Update 2012-11-01
1 November, 2012
Covering the period from 1 September to 31 October, 2012
1. By Region/Country
Visit the Project News/Blog for details.
International
The UN Human Rights Commision has issued a
document
that purports to base
the restriction or suppression of freedom of conscience among health care
workers on human rights claims. It calls for
changing laws and policies that allow conscientious objection "to hinder
women's access to a full range of services." The
resolution was endorsed by New Zealand, Burkina Faso, and Colombia and
enumerates access to abortion among "sexual and reproductive health rights."
20 of the 47 council members opposed the text. [CFAM]
Spain
According to a law that went into effect on 1
September, Spanish physicians may not provide health
care for undocumented migrants except in cases of emergency,
pregnancy, or delivery. The Spanish Society of
Family and Community Medicine (SEMFyC), supported by the
Spanish Medical Colleges is advising physicians to become
"conscientious objectors" to the law. [Hastings
Center Bioethics Forum] The Society calls this
"conscientious objection," but it can be understood in
two ways: as conscientious objection to the law, and as
an exercise of freedom of conscience in providing rather
than in refusing to provide a service.
United States
The main news from the United States is the continuing controversy over
the Obama Administration's plan to force employers to
provide insurance coverage for birth control and sterilization even if
they object to the services for reasons of conscience.
The Becket Fund reports that more than 100 plaintiffs have now joined
lawsuits against the federal government [Becket
Fund HHS Page].
While the
contested regulation does not bear directly
or immediately upon freedom of conscience for
health care workers, it does raise significant
issues about the nature and extent of freedom of
conscience and religion in a liberal democracy.
Moreover, the public discourse associated with
the controversy shapes social and professional
environments, and this has implications for
conscientious objectors. This is reflected
in Resolution 507 (Physician Conscience
Protection Rights) passed by the American Academy of Family Physicians (AAFP)
to support freedom of conscience for physicians. [MedPage
Today] It is also reflected in a warning to physicians attending a
Catholic Medical Association
conference that they are practising medicine in an
increasingly toxic culture, and that even physicians who do not follow
Church teaching may be forced to do things that they believe to be
wrong. [NCR]
Two pharmacists have won an appeal against a 2005
executive order issued by the Governor of Illinois that
required all pharmacies to fill prescriptions for the
morning after pill. The appeals court
upheld a lower court injunction based on the
Illinois
Health Care Right of Conscience Act.
The American Nurses' Association has prepared a draft policy document
opposing
nurse participation in euthanasia and assisted suicide. Some of
those opposed to the procedures remain concerned that the draft
statement equates the provision of food and fluids with medical
treatment. In any case, the document demonstrates that
legalization of assisted suicide and euthanasia is likely to cause
conflicts of conscience among some health care workers.
Philippines
A new version of the controversial
Reproductive Health bill
is being circulated among Filipino lawmakers. The substitute bill,
proposed by the sponsor of the original bill, is reported to include a
number of changes responsive to concerns of the bill's opponents. Some
of the proposed changes deals with sections of the bill that could have an
adverse impact on health care workers opposed to some birth control methods
for reasons of conscience. The bill's author is now prepared to remove
the provision that threatens objectors with prosecution if they speak out,
and to exempt denominational hospitals from a requirement to provide
services that contravene their religious ethos. [Inquirer]
192 professors of the Jesuit Ateneo de Manila University from its Loyola
Schools, School of Medicine and Public Health, Law School and School of
Government have publicly expressed support for the bill. Their declaration fails to refer to provisions that are problematic from the perspective of freedom of
conscience. In describing the bill as an affirmation of human
rights, it adopts the position of activists who are using human right
claims to force objecting health care workers to participate in or
facilitate contraception and abortion. [Declaration]
[The
Philippines RH bill of 2011: the shape of things to come?]
Denmark
A 19 year old girl who was seriously injured in a car
crash in October, 2011, narrowly escaped having vital
organs removed for transplant following what appears to
have been a misdiagnosis by attending physicians. [Medical
Daily] The case is a good illustration of one
of the practical reasons for respecting freedom of
conscience among health care workers who may have
ethical reservations about procedures in some
circumstances.
2. News Items
All news items are now on the Project
News/Blog, archived by country. They can also be
searched by topic using the blog search box.
3. Recent Postings
All recent postings are now on the
Project News/Blog, archived by year and month.
4. Action Items
5. Conferences/Papers
The Project will post notices of conferences
that are explore and support the principle freedom of conscience, including the
legitimate role of moral or religious conviction in shaping law and public
policy in pluralist states or societies.
6. Publications of Interest
Conscientious actors vs. conscientious objectors
Writing in the New England Journal of Medicine, Dr. Lisa Harris, who
specializes in late term abortions, argues that protection of conscience
laws are unbalanced because they support conscientious objectors but not
physicians who, for reasons of conscience, provide morally contested
procedures like abortion or assisted suicide. [Harris LH,
Recognizing Conscience in Abortion Provision
N Engl J Med 2012; 367:981-983]
Similarly,
Elizabeth Sepper of Washington University in St. Louis asserts that protection of conscience laws and policies are
neglecting those who provide morally contentious services despite
opposition from employers or other authorities. The forthcoming
issue of the Virginia Law Review will include a paper by
Sepper, "Taking Conscience Seriously," that makes this argument.
Citing Catholic hospitals and
contraception, she argues that individual health care workers at
denominational hospitals may be denied freedom of conscience by their
employers. [ScienceDaily]
The publications appear to signal a new development in discourse about
freedom of conscience.
The Protection of Conscience Project makes a principled distinction between
conscientious objectors and conscientious actors, identifying the former
as being in particular need of protection. (See
Notes toward an
understanding of freedom of conscience.)
Muslim medical students
Card discusses issues raised by Muslim medical students who, citing
religious prohibitions, are unwilling to perform physical examinations
of patients of the opposite sex, or to learn about alcohol or sexually
related diseases. It is noteworthy that the anecdotes he cites
originate in a Times newspaper article from 2007, which makes
clear (as he does not) that Muslim authorities and medical practitioners
in the United Kingdom did not support the position of the students.
Similarly, Professor Abdulaziz Sachedina (author of Islamic
Biomedical Ethics) and Dr. Shahid Athar, Muslim advisors to the
Project, discount the notion that Islamic law prevents Muslim physicians
from examining or treating members of the opposite sex. While Card
does make some interesting observations, and his article warrants a more
extended response, it is regrettable that he did not consider the
possiblity that what he calls the "deeper and more troubling" objection
by Muslim students might be addressed effectively from within the
Islamic tradition.
7. Video
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8. Audio
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