vaccines for rubella(Meruvax), and Hepatitis A, (VAQTA,
HAVRIX). The CMA stated that it is unethical to prepare, distribute, or market
such vaccines; their use is a more complex matter. Conscientious objection to
such vaccines can occur among patients as well as health care workers.
The Constitutional Court in Columbia has ruled that a complete ban on abortion
is "irrational" and has allowed abortion in the case of rape or incest. The
decision was criticized by a spokesman for the Bishops' Conference of Colombia,
who said that the punishment for rape or incest should be imposed on the
criminal responsible. The Archbishop of Bogotá reminded Catholics that Catholics
who procure or facilitate abortions are automatically excommunicated, and it has
been reported that civil disobedience has been suggested. The case was intitated
by Monica Roa of the UN funded Women's Link Worldwide (WLW), which intends to
use the courts to force legalization of abortion in countries where democratic
means are unsuccessful. The controversy following the ruling indicates that it
is likely to lead to conflicts of conscience if health care workers are expected
to implement it. [Catholic World News, 12 May, 2006]
In a statement that illustrates the potential for conflicts of conscience among
health care workers, the Kenyan Catholic bishops' conference has condemned in
vitro fertilization, as well as genetic screening, as morally unacceptable.
[Catholic World News, 12 May, 2006]
The House of Lords in the United Kingdom rejected Lord Joffe's Assisted Dying
for the Terminally Ill bill by a vote of 148 to 100, though 500 peers did not
vote. Opposition to the bill was manifested in a petition with 100,000 names.
Lord Joffe will bring the bill forward again in the next parliamentary session.
The measure was opposed by the Royal College of Nursing; 73% of members of the
Royal College of Physicians were reported to be opposed to both physician
assisted suicide and euthanasia. Similarly, more than 70% of nearly 200 members
of the British Association of Oral andMaxillofacial Surgeons were against the
bill [NewsWales, 10 May, 2006] .The Anglican Archbishop of Canterbury, the
Catholic Cardinal Archbishop of Westminster and the Chief Rabbi of the
Commonwealth jointly spoke against the bill. [The Times, 12 May, 2006]
Opposition to the bill was dismissed by Polly Toynbee of the Guardian newspaper
as "a cabal of bishops, rabbis, imams, Catholics, evangelicals and other
believers" [Guardian, 12 May, 2006].
74 year old Ted Atkinson of Norfolk, England, was jailed for 28 days after he
persisted in sending images of aborted babies to Elizabeth Hospital, King's
Lynn, despite a warning to stop. He received an additional 14 day sentence for
failing to pay a £650 fine received for a similar offence in 2002; £500 will be
deducted from his pension for court costs. The images were described as
"malicious communications." Hospital staff, including the chief executive, who
received photos of aborted children and a video of a child being aborted, were
reported to have been "quite disturbed" by them; Atkinson agreed that the
material was "horrendous, monstrous and sickening," but pointed out that it
accurately reflected reality. Atkinson was, at one time, dismissed as a hospital
porter when he refused to take a woman to a location where she was to have an
abortion [Eastern Daily Press, 12 May] [The Times, 12 May].
In addition to the criminal sanctions, the hospital has removed Atkinson from
a wait-list for hip surgery and has also decided to deny him anything other than
life-saving treatment. A spokesman for Elizabeth Hospital, King's Lynn, stated,
"We exercised our right to decline treatment for anything other than
life-threatening conditions."
Refusing to treat a patient because of his political activism or criminal
convictions is is not an example of conscientious objection. The conduct of the
hospital is remarkable in view of the fact that that health care workers who
decline to facilitate procedures to which they object for reasons of conscience
are often condemned for 'abandonment.'
Britain's Human Fertilisation and Embryology Authority has agreed to permit
eugenic screening of embyros conceived in vitro for dispositions toward
cancer of the breast, ovaries and colon, but declined to allow screening for
asthma, eczema or schizophrenia. [BBC, 10 May] [Times, 10 May] Both decisions
illustrate the underlying dynamic that tends toward expansion of the service and
increased likelihood of conflicts with beliefs of health care providers.
Spanish police are investigating the death of 53 year old Jorge Leon Escudero, a
quadrapalegic for six years who needed a ventilator to breathe. He was found
dead, with his ventilator disconnected, and had apparently been given a
sedative. Escudero had been seeking help to commit suicide. Although the Spanish
government is opposed to legalizing euthanasia, some doctors' groups in the
country have advocated legalization, and the United Left party plans to
introduce a motion to 'clarify' the law [Guardian, 9 May, 2006].
The combination of human and animal genetic materials to produce hybrids
continues to excite interest and opposition, as evidenced by an article in the
May, 2006 number of Nature Biotechnology. Britain's Ian Wilmut continues
to use a technique developed in China in 2003 to produce human-rabbit
blastocysts, and Harvard researcher Douglas Melton will use it to study diabetes
and Parkinson's and Alzheimer's diseases. According to the article, most
scientists do not expect that neural stem cell transplants would give rise to
human consciousness in animals. Opposition to the production of chimeras is
countered by statements like those of a panel of ethicists convened in 2005 at
John Hopkins, who asserted that it is impossible to determine what is natural
and unnatural.
Mrs Valerie Sliwinski, of Essex, who had cancer and multiple sclerosis,
committed suicide at a Dignitas facility in Switzerland. Her son, who travelled
with her, has been charged in Britain for assisting suicide. [Mirror, 8 May,
2006] The incident is part of a general controversy in the United Kingdom
concerning the legalization of assisted suicide and euthanasia.
In a reversal of its longstanding tradition of advocacy for those persecuted for
the exercise of freedom of conscience, Amnesty International is reported to have
drafted a "Policy statement on Sexual and Reproductive Rights" that includes an
attack on conscientious objectors in health care. The organization is seeking
comments from its members by 20 May, 2006, and will deal with the issue in 2007
at the Amnesty International 2007 International Council Meeting. The draft is
reported to include the demand that governments "must refrain from denying or
limiting equal access to sexual and reproductive health services" and "act with
due diligence to punish abuses of sexual and reproductive rights by private
persons, organizations and other non-state actors." Both statements could be
interpreted to justify the active suppression of freedom of conscience by
individual health care workers or organizations opposed to abortion. Moreover,
the draft is reported to state: "The right of individual health care
professionals to object on grounds of conscience to providing certain
information and services does not absolve them or the health care system for
which they work from taking immediate steps to ensure that the necessary
treatment is given without delay." This constitutes a direct attack on freedom
of conscience, since it would impose a requirement for referral by conscientious
objectors. [AI
United Kingdom] [Lifesite
re: UK][Lifesite
re: NZ]
Controversy over artificial reproduction erupted in the United Kingdom following
an announcement that a 63 year old British psychiatrist has been impregnated
using an egg purchased from Russia. The source of the sperm has not been
reported, but appears to have been her husband. Critics, including IVF
specialist Dr. Mohammed Taranissi and the London Telegraph, have questioned the
morality of IVF in such circumstances. The number of IVF pregnancies in the
United Kingdom tripled between 1992 and 2002, but the number of IVF births to
women between 45 and 49 increased almost sevenfold during the same period (from
15 to 106), while children born to women over 50 increased from 1 to 24 [London
Telegraph, 5 May,2006]. Dr. Taranissi's comments demonstrate that there are
circumstances in which conflicts of conscience could arise among those working
in the field of artificial reproduction.
After drafting a proposal that would allow pharmacists to refuse to dispense
drugs for reasons of conscience if a non-objecting pharmacist is on hand, the
Pharmacy Board in Washington state has prepared a second proposal that may
provide additional protection for conscientious objectors. The board is expected
to consider both proposals at a meeting on 1 June, 2006.
Les Burke, of England, who is terminally ill with cerebella ataxia, is going to
the European Court of Human Rights to ensure that British doctors following
General Medical Council guidelines will not withdraw his nutrition and
hydration. A ruling in his favour by the High Court was overturned on appeal,
and he was denied leave to appeal to the House of Lords. [BBC News, 29 April].
The case illustrates the argument that freedom of conscience should be protected
for health care workers so that patients like Mr. Burke have the opportunity to
be cared for by persons who share their convictions.
A protection of conscience bill approved by the Michigan House of
Representatives by a vote of 68-38 will move to the state senate. It will allow
health insurance providers and HMO's to decline to provide coverage for services
or benefits that contradict their moral or religious beliefs. Planned Parenthood
and the American Civil Liberties Union argue that they should be denied freedom
of conscience because they are concerned that companies that are not forced to
provide coverage for abortion or contraception may be unwilling to do so[
HB4745 &
HB4746] [News
release].
The California Supreme Court will hear a civil suit brought against two
Christian doctors by a lesbian claming that she had been discriminated against
because they refused to artificially inseminate her. The physicians argued that
their decision was based upon the fact that she was not married, not upon her
sexual preferences. Moreover, they had referred her to a fertility specialist
and had agreed to provide all of the pre- and post-natal care as well as absorb
any of the costs incurred by the patient as a result of the referral. A lower
court had held that the physicians could defend themselves on the basis of their
religious convictions [Benitez
v. North Coast Women's Care Medical Group].
Citing the precedent of 'harm reduction' by providing syringes to drug addicts,
some members of the Royal College of Nursing are advocating that patients who
mutilate themselves by burning or cutting be allowed to keep their 'tools' with
them in hospital. They claim that this helps patients deal with mental trauma
and actually reduces suicidal ideation. St. George's mental health hospital in
Staffordshire provided cleaning equipment for blades and similar 'tools' in a
pilot project, and has suggested that this should be included in a patient care
plan. [BBC] It is
likely that the practice would give rise to conflicts of conscience among nurses
expected to implement such plans.
The Royal College of Nursing states that input from its 380,000 members,
including a survey of 1,000 and consultation with 50,000, indicates that 70% of
its members support its opposition to Lord Joffe's assisted suicide bill.
[Medical News Today, 30 April, Dignity in Dying, 23 April] This indicates that
legalization of assisted suicide or euthanasia without adequate protection of
conscience measures would likely cause problems for many nurses.
It is not clear whether or not a policy now being drafted by the Washington
State pharmacy board will tolerate full freedom of conscience among pharmacists.
The Washington State Pharmacy Association had proposed a policy that would have
protected conscientious objectors in the profession, but the governor of the
state, Planned Parenthood and other advocates of "choice" were opposed to
allowing pharmacists any choice on moral issues. The most recent draft of the
rule is reported to allow conscientious objection only if another pharmacist is
available to fill the prescription.[Olympian]
Committees in both the Senate and House of Representatives in Minnesota have
sent bills to their respective bodies for a vote. The Senate bill (SF2647)
is much more restrictive than the House bill (HF3032).
The governor of Hawaii will be presented by a bill (
HB
1242) passed by the legislature that describes "the right to reproductive
choice" as "a fundamental right under the Hawaii constitution" while retaining
the
protection of conscience clause in the statute. There appears to be a
contradiction involved in describing "reproductive choice" as a "fundamental
right" while permitting conscientious objection to participation in morally
controversial procedures related to the the exercise of that 'right'.
Rodolfo Cardinal Quezada Toruño, the Catholic archbishop of Guatemala City,
announced that the Catholic Church is going to the High Court to contest
legislation now in the Guatemalan Constitutional Court. "This law is manifestly
unconstitutional because it does not respect the human embryo, it does not
respect the right of parents to teach their kids about sexuality and it even
forces private Catholic schools to teach things that go against their
consciences." [EWTN] The announcement is indicative of the potential posed by
the legislation for conflicts of conscience among health care workers in the
country.
The Flemish Socialist party, a member of Belgium's coalition government, now
seeks to extend the provision of euthanasia to children and adolescents.
Currently, one must be over 18 to qualify for euthanasia. The Netherlands has
already moved to permit euthanasia of babies and children under 12 years old.
The legalization of euthanasia was accomplished without the general support of
the Belgian medical community, but it has led to demands for mandatory referral
for euthanasia by objecting physicians, and to a redefinition of palliative care
as part of a continuum of care including euthanasia. [
Belgium:
Redefining Palliative Care and Forcing Physicians to Refer for Euthanasia]
The morning after pill will be provided by pharmacists in the United Kingdom
free to girls as young as 12 years old without parental knowledge. The programme
will be implemented in any region where local health officials believe that
there is a problem with under-age pregnancies. [Daily Mail, 7 April] A few
pharmacists in the United Kingdom have refused to dispense the drug for reasons
of conscience. Providing the drug to a 12 year old may be more than some other
pharmacists are willing to do, for the same reason.
Legislation that would allow in vitro fertilization and human cloning has
been condemned by the Spanish Catholic Bishops' Conference [Life Site, 4
April]. The statement illustrates the potential for conflicts of conscience
among health care workers who may be asked to facilitate the procedures.
One attendee at the annual ethics conference sponsored by the BC College of
Physicians and Surgeons has reported very favourably on the conference. The
focus of the second day of the conference was the importance of professional
integrity. During the panel topic, "Can a Few Individuals Change the World" a
woman in the audience asked a question to the following effect: " In view of the
fact that you are all speaking about the importance of personal integrity,
taking into account that the medical establishment tends to take on the values
and the ideologies that are most popular in a given society so that it tends to
propagate the performance of certain procedures as being medical procedures when
in fact they are more about women's rights- and I am referring specifically to
abortion - how do you view those colleagues of yours who are dissidents? Are
they being accepted into the medical community as they should be?"
The response, from George Webster, referred to the need to learn how to
dialogue with those who do not hold one's views. Pharmacist Cristina Alarcon
then stated that she was a dissident pharmacist who will not dispense the
morning after pill, and that a year before she had put a problem to Professor
Emund Pellegrino. She told him that the BC College of Pharmacists propagates the
notion that it is a virtue to efface oneself to the extent of forgetting about
one's own values and principles, so as to do whatever the client wants [2001-01:
College of Pharmacists of British Columbia: Conduct of the Ethics Advisory
Committee]. Pellegrino responded that it is not a question of putting the
rights of a client up against the rights of the professional, but rather it is a
question of living with integrity and being a coherent person, because the
client can always choose freely where to go.
A case before the Constitutional Court in Colombia that could lead to
legalization of abortion in the country generated a protest by over 100,000
people who took to the streets in a peaceful march in Bogota. The protest
indicates the likelihood that legalization of the procedure will cause conflicts
of conscience among health care workers unless adequate provision is made for
conscientious objection.