Update 2015-03-01
1 March, 2015
Covering the period from 1 January to 28 February, 2015
1. Developments by Region/Country
Visit the Project News/Blog for details.
An anti-vaccination group that appears to be motivated by concerns about
purported vaccine side effects and/or alleged lack of effectiveness is
reported to be encouraging its adherents to create a fake church in order to
use a religious-based exemption to avoid vaccinating their children.
This kind of fraudulent ploy can bring the legitimate and sincere exercise
of freedom of conscience into disrepute.
A serial rapist and murderer was to be killed under the country's
euthanasia law to end his mental anguish arising from 26 years of
imprisonment with no prospect of release. However, the plan was
cancelled as a result of further medical advice, and he has been transferred
to a new psychiatric treatment.
In a 9-0 ruling the Supreme Court of Canada has
authorized both physician assisted suicide and physician administered
euthanasia in the case of competent adults who have clearly consented to
being killed, and who have a grievous irremediable medical condition
"including an illness, disease or disability" that causes "enduring
suffering that is intolerable to the individual."
However, acknowledging the joint intervention in which the Project
participated and other submissions, the Court stated: "In our view, nothing in the declaration of
invalidity which we propose to issue would compel physicians to provide
assistance in dying," adding that "a physician's decision to participate in
assisted dying is a matter of conscience and, in some cases, of religious
belief." While they acknowledged that "the Charter rights of
patients and physicians will need to be reconciled," the judges offered no
guidance as to how this should be done.
The ruling has increased concern about ongoing efforts by medical
regulators to suppress freedom of conscience among physicians.
There strong opposition to a draft policy of the College of Physicians and Surgeons of Ontario. Professional
Obligations and Human Rights (POHR) that will force objecting physicians to
facilitate abortion, euthanasia, assisted suicide and other morally
contested procedures by referral. An overwhelming majority of written
comments during the first consultation supported freedom of conscience for physicians, but only about 2% advocated
a policy of mandatory referral. On-line Survey responses indicated that a
mandatory referral policy
is controversial. The great majority of respondents in the current
consultation, including the submission of the Ontario Medical Association,
are opposed to the demand for mandatory referral.
Nonetheless, College officials seem determined to
enact POHR. Briefing materials supplied to Council in support of
POHR were not only seriously deficient, but erroneous and seriously
misleading. Officials have even attempted to
manipulate the consultation process by intervening in a Discussion Forum about
POHR, apparently to discredit critics and
defend the policy.
The College of Physicians and Surgeons of Saskatchewan
is proposing a draft
policy demanding that physicians who object to "legally permissible and
publicly-funded health services" must direct patients to colleagues who will
provide them. This will now include not only abortion, but euthanasia
and assisted suicide. If another physician is unavailable, the College demands
that they provide "legally permissible and publicly-funded" services, even
if doing so "conflicts with physicians' deeply held and considered moral or
religious beliefs." The policy is virtually a word-for-word copy of the
Model Conscientious Objection Policy proposed by euthanasia and
abortion activists – without attribution.
The Colombian Constitutional Court has given the
Ministry of Health 30 days to implement a number of protocols pertaining to
euthanasia, setting guidelines for all health care providers. The
order is intended to force the government to implement a 1997 Constitutional
Court ruling that legalized the practice.
It is reported that Kenyan doctors, nurses and other health practitioners
are secretly performing female genital mutilation at the request of
families: up to 18 percent of the estimated total number. The
practice is being exposed and strongly opposed by churches, rights groups
and other activists. The reports demonstrate that procedures do not
become morally or ethically acceptable simply because they are performed by
health care workers. It is also possible that the medicalization of
the practice places health care workers who object to it in a difficult
position, especially if they are junior to those providing the service.
Britain's Supreme Court ruled against two Catholic midwives who fought
their employer's orders to supervise the provision of abortion. The
women now face a legal bill estimated to be as much as £300,000.
As a result of continuing efforts to legalize assisted suicide in
Scotland and England, the Royal Pharmaceutical Society has developed a
policy that deals with the subject. It proposes a protection of
conscience provision that operates by having pharmacists "opt in" to provide
lethal prescriptions rather than "opt out," and it does not require
objecting pharmacists to refer patients to willing colleagues.
The American Medical Association has made a
submission to the public consultation on physician freedom of conscience
being conducted by the College of Physicians and Surgeons of Ontario (CPSO).
The AMA letter provides important details about a policy on physician
freedom of conscience adopted by the AMA House of Delegates in November,
2014, but not due to be formally published until June of this year. A
key element is the decision that physicians should not be forced to refer
patients for procedures to which they object for reasons of conscience.
The American Civil Liberties Union (ACLU) is suing a Washington state
public hospital district, claiming that it is failing to provide medical and
surgical abortions. In fact, the hospital district provides both, but
refers patients to other facilities for abortion when they cannot be
provided because of conscientious objection
by staff. It thus appears that the ACLU is not
content with forcing facilities to refer for abortion, but intends to force
them to provide the procedure despite conscientious objection by physicians
and health care workers.
A paediatrician in Michigan made headlines when she
refused to accept a child as a patient, apparently because the child's
mother is in a lesbian relationship with another woman who also wishes to be
considered the child's parent. The physician's refusal does not appear
to involve the elements of conscientious objection to treatment: a moral or
religious conviction that it would be wrong to treat the child or to accept
the child as a patient. In a letter sent to the women following their
meeting, reproduced in a news report, the physician said, "I felt that I
would not be able to develop the personal patient doctor relationship that I
normally do with my patients." She apologized for having caused any hurt or
angry feelings, and emphasized that they were always welcome in the clinic
and could see other physicians there.
2. News Items
You can search news items by date, country and topic in the
Project News/Blog.
Belgian court grants killer rapist the right to be put to death
after he argues he cannot overcome his violent sexual impulses
Belgian serial rapist will not be euthanized: minister
All Saskatchewan doctors must refer for abortions: draft policy
Saskatoon doctor worried about Supreme Court assisted suicide
ruling
Anti-vaccination group 'encouraging parents to join fake church'
for religious loophole
A modest proposal for respecting physicians' freedom
of conscience
Why I support some religious exemptions (though I myself am not
religious)
Euthanasia clinic criticised for helping woman with severe
tinnitus to die
Euthanasia is so accepted that doctors must now justify
prolonging a life
Dying Dutch: Euthanasia Spreads Across Europe
Inside Canada's secret world of medical error: 'There is a lot
of lying, there's a lot of cover-up
African church leaders worry about the 'medicalization'
of female genital mutilation
Colombia to Finalize Euthanasia Law in March
The Carter v. Canada Conundrum: Next Steps for Implementing
Physician Aid-in-Dying in Canada
American Civil Liberties Union: referral for abortion not good
enough
Pediatrician won't treat baby with 2 moms
An attack on the conscience rights of physicians
Silencing the Voices of the Faithful in Health Care
Protect doctors' right to choose
Doctors with conscience speak out
If Supreme Court decriminalizes physician-assisted suicide,
doctors may be obligated to help with euthanasia
Canada Court Strikes Down Ban on Aiding Patient Suicide
Doctor-assisted suicide a therapeutic service, says Canadian
Medical Association
Helping suffering patients die may be doctor's most humane
option, Canadian Medical Association says
How far should a doctor go? MDs say they 'need clarity' on
Supreme Court's assisted suicide ruling
'This is moral genocide': Canadian doctors blast plans to force
them into helping patients procure abortion
Saskatchewan doctors could face discipline over assisted suicide
Groups make effort to protect physicians' conscience rights
Midwives left with £300,000 legal bill after abortion conscience
fight
Euthanasia cases leap 73% at cautioned clinic
York Region health care professionals offer mixed views on
doctor-assisted suicide
Archbishop of Toronto: trust in physician regulators is
misplaced
Ontario policy forcing doctors to have role in abortion will
have 'devastating' consequences: bishops' group
Why conscience (or lack of it) is in the news
Keep the state out of the killing rooms of the nation
Why a 'conscience clause' is essential in assisted suicide
legislation
Physician-assisted suicide is a non-issue for most MDs
Let it be known that freedom of conscience still matters
3. Recent Postings
General
CBC interviewer fails to ask tough questions
Decriminalization of assisted suicide and the violation of our
rights
Moral Reflections on Vaccines Prepared from Cells Derived from
Aborted Human Foetuses
Supreme Court of Canada orders legalization of physician
assisted suicide – AND euthanasia
Torture: sometimes a man's gotta do what a man's gotta do, say
bioethicists
Re: College of Physicians and Surgeons of Saskatachewan
Saskatchewan physicians to be forced to participate in killing
their patients
Saskatchewan physicians to be forced to do what they believe to
be wrong
What is plagiarism? Saskatchewan College of Physicians provides
"teachable moment" for students, teachers
Re: College of Physicians and Surgeons of Ontario
Resuts of the first CPSO consultation on
Physicians and the Human Rights Code (Ending 5 August,
2014)
College of Physicians, please stand up for religious minorities
Access – or ethical cleansing?
Ethical Cleansing in Ontario
A watchdog in need of a leash: Ontario College of Physicians
manipulates consultation process
American Medical Association provides details of new freedom of
conscience policy
No legal "duty to refer" for euthanasia or assisted suicide
anywhere in the world
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.
Call for papers:
Thomas Aquinas' Theory of Conscience and Contemporary Debates on
Conscientious Objection: Deadline: 15 June, 2015 (Diametros:
An Online Journal of Philosophy)
6. Publications of Interest
Behrens KG.
Why physicians
ought not to perform virginity tests. J Med Ethics
doi:10.1136/medethics-2014-102344
Biggar, N. (2015). Why religion deserves a place in
secular medicine. Journal of Medical Ethics, 41:
229-233
Bolt EE, Snijdewind MC, Willems DL, van
der Heide A, Onwuteak-Philipsen BD.
Can physicians
conceive of performing euthanasia in case of psychiatric
disease, dementia or being tired of living?
J Med Ethics
doi:10.1136/medethics-2014-102150
Cheon J, Coyle N, L.
Wiegand DL, Welsh S.
Ethical Issues Experienced by Hospice and Palliative Nurses.
Journal of Hospice and Palliative Nursing. 2015;17(1):7-13.
Nieminen P, Lappalainen S, Ristimäki P,
Myllykangas M, Mustonen A-M.
Opinions on conscientious objection to induced abortion
among Finnish medical and nursing students and professionals.
BMC Medical Ethics 2015, 16:17
doi:10.1186/s12910-015-0012-1
Rich BA.
Your morality, my mortality: conscientious
objection and the standard of care. Camb Q Healthc Ethics.
2015 Apr;24(2):214-30. doi: 10.1017/S0963180114000528
7. Video
Saskatoon
groups concerned over assisted suicide ruling (Global News)
Webcast
on Ontario Physicians' Conscience Rights (Catholic Civil Rights League,
the Toronto Catholic Doctors' Guild, and Canadian Catholic Bioethics
Institute)
Freedom
to Care: The Threat to Conscience Rights in Medicine (Christian Medical
and Dental Society)
Website and petition
launched to protect physician freedom of conscience in Canada
8. Audio
None noted.