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Protection of Conscience Project

Service, not Servitude

Update 2014-12-31

31 December, 2014

Covering the period from 1 November to 31 December, 2014

1.  By Region/Country

Developments relevant to freedom of conscience. Australia - Canada - Croatia - NetherlandsPhilippines - United Kingdom - United States

2.  News Items

Links to news summaries.

3.  Recent Postings

Links to resources added to Project site.

4.  Action Items

Support protection of conscience initiatives near you.

5.  Conferences/Papers

Seminars, conferences and workshops relevant to conscience advocacy.

6.  Publications of Interest

Relevant to freedom of conscience issues.

7.  Video

Presentations, discussions, etc.

8.  Audio

Presentations, discussions, etc.

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

The Protection of Conscience Project celebrates its 15th anniversary in December, 2014. The formation of the Project was one of the eventual results of a meeting in Vancouver with British Columbian Senator Ray Perrault in the spring of 1999.  Most participants were physicians or pharmacists. They spoke of their growing concern that they would be penalized or forced out of their professions if they continued to practise in accordance with their religious or moral beliefs. This was a key factor in the establishment of the Project nine months later.


The six member Legal and Constitutional Affairs Committee of the Australian Senate has issued a report recommending that Greens senator Richard di Natale reflect and consult further with experts concerning his euthanasia and assisted suicide bill.  The Committee also recommended that, if a revised bill is formally introduced, senators should be allowed a "conscience vote" on it. The bill has some provisions that provide some protection for objecting physicians, but they are problematic in some respects.

Flag CanadaCanada

A draft policy of the College of Physicians and Surgeons of Ontario demands that physicians must provide services to prevent imminent "harm, suffering and/or deterioration," even if doing so is contrary to their moral beliefs.  In less urgent circumstances, the draft policy demands that objecting physicians refer patients to colleagues who will provide the morally contested service.  As written, the policy will apply to euthanasia and assisted suicide should the Supreme Court of Canada legalize the procedures.  Those who refuse to comply may face disciplinary action.  College officials have said publicly that physicians unwilling to provide or refer for contraception or abortion should leave family practice.  A public consultation on the draft policy is open until 20 February, 2015.

The Canadian Medical Association says it is preparing for the Supreme Court of Canada decision in Carter v. Canada, which may (or may not) legalize physician assisted suicide and euthanasia.  Some concerns are being expressed that the preparation seems to favour legalization of the procedures.

New Brunswick’s Minister of Health and the President of the province’s Medical Society both claim that physicians who refuse to provide abortion for reasons of conscience have an obligation to refer patients to colleagues who will. These assertions contradict the positions of the Canadian Medical Association and the College of Physicians and Surgeons of New Brunswick. and fail to take consider how such a policy would play out should assisted suicide and euthanasia be legalized. The Project has written to both officials.

Flag CroatiaCroatia

Complaints have been made that, of 27 licensed public hospitals in Croatia, five have stopped providing abortions because staff physicians are unwilling to perform them for reasons of conscience: Zagreb’s "Sveti duh" hospital, the general hospitals in Nasice, Vinkovci and Virovitica, and the general hospital in Knin.  Abortion activists insist that public hospitals should not employ physicians who object to abortion.  There have been unsubstantiated accusations that some doctors in Zabok and Zagreb who claim a "conscientious objection" to performing abortions in public hospitals actually do provide them in illegally in private practice. 

Subsequently, the hospitals in Nasice, Virovitica and Vinkovci hired external gynecologists to provide abortions, some gynecologists at the Knin General Hospital have rescinded their conscientious objections, and Zagreb’s "Sveti duh" hospital has signed a contract with the "Sestre milosrdnice" hospital to perform abortions on request. 


Professor Theo Boer, a former member of one of the Netherlands' regional euthanasia control committees, has expressed concern that the Dutch euthanasia law has gone too far.  Dr. Boer reviewed about 4,000 cases of euthanasia during his nine year term with the committee.  He continues to agree with voluntary euthanasia when provided only for terminally ill patients who experience "unbearable suffering," but now thinks that this term is too subjective to be safely applied.  He is also concerned about the activities of the Levenseinde Kliniek, a euthanasia facility opened to serve patients whose physicians would not provide euthanasia.

Those running Levenseinde Kliniek believe that everyone over 70 years old should be allowed to have euthanasia if they are tired of living.  The facility has been reprimanded by Dutch euthanasia authorities because of its handling of two cases.  Doctors at the clinic have complained that some  Dutch pharmacists refuse to provide euthanasia drugs.

It does not appear that publication of Professor Boer's concerns has generated any widespread public concern in the Netherlands, and the Levenseinde Kliniek has rejected his criticisms.  This suggests that Dutch health care workers who refuse to be involved in euthanasia or assisted suicide may find themselves increasingly isolated and vulnerable to discrimination and coercion. 


The Supreme Court of the Philippines has issued a decision concerning the controversial Responsible Parenthood and Reproductive Health Act of 2012 ( RH Law).  The ruling confirms the Protection of Conscience Project’s criticism of the parts of the law that adversely affected freedom of conscience among health care workers.  Those sections have been struck down by the Court.

The Supreme Court of the Philippines consists of 15 judges.  With respect to the issue of freedom of conscience among health care workers and institutions:

  • 11 judges held that the mandatory referral provision in the law was an unconstitutional violation of freedom of conscience;
  •  10 of the 11 also ruled that forcing an objecting health care worker to provide "complete and correct information" about contraception was a violation of freedom of conscience
    • The eleventh judge held that this was not, but added that the provision could not be used to suppress the freedom of objecting health care workers to express professional or other opinions concerning contraception.

Sections of the majority and individual opinions supportive of freedom of conscience are reproduced on the Project website.

FLag UKUnited Kingdom

Women have successfully sued the National Health Service for hundreds of thousands of pounds because they have given birth to healthy babies after failed abortions or sterilizations.  Claims were paid out to compensate for pain giving birth and discomfort during pregnancy.

Britain's Supreme Court ruled against two Catholic midwives whose employer required them to supervise the provision of abortions.  The trial court ruled against them, but they were successful on appeal, and the employer then appealed to the Supreme Court. The Supreme Court ruling narrowly interpreted the protection of conscience clause in the Abortion Act 1967 to allow exemptions only from the direct performance of abortions.  Moreover, the court gratuitously asserted that physicians unwilling to perform abortions are obliged to refer patients to colleagues who will do so.  It now appears that the midwives may have to leave the profession. 

The ruling comes as the House of Lords approved Lord Falconer's physician assisted suicide bill after adopting amendments to ensure that judges have the final say in approving applications for the procedure.  The measure apparently satisfied a number of critics of the bill who wanted to see sufficient safeguards in place.  Like the Abortion Act, Lord Falconer's bill includes a protection of conscience provision that allows objecting physicians to refuse to "participate" in assisted suicide.  The Supreme Court ruling indicates that, if the bill ultimately passes, objecting physicians will be compelled to facilitate assisted suicide.

Two thirds of British general practictioners are said to be refusing to comply with a National Health Service policy that they must offer to prescribe statins to anyone with a one in 10 chance of developing heart disease within ten years (i.e., most men over 60 and most women over 65 - 40% of the public).  The demand is backed by the power of the NHS to cut fees for physicians who fail to meet the targets set.  While the policy has been defended by some cardiologists, those opposed to it protest that a practice that may benefit those who have heart disease has not been shown to benefit those without it.  There are also disputes about the side effects of the drugs.  Objecting physicians are not being portrayed as "conscientious objectors," apparently because their opposition is not seen to involve a moral or ethical judgement.  This view is erroneous.

Flag USAUnited States

Two psychologists contracted by the CIA to create enhanced interrogation techniques for al-Qaeda detainees have been criticized by the Senate Select Committee on Intelligence for violating human rights and medical ethics.

A U.S. Navy nurse who faces discharge from the military for refusing to force-feed prisoners at Guantánamo Bay is being supported by the American Nurses Association(ANA) and Physicians for Human Rights (PHR).  The ANA has written Secretary of Defense Chuck Hagel, insisting that the nurse should not be punished for making an independent ethical decision. PHR wants an end to the disciplinary proceedings against the nurse.

On 1 November, Brittany Maynard,  a 29 year old woman with terminal brain cancer, committed suicide in Oregon State with the assistance of a physician (and, presumably, a pharmacist), who provided the lethal medication she consumed.  In the weeks leading up to her death she had publicly advocated for legalization of assisted suicide.  The story seems to be fuelling a dramatic increase in support for the procedure. 

The American Center for Law & Justice (ACLJ) successfully assisted a pharmacist in Virginia who was the subject of a formal complaint because she her refused to fill prescriptions for oral contraceptives.

Several Walgreens customers in Florida have complained that Walgreens' pharmacies are refusing to fill valid prescriptions for pain-controlling drugs.  The refusals are the result of a company policy aimed at reducing narcotics abuse, not ethical concerns about the drugs themselves or the mechanism of action.  It appears to be a consequence of having been fined $80 million for filling fraudulent prescriptions in Florida.


2.  News Items

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

Physicians in Croatia refusing to provide abortion

Top nursing group backs Navy nurse who wouldn't force-feed at Guantánamo

Euthanasia in the Netherlands is getting out of hand: ethicist who screened over 4,000 euthanasia cases

Proposed Australian euthanasia bill may return in 2015

Should midwives opposed to abortion have the right to refuse any involvement in cases?

Fury after mothers get thousands in compensation – for healthy babies they tried to have aborted

Supreme Court of the United Kingdom to hear midwives's case on 11 November

Lords back assisted dying providing judge gives final ruling

Lessons Learned: May a Healthcare Professional Say No To Treating Ebola?

Doctors refusing to prescribe statins

Conscientious objection to abortion: Catholic midwives lose in Supreme Court

Canadian Medical Association says it's getting ready for legalized euthanasia, but critics say it is pushing it

Canadian doctors preparing for 'all eventualities' in case top court strikes down ban on assisted suicide

Doctors who oppose abortion should leave family medicine: Ontario College of Physicians

Catholic midwives' abortion ruling overturned by supreme court

Catholics doctors who reject abortion told to get out of family medicine

Catholic midwives must supervise abortions, Supreme Court decides

Midwives 'forced to leave profession because they refuse to partake in abortions'

Supreme Court rules against Glasgow midwives

'Frightening': Life and family leaders react to Ontario College of Physicians' draft policy

Freedom of Conscience Protected in Virginia

Ontario physicians college draft policy would trample conscience rights

Assistant minister says issue of access to abortion resolved

Customers claim Walgreens refuses to fill legitimate prescriptions

With assisted suicide, what begins in compassion seems to end in eugenics

3.  Recent Postings

Good News and Bad News

Navy Nurse Should Not be Punished for Declining to Force-Feed Guantánamo Detainees

American Nurses' Association supports conscientious objection by U.S. Navy nurse

When is a problem not a problem?

Judgementalism and moralising in response to Brittany Maynard suicide

Supreme Court of the Philippines majority opinion on the RH Law

Clarifying Our Terms for 2015

Ontario physicians to be forced to do what they believe to be wrong: Draft policy demands that objectors provide or refer. Policy would apply to euthanasia, if legalized.

New Brunswick health minister unaware of abortion-euthanasia connection

Looking back on 15 years: an anniversary

Proposed policy of Ontario College of Physicians "appalling"

Ontario College of Physicians' new policy violates basic tenets of law

Psychologists criticised in CIA torture report

The Globe and Mail: bullying from a bully pulpit

Project letter to the New Brunswick Minister of Health

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.

6.  Publications of Interest

None noted.

7.  Video

None noted.

8.  Audio

None noted.