January-March, 2010
The Governor of Idaho has signed
Idaho Senate Bill 1353, which now becomes
law in the state. [Lifenews]
Citing the case of a New York nurse who was compelled to participate in
an abortion, an American commentator states that the Obama administration's
policies give "a green light for federally-funded governments and hospitals
to violate the conscience rights of pro-life health providers-and for HHS
itself to break the law." Matt Bowman also asserts that the protection of
conscience measures in the health care reform bill just passed are
inadequate.[Washington
Examiner]
A bill proposed by the government of Quebec will deny public services,
including health care at hospitals, to Muslim women who wear a niqab (head
and face covering). The government appears to be using access public
services, including access to health care, as a means to enforce government
policy that is unrelated to the practice of medicine. What is remarkable is
that the bill has not elicited complaints from groups that do not hesitate
to level charges of discrimination and "denying access to health care"
against health care workers who refuse to provide abortion or other
controversial services for reasons of conscience. [The
Star]
The General
Pharmaceutical Council (GPhC), a newly-formed regulatory authority in
the the United Kingdom, will will take over regulation of pharmacists from
the Royal Pharmaceutical Society this year. The Council has
announced that draft standards of practice will be issued for public
consultation and will include "conscience clause." The announcement has been
greeted with criticism from groups like the National Secular Society that
oppose freedom of conscience in health care. [BBC]
Laywers with the Alliance Defense Fund and the Christian Legal Society
are continuing litigation in three lawsuits to defend a
Department of Health and Human Services protection of conscience regulation
against state governments that are suing to invalidate it. The lawyers are
acting for Concerned Woman for America (CWA), Christian Pharmacists
Fellowship International, Care Net, Heartbeat International, the New Jersey
Physicians Resource Council, Christian Medical Association, Catholic Medical
Association, and American Association of Pro-Life Obstetricians and
Gynecologists. ADF attorneys are also pressing for enforcement of the
regulation in the case of a nurse who was forced to assist in an
abortion at the Mount Sinai Hospital in New York. [ADF
news release] [Advocates
International news release]
Noting that the health care reform bill passed by the US Senate lacks
adequate protection of conscience measures, the Christian Medical
Association is warning that the new law "opens the door to an increase in
discrimination against physicians, hospitals and clinics that decline to
participate in abortion and other morally controversial procedures." This
may drive health care professionals from medicine and reduce access to
medical care. [CMA
news release]
President Barack Obama has gained the votes necessary to secure passage
of the health care reform bill by signing an Executive Order. With respect
to protection of conscience, the Order states:
"Under the Act, longstanding Federal laws to protect
conscience (such as the Church Amendment, 42 U.S.C. §300a-7, and the Weldon
Amendment, Pub. L. No. 111-8, §508(d)(1) (2009)) remain intact and new
protections prohibit discrimination against health care facilities and
health care providers because of an unwillingness to provide, pay for,
provide coverage of, or refer for abortions." [Full
text]
Critics have pointed out that the order does nothing to ensure protection
of conscience in health care, but merely takes note of existing federal
laws. They also state that the
protection of conscience provisions in the bill prohibit discrimination
by health care plans, but not governments. Finally, they note that an
Executive Order cannot override a statute, and can be amended or cancelled
at any time.[Inside
Story from Capital Hill]
On the other hand, the Obama administration is committed to revoking
the regulation that was meant to give practical effect to those laws. In
a current case in New York, Mount Sinai Hospital claims that a nurse who was
forced to participate in an abortion has no right of action under the
federal law cited in the Executive Order [ADF
rebuts NY hospital's claim that pro-life nurse can't sue].
Idaho Senate Bill 1353 has been passed by
the Idaho House of Representatives and now proceeds to the state Governor
for his signature. [Spokesman
Review] The American Association of Retired People (AARP) continues to
oppose the bill. [Idaho
Reporter]
In Washington Post blog "On Faith," spokesmen for the United States
Conference of Catholic Bishops (USCCB) have stated that the health care
reform bill now before the US Senate is unacceptable because it lacks
conscience protections for individuals and institutions, fails to provide
for immigrants and will provide funding for abortion. [Washington
Post]
Citing the failure to provide protection for freedom of conscience in
health care and concerns about funding of abortion, the 17,000 member
Christian Medical Association in the United States has issued a statement
calling upon lawmakers to reject the health reform bill now before the U.S.
Senate.[News
Release]
A news report from Viet Nam, which does not prohibit abortion, states
that "psychological trauma" experienced by physicians "could emerge as an
important issue with the rapidly increasing number of people seeking to have
abortions. " Dr. Nguyen Thi Hong Minh, director of the Central Obstetrics
and Gynecology Hospital in Hanoi, described her adverse reaction to having
to perform abortions at 20-22 weeks gestation. [Than
Nien News] While there is no indication in the report that
physicians are compelled to provide abortions, their adverse reactions
highlight the importance of protection of conscience legislation.
Idaho Senate Bill 1353, has been passed by
a committee of the Idaho House of Representatives and will be considered by
the full House. [CNBC]
A woman is complaining that she was refused the contraceptive pill by a
pharmacist at a Lloyd's Pharmacy in Sheffield, England, who had religious
objections to the drug. The woman was told that she could return the next
day to get the drug from another pharmacist, but was not satisfied with
that. [BBC]
As a result of a petition that gathered over 100,000 signatures, the
Ducth parliament will consider legalizing assisted suicide in the case of
anyone over 70 years old who no longer want to live, whether or not they are
ill. Non-medical suicide assistants would be trained to help them take a
lethal drug. [Daily
Mail] While this would appear to reduce the likelihood of conflicts of
conscience in the medical profession among those who do not want to
participate in the procedure, it is doubtful that conflicts will be entirely
eliminated. It is likely that there would be demands for referral and other
forms of indirect participation by objectors, inside and outside the medical
profession.[See
Belgium: mandatory referral for euthanasia (December, 2003)]
An Australian Family Court judge has approved the sterilization of a
severely disabled eleven year old girl. It is not clear from the news report
whether the procedure is sought to prevent pregnancy or to prevent epileptic
seizures during heavy menstrual periods. Disability rights groups are
divided in their responses to the ruling. [Sydney
Morning Herald]. Depending upon the circumstances, such cases could
give rise to conscientious objection among health care workers.
Archbishop Charles J. Chaput, speaking to an audience of Catholic health
care professionals in Houston, Texas, stated that there is an increasing
danger that Catholics who adhere to Catholic Church teaching will be
excluded from health care professions as a result of an increasing tendency
to subordinate the Church to the state. "There's no more room in American
life," he said, "for easy or tepid faith." One consequence of this, he
suggested, is that those working in Catholic health care who have objections
of conscience to Catholic teaching should consider leaving Catholic health
care to pursue their occupations. "What really can't work is
staying within Catholic health care and not respecting its religious and
moral principles with all your skill, and all your heart." [Text
of address]
The American Psychological Association has removed a clause in its
Code of Ethics that permitted state laws and regulations to override
the ethical obligations of its members. The clause was first inserted into
the Code in 2002 and was used to justify the participation of
psychologists in abusive interrogations in Guantanamo Bay. The Code still
includes a clause that permits members to ignore ethical obligations in
research on the basis of state law.[APA
removes Nuremburg Defense] The development is of interest because of
repeated claims that health care workers are obliged to set aside
conscientious objections with respect to any "legal" service or procedure.
A University of Oxford blog on Practical Ethics discusses an editorial in
the British Medical Journal (Grubin
D, Beech A, BMJ 2010; 340:c74)about compulsory chemical castration of
sex offenders and the participation of physicians in the process. [Castration
and Conscience]
By a vote of 21-13 the Idaho Senate passed
Idaho Senate Bill 1353, which replaced
SB1270, an earlier version of the bill.[KPVI
News]
Britain's Director of Public Prosecutions has published
guidelines to assist Crown Counsel in England and Wales to decide
whether or not to lay criminal charges in cases of assisted suicide.
Addressing the American Congress and U.S. President Obama on the subject
of health care reform, the Catholic Medical Association of the United States
emphasized that there is "no right more central to American constitutional
order than the right to freedom of conscience and religion." [CMA
statement]
A group of New Zealand physicians has launched a court challenge to a
statement of policy proposed by the New Zealand Medical Council, the
country's regulatory authority. The Council states that the Statement on
Beliefs and Medical Practice was developed to provide guidance to
physicians in cases where their "rights" are apparently in conflict with
"rights" of a patient. The Council has agreed not to publish the statement
pending the decision of the court, but what appears to be a copy of the
statement has been posted by New Zealand Right to Life. [News
Release] [Statement
on Beliefs and Medical Practice]
Gaétan Barrette and Yves Lamontagne of the Quebec College of Physicians,
the regulatory authority for physicians in the province of Quebec, told a
committee of the province's National Assembly that Quebec physicians favour
euthanasia but not assisted suicide, though Barrette acknowledged that some
physicians would refuse to participate in euthanasia. Barrette claimed that
euthanasia is already being practised in hospitals in the province. [Montreal
Gazette]
St. Charles Medical Center, in Bend, Oregon, which was founded by the
Sisters of St. Joseph, has been formally declared a non-Catholic facility by
the bishop of the Catholic Diocese of Baker, Oregon. The declaration follows
the decision of the hospital to provide tubal ligations in violation of
Catholic teaching. The hospital became a community non-profit institution
about thirty years ago. For some reason, James Diegel, president of the
company that owns the hospital, stated that the institution will continue to
be guided by "Catholic values," an assertion that cannot be squared with the
declaration of the bishop of the diocese. [KTVZ
News] No reference was made to the problem of conscientious objection by
medical professionals who wish to adhere to Catholic teaching that conflicts
with the "values" espoused by Diegel.
Northern Ireland's Department of Health, Social Services and Public
Safety has re-issued guidelines on abortion for Northern Ireland, despite a
court ruling to the effect that the guidelines were defective and should be
withdrawn. The re-issued version of the guidelines is without sections on
non-directive counselling and conscientious objection by medical personnel
removed [LifeSite
News][See
Northern Ireland abortion guidelines rejected by court]
A poll of about 2,000 Britons has disclosed that about three quarters
favour legalizing assisted suicide, while 80% oppose prosecution of
relatives who have assisted terminally ill people who want to commit
suicide. Euthanasia and assisted suicide advocates continue to press for a
change in the law, and poll may be indicative of increasing public support
for the procedure [The
Telegraph]. In the absence of robust protection of conscience
legislation, legalization would likely have an an adverse impact on
conscientious objectors within the medical profession.
A protection of conscience bill in the Idaho Senate is reported to be
under review by its sponsors, with a view to the introduction of a revised
version. [Idaho
Statesman] See
Protection of
conscience bill introduced in Idaho.
An 89 year old Canadian woman has committed suicide at the Dignitas
facility in Switzerland. Kathleen Carter was suffering from spinal tenosis,
a degenerative condition incorrectly described as "terminal" in news reports
of the incident. She was accompanied by family members. Her plans were not
made public because of concern that a police investigation would be
triggered over possible aiding and abetting by those supporting her. She is
reported to be the tenth Canadian to have committed suicide at the Dignitas
facility. Her death is being cited as a reason to legalize assisted suicide
in Canada, [Canwest]
which would likely have significant implications for health care workers
opposed to the procedure.
The Wild Rose Alliance, a new political party in Alberta, has stated that
it will enact legislation "to protect the 'conscience rights' of health care
professionals." [Policies]
Human Rights Watch has issued a
report
that demands that Ireland decriminalize abortion and require the procedure
to be provided as part of health care. The report claims that abortion is a
human right. Human Rights Watch insists that conscientious objection to
abortion be controlled by government guidelines, that any health care
institution receiving public funding have staff members willing to perform
abortions, that institutions should be compelled to provide abortions, and
that objecting physicians should be forced to refer patients for the
procedure.
In a
letter to Congress, the United States Conference of Catholic Bishops
affirms its commitment to health care reform, but insists that effective
protection of conscience provisions must be included. The bishops state that
the provisions in both bills before Congress are inadequate: "It is
critical that the final bill retain the freedom of conscience that insurers,
purchasers, plan sponsors, and health care providers currently have under
federal law."
Bill 1270, introduced in the Idaho Senate, would prevent health care
workers from being forced to participate in, counsel for or refer for
abortion, dispensation of an abortifacient drug or drugs that may act
as abortifacients, human embryonic stem cell research, human embryo cloning,
euthanasia orassisted suicide.
A bill proposed by a member of the Scottish Parliament, Margo MacDonald,
would legalize assisted suicide in Scotland for anyone aged 16 and over
suffering from a terminal illness or incurable physical disability that
precludes independent living. While the
End of Life Assistance (Scotland) Bill requires that the
medical practitioner must be in agreement with the patient seeking assisted
suicide, it does not include a protection of conscience provision to protect
objecting health care workers.
Attorney General Martha Coakley of Massachusetts, who provoked angry
reactions by suggesting that objecting health care workers should not work
in emergency rooms, has been defeated in the election for the senate seat
vacated by the death of Edward Kennedy. Coackley's defeat is expected to
make passage of health care reform bills more difficult.
The Royal College of Physicians has sent a strongly worded letter to
Britain's Director of Public Prosecutions (DPP), stating that physicians who
assist in suicide should be prosecuted. The College was responding to
interim guidelines issued by the DPP to give direction as to when charges of
assisted suicide should and should not be laid. Among other things, the
College protested that the guidelines discriminated against the disabled,
whose death, according to the guidelines, would be less likely to result in
prosecution. [Telegraph]
The reaction indicates the conflicts of conscience likely to arise within
the medical profession if the procedure were legalized.
Martha Coakley is Attorney General of Massachusetts and Democratic
candidate for the U.S. Senate. During a radio interview she stated that
people should not work in emergency rooms if they are unwilling to provide
the morning after pill, and also said that she would not support a bill that
permitted conscientious objection to "legal" procedures and services. [Details]
The US Conference of Catholic Bishops has launched a nationwide campaign
in an effort to secure changes to the Patient Protection and Affordable Care
Act that passed the US Senate in December. The focus of their attention is
funding of abortion, which they consider to be unacceptable. However, they
also express concern about lack of adequate protection for freedom of
conscience in the bill. [USCCB
News Release][USCCB on health
care reform]
An editorial in the British Medical Journal (Grubin
D, Beech A, BMJ 2010; 340:c74)about compulsory chemical castration of
sex offenders and the participation of physicians in the process asserts
that doctors should avoid becoming agents of social control.
President Obama's decision to appoint Amy Gutman and James Wagner as
Chair and Vice Chair of the
Presidential Commission for the Study of Bioethical Issues was
"inspired," says F. Daniel Davis. Davis was executive director of the
President's Council on Bioethics from January 2006 to September 2009.
Responding to criticism that the previous Commission had been too
philosophical and not sufficiently policy-oriented, Davis argues that it is
reasonable to believe that the Commission can, if properly structured,
pursue both practical policy options and "deep" philosophical discussion. [Bioethics
Forum]