October-December, 2011
Congressman Chris Smith, who supported objecting nurses against the
hospital run by the University of Medicine and Dentistry of New Jersey when
it attempted to involve them in abortions, states that the hospital should
adopt transparent policies to ensure that freedom of conscience will
continue to be respected in the institution. A hospital spokesman responded
that they are satisfied with the agreement reached with the nurses, and that
the hiring of additional nurses allows the hospital to ensure access to
abortion while accommodating freedom of conscience for those who object to
it. [National
Catholic Register]
The University of Medicine and Dentistry of New Jersey has agreed not to
replace objecting nurses who have filed suit against the University
Hospital, or reduce their hours. The nurses have agreed to protect patients
in an emergency until someone else can attend to assist. The hospital has
been warned by the court that it is not free to penalize them, assign them
to work abortion cases, or otherwise attempts to require them to assist with
abortions. [News
release]
Colorado Christian University (CCU) has begun a civil suit against the US
federal government for suppression of religious freedom and freedom of
conscience. While the university does not object to paying for insurance
coverage for contraception, it does object to paying for coverage of drugs
or devices that could have embryocidal or abortifacient effects, even if
they are described as contraceptives. [New
release]
Representatives of 60 non-Catholic groups have sent a
letter to President Barak Obama expressing their solidarity with
Catholics and Catholic institutions and their own objections to the Obama
administration's plans to force employers to pay for insurance for
contraceptives, embryocides and abortifacients, even if they object to such
drugs or services for reasons of conscience. "Mr. President, religious
organizations beyond the Catholic community have deep moral objections to a
requirement that their health insurance plans must cover abortifacients. . .
object to the current narrow exemption which puts them outside the
definition of "religious employers" . . . object to any revision of the
exemption that would limit it to churches and denominationally affiliated
organizations."
Britain's General Medical Council (GMC) is considering how it should deal
with physicians who are accused of assisting people to commit suicide, but
who are not prosecuted. The problem has arisen because Crown Counsel in
England are permitted to prosecute only people whose conduct violatesguidelines
that are more permissive than the criminal law, which still technically
prohibits assisted suicide. Assisting suicide in Scotland is not illegal,
though the facts in some cases might lead to prosecution for murder. In
effect, police and prosecutors have become regulators of the practice. If
they decide not to prosecute a physician who has assisted a suicide, the GMC
is left with the problem of what, if anything, should be done by way of
discipline. In addition, some kinds of more indirect assistance that would
not support prosecution might give rise to complaints of professional
misconduct. [The
Guardian;
Daily Mail]
75% of the delegates at a meeting of the Massachusetts Medical Society
have reaffirmed the policy of the Society against physician-assisted
suicide. [News
release] An initiative supporting an assisted suicide bill has secured
enough signatures to bring the bill to a ballot in 2012. Although the bill
states that participation in the procedure must be "entirely voluntary,"
participation is defined to exclude referral. Thus, the bill would, if
enacted, support compulsory referral by physicians for assisted suicide,
something that would be incompatible with the position of the Massachusetts
Medical Society. It would also require objecting institutions not only to
permit referral, but would require them to permit physicians in their
facilities to contract for off-premises provision of assisted suicide. [See
Massachusetts Initiative Petition (2011-2012)]
A bill in the Florida State Senate that will ensure that insurance plans
covering contraceptives will not impose long waiting periods or steep
co-payments on employees. Nancy Detert'sBill
598 includes a
protection of conscience provision provision to ensure that religious
employers are not forced to cover contraceptives that are contrary to their
religious convictions. However, Planned Parenthood is protesting the
exemption, demanding that employers be forced to pay for procedures or
services they believe to be wrong. [Florida
Independent]
The University of Medicine and Dentistry of New Jersey will hire
additional staff to perform work related to abortions that 12 of 16 nurses
working at the Same Day Surgery Unit at the University Hospital refuse to
perform for reasons of conscience. [The
Star Ledger]
The Medical Defence Union in the United Kingdom, the organization that
defends physicians accused of malpractice or unethical conduct, has warned
its members that they could be prosecuted if they provide medical records to
a patient when they have reason to believe that the records will be used to
access assisted suicide. The warning is found in a case study in the
MDU
Journal and is reviewed (and corrected in part) by Dr. Peter Saunders in
National Right to Life News Today. It is of interest because of
the contrast it provides to the frequent dismissal of the notion that
referral and other forms of indirect facilitation of procedures may be
morally significant.
The government of Indonesia is considering the possibility of imposing
legal limits to population growth. It is thought that local governments
would become more active in population control if such legislation were
passed. Government enforced regulations restricting births would have a
significant impact on health care professionals who object to some forms of
birth control or abortion. [Jakarta
Post]
A trial begins today in Washington State in the case of Stormans v.
Selecky. The plaintiffs include a family-owned pharmacy and two
individual pharmacists, who have religious objections to dispensing Plan B
and ella. Their religious beliefs forbid them from dispensing these drugs
because they can operate as embryocides. A Washington State regulation
demands that they dispense the drugs despite their objections. [Media
Advisory]
Abortions have not been performed on Prince Edward Island for almost
thirty years. Women seeking abortions must go to Halifax, Nova Scotia, or
Fredericton, New Brunswick. The province will pay for abortions only if done
in a Halifax hospital and if a woman is referred by two physicians. Women
who have abortions in private clinics in Halifax or Fredericton must pay for
the procedures themselves and are not reimbursed. The P.E.I. Reproductive
Rights Organization (PEIRRO) was formed to lobby for easier access to
abortion. Proposals least likely to impact freedom of conscience for health
care workers involve dropping the requirement for physician referrals,
paying for abortions done in clinics and paying the associated travel costs.
However, PEIRRO also encourages people to make complaints of
professional misconduct against physicians who decline to refer for abortion
for reasons of conscience. [See
Abortion and Prince Edward Island]
The Royal Society of Canada, which describes itself as "a national
organization of distinguished scholars, artists and scientists," has
published a
report advocating legalization of assisted suicide and euthanasia. The
report also recommends that objecting health care professionals be forced to
facilitate the services by referral. The report is the product of a 'panel
of experts' it commissioned to consider the legalization of assisted suicide
and euthanasia. Of the six experts, four (Johannes van Delden, Jocelyn
Downie, Ugo Schuklenk, and Sheila McLean) had previously advocated
legalization of the procedures [LifeSite
News], and Downie has repeatedly argued that objecting physicians should
be forced to refer for abortion. [See
Abortion: Ensuring Access]
The University of Medicine and Dentistry of New Jersey has filed a brief
opposing an injunction being sought to protect nurses who object to
participating in abortions. The brief claims that nurses have not been made
to assist with the procedures, nor will they be asked to do so, but have
only been asked to provide pre-operative and post-operative care that some
of them have provided in the past without objection. The brief notes that
the court rejected an attempt by lawyers for the plaintiffs to prevent
discussion of accommodation, and that 9 of the 12 plaintiffs have indicated
that they are willing to meet to discuss the issue.[Brief]
Lawyers representing 12 nurses who object to abortion have returned to
court alleging that the University of Medicine and Dentistry of New Jersey
is attempting to impose adverse changes in their employment or assignments.
The new complaint arises from a
letter to the nurses asking them to attend meetings to discuss
accommodation of their concerns. [News
release]
The New Zealand Medical Council has withdrawn its appeal of the judgment
of Justice MacKenzie given in the High Court in Wellington in December 2010.
The judgment held that a medical practitioner who objected to abortion for
reasons of conscience was not obliged to refer for the procedure. [News
release]
A survey of 1800 American obstetrician/gynaelecologists with a response
rate of 66% found that over half of the respondents believe that pregnancy
begins at conception rather than implantation. The finding is significant
because it demonstrates that a significant number of practitioners reject
redefinions of pregnancy proposed by groups like the by institutions like
the American College of Obstetrics and Gynecology (ACOG). [Reuters]
(Chung GS, Lawrence RE, Rasinski KA, et al.
Obstetrician-gynecologists' beliefs about when pregnancy begins. Am J
Obstet Gynecol 2011;206)
Nancy Pelosi, Minority Leader (Democratic Party) in the US House of
Representatives, told a Washington Post Reporter that she opposes freedom of
conscience for health care workers opposed to abortion because they would
allow women to "die on the floor." She complained that abortion opponents
"have this conscience thing." The reporter did not ask Pelosi, who purports
to be a "devout Catholic," if she would also characterize longstanding
American support for this fundamental freedom as "a conscience thing." [Washington
Post]
Philippines House Majority Leader Neptali Gonzales II states that the
controversial Reproductive Health Bill is unlikely to come to a vote before
2012 because, for the time being, there are enough members of congress
opposed to it to prevent its passage. [Philippine
Daily Inquirer] Protection of conscience provisions in the bill are
seriously deficient. [See
Philippines "RH Bill" of 2011: the shape of things to come?]
Appearing at a news conference in front of the hospital run by the
University of Medicine and Dentistry of New Jersey, Representative Chris
Smith described the hospital's policy on abortion as "coercive," "highly
unethical" and "blatantly illegal." [News
release] One of the 12 plaintiff nurses present said that one of them
was told by the nurse manager, "You just have to catch the baby's head.
Don't worry, it's already dead." [The
Star-Ledger] A statement issued at the news conference by
University representatives said, "No nurse is compelled to have direct
involvement in, and/or attendance in the room at the time of, a procedure to
which she or he objects based on his/her cultural values, ethics and/or
religious beliefs." [National
Catholic Register]
Dr. Douglas McGregor, regional director of palliative care for the
Vancouver Coast Health Authority, has testified that physicians value and
esteem life "above everything else." Identifying that as his own conviction,
he stated that he did not think that many of his colleagues would take a
different view. Dr. McGregor was testifying during a trial in British
Columbia Supreme Court initiated by plaintiffs who want physician assisted
suicide legalized. He agreed that physicians could comply with ethical
guidelines should the law be struck down, but added, "I'm not sure that's
the right thing to be doing in our society." [The
Province] It does not appear that the question or his answer
contemplated the position of objecting physicians who might refuse to adhere
to ethical guidelines demanding that they facilitate euthanasia.
Doctors for Voluntary Euthanasia
Choice has been formed in Australia by physicians supporting
legalization of the procedure. The group plans to make submissions to the
parliaments of South Australia and Tasmania. The Australian Medical
Association has no position on euthanasia because physicians are divided on
the issue. [Western
Advocate] The group's website states, "Many professional medical
societies maintain a stance of neutrality towards voluntary euthanasia to
reflect the range of views among their members and to facilitate each member
acting according to their own conscience."
A pharmacist at a Boots Pharmacy in Middleton Grange Shopping Centre,
Hartlepool, England, has been criticized for refusing to dispense the
morning after pill for reasons of conscience. The customer was directed to
another store, but said that she did not have an opportunity to have the
prescription filled until two days later. She was particularly angry because
the same pharmacist had just provided methadone to a heroin addict. Store
management noted that the pharmacist acted in accordance with the General
Pharmaceutical Council's Standard of Conduct, Ethics and Performance,
which requires objecting pharmacists to refer customers to other providers.
[Hartlepool
Mail] Those criticizing the pharmacist insisted, in effect, that
the pharmacist should have acted according to their moral judgement rather
than his own.
A lawyer for the Alliance Defence Fund (ADF) has accused the University
of Medicine and Dentistry of New Jersey of lying about the abortion policy
at the University Hospital. Responding to an e-mail from a lawyer
representing the University, Matt Bowman states that the ADF went to court
to prevent two of the objecting nurses from being forced to assist with
abortions, which seems to refer to assignments to pre-operative and
post-operative care. It appears that the position of the hospital is that
such assignments do not amount to assisting with abortion[National
Review].
Assisted by the Becket Fund for
Religious Liberty, Belmont
Abbey, a small Catholic liberal arts college in North Carolina, has
filed a civil suit against the US government because of a regulation that
would force it to pay for insurance coverage for contraceptives, embryocides
and abortifacients for students or terminate all health insurance plans for
employees or students. "The mandate is nothing other than a deliberate
attack by the government on the religious beliefs of millions of Americans,"
said Becket Fund counsel. "In the end, the government is forcing religious
orders and believers to pay for services they find immoral or pay a stiff
fine." [News
release]
The Patients Association
in the United Kingdom has issued what the Daily Mail calls "a damning report
. . .that has revealed a catalogue of abuse" in British state hospitals. As
a result of pressure from the Daily Mail and the Patients Association, the
Care Quality Commission conducted hospital inspections and found that "in a
fifth of them the care was so bad they were breaking the law." [Daily
Mail] In such circumstances, it is possible that some health care
workers would find themselves in conflicts of conscience as a result of the
difference between their moral standards and those of the institution.
7 November, 2011
A woman who used in vitro fertilization to achieve a pregnancy
at age 57 now concedes that her critics were right in asserting that she was
too old to have a child. Her relationship with the father of the child ended
because of the "shock" of having a baby. [Irish
Independent] The story illustrates the kind of foreseeable problem
that may cause some health care workers to refuse artificial reproduction in
some circumstances for reasons of conscience, but which might not be taken
into account by an adjudicator fixated on enhancing the personal autonomy of
a patient at the expense of an objecting health care worker.
A federal judge issued a temporary restraining order that prohibits a
hospital run by the University of Medicine and Dentistry of New Jersey from
forcing any of 12 objecting nurses who have sued the facility to participate
in training or services related to abortions. [News
release]
The Ministry of Health and Long Term Care in Ontario has fully funded and
published a report from an "expert panel" with recommendations to improve
abortion services in the province. The report, dated May, 2011, states that
the panel had met for a year and based the report on "their own expertise,
key stakeholder consultation" and a study that was still in preparation. No
information was provided about how the members of the "expert panel" were
selected, nor about the "key stakeholders" consulted. Among the goals the
report recommends: mandatory abortion training for medical and nursing
students, and mandatory referral and facilitation of abortion by all medical
practitioners, including those who object to the procedure. [Report]
The US House of Representatives Energy and Commerce Sub-Committee on
Health held a hearing on the subject, Do New Health Care Mandates
Threaten Conscience Rights and Access to Care? In his
opening remarks, the Chairman of the committee, Joseph R. Pitts,
commented that "we should universally support the notion that the federal
government should be prohibited from taking coercive actions to force people
to abandon their religious principles."
William J. Cox President and CEO of the Alliance of Catholic Health Care,
testified that the religious exemption clause in the HHS regulation
violates the right of churches and religious institutions "to define and
govern themselves free from government interference. . .by redefining
Catholic institutional ministries in a manner that excludes central elements
of their faith." The criticism was backed by Dr. David L. Stevens of the
Christian Medical Association, who
complained that the exemption "is meaningless to conscientiously
objecting health care professionals, insurers and patients." The Chancellor
of the Roman Catholic Archdiocese of Washington
noted that "tens of thousands of non-Catholics" are served by
Archdiocesan facilities. "No one is required to become Catholic in order to
receive these services," she said. "Yet this mandate would require us to
violate our religious beliefs to serve them." [National
Catholic Reporter]
The Alliance Defense Fund has filed suit against a hospital run by the
University of Medicine and Dentistry of New Jersey that alleges that the
hospital is requiring 12 objecting nurses to assist with abortions, contrary
to federal and state law. [News
release]
Writing to Joseph R. Pitts, Chairman of the US House of Representatives
Energy and Commerce Sub-Committee on Health, Daniel Cardinal DiNardo thanked
him for scheduling a hearing into the effects of a new federal regulation.
The Cardinal observed that the protection of conscience exemption in the
regulation is wholly inadequate. "Jesus and the apostles would not be
'religious enough' under such a test, as they served and healed people of
different religions," he wrote. [USCCB
news release]
Two experts have proposed that the practice of waiting until death has
been pronounced before organs are harvested should be dropped, and that new
standards should permit the removal of vital organs from living patients.
Instead, they propose that guidelines should ensure that donors are "beyond
suffering" and that their autonomy is respected. The suggestion generated a
strong adverse response. [National
Post]
The Secretary of State for the United Kingdom states that it is the
British government plans to pass regulations that will required local health
authorities to provide "appropriate access to contraception and abortion
services." [Daily
Hansard] It is not clear what effect this may have on conscientious
objectors who are employed by the health authorities.
Independent Lothians MSP Margo MacDonald is planning to introduce a new
version of an assisted suicide bill that was rejected by the Scottish
Parliament last year.[Scotsman]
Absent sound protection of conscience legislation, legalization of the
procedure would likely cause problems for health care workers unwilling to
participate.
The Chair of the USCCB's Ad Hoc Committee for Religious Liberty,
Bishop Lori of Bridgeport, testified before the House of Representatives
Judiciary Committee about the threats to freedom of conscience and religion
posed by policies and regulations now being implemented by the US federal
government. Citing a number of "serious threats to religious liberty," he
warned that "they represent only the most recent instances in a broader
trend of erosion of religious liberty in the United States."[Testimony]
Special Rapporteur on Health Anand Grover has submitted a report to the
UN General Assembly demanding the removal of all legal restrictions on
abortion, claiming that access to abortion is required by human rights law.
The Holy See reminded the General Assembly that no right to abortion exists
in international law. [European
Life Network] The notion that access to a particular service or
procedure is a 'human right' would have a significant effect on freedom of
conscience in health care.
American Senator Pat Toomey of Pennsylvania has joined those supporting
the
Respect for Rights of Conscience Act of 2011, which would ensure freedom
of conscience for religious health care providers whose beliefs conflict
with demands to provide services arising from US health care reform. [Post
Gazette]
The Royal College of Nursing plans to issue guidelines to remind nurses
that it is illegal to offer information about assisted dying, including
contact information for those willing to provide the procedure, in case the
provision of information might be seen as 'encouragement'. Nurses will be
instructed that if confronted by a patient who expresses a wish to die that
they should advise them that there is "nothing they can do to help." [Daily
Mail] The guidance contrasts sharply with demands for referral for
controversial procedures by conscientious objectors.
A case in New Zealand indicates the importance of protection of
conscience legislation. A technician working for the Canterbury District
Health Board was threatened with dismissal if she did not help to prepare
instruments to be used for abortions. She refused to do so for reasons of
conscience and sought advice from Right to Life New Zealand, which brought
the case to the attention of the Abortion Supervisory Committee. As a
result, the Committee wrote to all district health boards in the country to
remind them of the protection of conscience provisions in New Zealand law.
The employer withdrew the threat of dismissal.[News
release]
An eleven year old boy in California is being given hormone blockers by
his lesbian guardians to arrest puberty because they say that he wants to be
a girl. Their plan is to continue delaying puberty until he is 14 or 15 and
makes a decision about a sex change. [news.com.au]
The case illustrates the kinds of demands that can lead to conflicts of
conscience among health care workers, especially in jurisdictions that
propose that there is a legal 'right' to such services through state health
care.
The Obama administration has refused to continue funding an anti-human
trafficking programme run by the US Conference of Catholic Bishops Migration
and Refugee Services because the organization will not provide abortion,
contraception or sterilizations. Steve Wagner, who directed the
anti-human-trafficking program at the Department of Health and Human
Services from 2003-2006, described the USCCB program as "hands down the best
agency working to assist victims of human trafficking in the U.S." [National
Catholic Register]
A spot check of 100 National Health Service hospitals by the Care Quality
Commission (CQC) in the United Kingdom has found that in at least five
hospitals, staff routinely completed do-not-resuscitate orders for elderly
patients without notifying the patients or their families. Numerous cases of
neglect were also documented.[The
Telegraph] Such circumstances could lead to conflicts of conscience
among staff who are concerned about the welfare of patients but expected to
comply with the standards actually in effect in such locations.
The US House of Representatives has passed
HR 358, a bill that includes protection of conscience measures and
restricts the use of federal funds in paying for insurance coverage for
abortion. President Obama will veto the bill if it passes Congress. [National
Journal]
The
Reproductive Health Bill has stalled in the Philippines Senate because
of the need to begin discussion of the national budget. Debate on the
controversial bill is expected to resume in the new year. [Philippine
Daily Inquirer]
A number of Catholic Colleges in the San Francisco Bay area are
protesting the federal regulation that would force them to pay for insurance
coverage for contraceptives. Saint Mary's College, the University of San
Francisco and Santa Clara University were among those who sent letters to
the Department of Health and Human Services. The regulation is opposed by an
association representing 200 Catholic post-secondary institutions, but some
schools that identify themselves as Catholic are reported to have been
paying for contraceptive coverage even before the regulation was announced.
[Contra Costa
Times]
In a
joint statement published in two Capitol Hill newspapers, the leaders of
20 national Catholic organizations have protested the "preventive services"
regulation issued by the Department of Health and Human Services (HHS) and
called for legal protection of freedom of conscience in health care.
Ron Paul, who is seeking nomination as a Republican candidate for the US
Presidency in 2012, has announced that he supports those seeking "authentic
opportunity" to refuse to provide services or procedures like abortion or
contraception for reasons of conscience. [News
Release]
Nebraska Senators Mike Johanns and Utah Senator Orrin Hatch and 26
other US Senators have sent
letter to HHS Secretary Kathleen Sebellius concerning her department's
intention to force employers to pay for insurance for morally controversial
services despite conscientious objection. [News
release] Commenting on the letter in an
editorial in the York News-Times, Senator Johanns noted that it asks
that the regulation be rewritten "so that no organization finding the rule
morally objectionable is mandated to follow it."
The US Federal Government is contesting the view that there is a
constitutional "ministerial exemption" for churches that prevents the
government from intervening in disputes between ecclesiastical ministers and
their superiors. Justices of the court commented that the position of the US
Solicitor General was "extraordinary," inasmuch as she proposed that the
case before the court be dealt with as if the dispute concerned a labour
union and its members, without reference to clauses in the US Constitution
guaranteeing the free exercise of religion and non-establishment of
religion. The plaintiff and US Federal Government are asking the Supreme
Court to rule that the doctrine of "ministerial exception" does not apply
when it would operate to impede access to civil authorities to secure a
legal right or to discharge an obligation imposed by civil law. Since the
Court has previously ruled that civil law can "trump" the religious
convictions of an individual, one of the questions raised by this case is
whether or not civil law can also trump the convictions of a religious
institution. [See the
oral argument;
The Atlantic]. The case is particularly significant because of
the controversy surrounding the Obama administration's efforts to force
Catholic institutions to cover the costs of insurance for contraceptives,
potential embryocides and abortifacient drugs and devices for employees. A
second case on the Supreme Court
docket, Weishuhn v. Catholic Parish of Lansing, arising from a
decision of the Court of Appeals in Michigan, also raises the issue of
"ministerial exception."
Pennsylvania Congressman Tim Murphy has protested the Department of
Health and Human Services regulation that will force employers to provide
insurance for contraceptives and other services, even if they object to the
services for reasons of conscience. He asks that the requirement be
discarded, and that the Department acknowledge "the need to create an
exemption for religious institutions . . . to ensure the rights it aims to
defend are fully protected." [Letter]