Update 2013-12-31

1.  By Region/Country
Visit the Project News/Blog for details.

Australia

The Australian Medical Students’ Association (AMSA) demands that physicians who believe abortion is wrong should be forced to direct patients to a colleague willing to provide it.  The attitude is consistent with a controversial law passed in the State of Victoria, which requires objecting physicians to refer to non-objecting colleagues.  The law has been publicly challenged by a physician who refused to refer a woman 19 weeks pregnant for a sex selective abortion. However, a petition to the Victorian parliament supporting the physician contained only 13 signatures.  Tasmania has passed a new abortion law that includes a requirement that objecting physicians provide patients with a "list of prescribed health services," but the law is not clear about whether or not the physician is permitted to provide any information or advice beyond what the state has approved.

The cause for freedom of conscience in health care was damaged by reprehensible comments made on Facebook by a physician that resulted in a disciplinary investigation.

Belgium

The Belgian Senate has approved a bill authorizing euthanasia for children.    Reports from Belgium suggest that objection to euthanasia has become a minority position in the country, and that increasing acceptance of the practice has led to its normalization, evidenced by the development of "new rituals" like a "last supper," final manicures and other forms of advance preparation.  One marker of this is the report that a Catholic priest was present and administered the sacrament of the sick to two deaf twins who were lethally injected because they were going blind; their family was described as devoutly Catholic. 

Dr. Wim Distelmans is a Belgian physician who is a leading practitioner and advocate of euthanasia.  He has provided euthanasia in a number of high-profile cases, and in "a lot more borderline cases," but declines to discuss them.  He is also co-chairman of the federal commission that reviews reports of euthanasia.  In an interview with a National Post reporter, he said that many physicians, hospitals and nursing homes  are reluctant to provide the service, though it is not clear why.  Dr. Distelmans implies that a physician has "a medical responsibility" to provide euthanasia in appropriate cases.

Canada

The Jewish General Hospital (JGH) strongly opposes Bill 60, on the grounds that the plan by the current Government of Quebec to ban overt religious symbols in the clothing of healthcare employees is discriminatory and deeply insulting to public-sector workers.

In a unanimous ruling, the Supreme Court of Canada has struck down three laws restricting prostitution.  Some observers are of the view that the ruling increases the likelihood that assisted suicide or euthanasia will be legalized in Canada, either by judicial fiat or by legislation supporting such a change.  In the prostitution judgement, the court granted lower courts much greater latitude to set aside earlier Supreme Court precedents if new legal issues are raised, or if there has been some other change that "fundamentally shifts the parameters of the debate."  The Supreme Court is set to hear an appeal from British Columbia in the case of Carter v. Canada, which turns on a precedent established by the Supreme Court in 1993 in the Rodriguez case.

A family in Canada has gone to court to stop the spoon-feeding of their elderly mother, who has Alzheimer's disease.  She is not force-fed if she does not open her mouth.  Her family has cites her "living will" signed in 1991, about ten years before she was diagnosed with Alzheimer’s, as justifying the cessation of feeding.  The nursing home refuses to starve the woman to death, which would be the consequence of following the family's instructions.

France

A panel of 18 people deemed representative of society, appointed by the French national ethics committee had decided that euthanasia/assisted suicide is a "legitimate right" for the dying or terminally ill.  The ethics committee had previously advised the French government against legalizing the procedures because of concern that it would be "dangerous" for society.   French President Francois Hollande is reported to be planning to bring forward a bill.

Ireland

Although the ink is hardly dry on the new Irish abortion law, an amendment has already been proposed to extend the grounds for abortion to include cases of severe foetal anomalies.  Expansion of the grounds for abortion usually increases the likelihood of conscientious objection.

Italy

According to a report from the Italian Ministry of Health, the abortion rate has continued to drop in the country, a trend evident since 1982.  There has also been an increase in conscientious objection to abortion among health care workers.  In Campania, almost 90% of gynaecologists refuse to perform the procedure, and the rate for all of southern Italy is about 80%.

Slovenia

Ten physicians at the Ljubljana UKC hospital’s surgery programme for congenital
heart defects of children are reported to have used a “conscience clause” in order to deal with a dispute involving the occasional engagement of foreign surgeons.  Their complaint centres on the fact that a visiting Israeli surgeon does not remain for post-operative care of the children.  It is not clear how this could have been done, since Slovenian protection of conscience laws are not applicable in the situation described.  The report elsewhere refers to the physicians’ action as a “collective resignation.” [STA News Service]  The engagement of the Israeli surgeon had previously been found to be and example of corruption [STA News Service].

United States

The U.S. Supreme Court has agreed to hear two cases concerning the controversial federal regulation that compels businesses employing more than 50 people to provide health insurance for birth control and surgical sterilization, even if the business owners object to doing so for reasons of conscience.  In one case (Hobby Lobby) the lower court supported the plaintiff’s position; in the other (Conestoga Wood Specialties) the lower court supported the federal government.  U.S. Supreme Court Justice Sonia Sotomayor issued an injunction against the U.S. federal government preventing it from enforcing a controversial regulation against the Little Sisters of the Poor Home for the Aged.  Other cases are continuing.  Meanwhile, the President of the U.S. Conference of Catholic Bishops wrote to President Obama asking that enforcement of the regulation be suspended until the Supreme Court has ruled on the issue in two cases it has agreed to hear.[USCCB]

A lawsuit has been filed by the American Civil Liberties Union (ACLU) against the U.S. Conference of Catholic Bishops (USCCB), alleging that the health care directives of the Conference were responsible for the failure of a Catholic hospital to properly treat a woman who was miscarrying a pregnancy at 18 weeks gestation.  Neither the hospital nor the treating physicians are named in the suit. As a result, the claim is not for medical malpractice or medical negligence by the physicians or hospital, but for negligence by the USCCB.

Representative Becky Nordgren of Alabama, is proposing a Health Care Right of Conscience Act in the state legislature.  The bill is intended to protect all health care providers from being compelled to participate, directly or indirectly, in abortion, human cloning, human embryonic stem cell research, and sterilization if they object to the procedures for reasons of conscience. 

Protection of conscience provisions are included in a bill to legalize assisted suicide in Massachusetts for residents who are at least 18 years old and diagnosed with a terminal illness with a life expectancy of six months or less.  It is not clear from the text of the statute whether or not an objector is exempt from all parts of the assisted suicide process ,or only from the requirement to actually provide the lethal medication [per Section 4(1)].  

2.  News Items

You can search news items by date, country and topic in the Project News/Blog. 

3.  Recent Postings

Impartiality, complicity and perversity

Does medical education make physicians susceptible to participating in torture?

Jewish General Hospital strongly opposes Bill 60 as patently discriminatory

Health professionals participated in cruelty and torture

New Tasmanian abortion law (protection of conscience provision) 

New Tasmanian abortion law (comment)

Alabama HB 31 Health Care Right of Conscience Act

4.  Action Items

None noted.

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.

3rd Annual Conference on Medicine & Religion
Responding to Limits and Possibilities of the Body
March 7-9, 2014
Chicago, Illinois, USA

Truth, Conscience and Religious Freedom
April 4-5, 2014
Franciscan University of Steubenville, Ohio, USA

6.  Publications of Interest

McLean M.  Conscientious objection by Muslim students startling.  J Med Ethics November 2013 Vol. 39 No. 11

Goldbert J, Jotkowitz A.  "In Defense of Religious Bioethics."  American Journal of Bioethics, December, Vol. 12, No. 12, 2012

7.  Video

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8.  Audio

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