Update 2015-05-01

1 May 2015

Covering the period from 1 March to 30 April, 2015

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

Canada

Legalization of assisted suicide and euthanasia: The Supreme Court of Canada ordered the legalization of physician assisted suicide and euthanasia (Carter v. Canada) in February, 2015, suspending the ruling for one year to give the federal and provincial governments time to develop a regulatory regime. However, the federal government had apparently done nothing by the end of April, and the Minister of Justice said that there would be no new law before the next federal election, which must take place by October, 2015.

The Supreme Court ruling provides an exemption to the law of murder in defined circumstances. The Criminal Code is a nation-wide statute under federal jurisdiction, while provinces are constitutionally responsible for health care. Hence, the provinces and medical regulators cannot establish regulations or guidelines until there is a clear indication from the federal government what amendments will be made to the Criminal Code to implement the Carter decision. This has not prevented people from speculating about and making tentative plans for medical education and using organs from euthanized patients for transplants.

Plans to suppress physician freedom of conscience: Unbeknownst to physicians, officials among medical regulators in several provinces have been making plans behind closed doors to suppress freedom of conscience in the medical profession. These efforts appear to be the work of the Conscience Research Group (CRG), a tax-funded intitiative by activist academics. Their goal is to compel physicians unwilling to provide morally contested procedures like abortion or euthanasia to refer patients to someone willing to do so. Details were obtained from an internal memo provided by the College of Physicians and Surgeons of Saskatchewan and made public by the Protection of Conscience Project.

College of Physicians and Surgeons of Ontario (CPSO) officials were among those lobbied by the Conscience Research Group. On 6 March, the College Council adopted a policy demanding that physicians who refuse to provide procedures or services for reasons of conscience or religion must promptly arrange for a willing colleague to do so by making an "effective referral." The reasoning offered by the College to justify the policy would apply equally to euthanasia or assisted suicide, but the policy states that it does not apply to those procedures.

The Project provided the Council with evidence that the briefing materials supplied in support of the policy were "seriously deficient . . . erroneous and seriously misleading." Further, the conduct of the College arguably gives rise to a reasonable apprehension of bias. For example, the final version of the policy was written at least nine days before the public consultation closed, and before the College had received at least 80% of almost 16,000 submissions, most of which opposed the requirement for effective referral.

The Christian Medical and Dental Society, the Canadian Federation of Canadian Catholic Physicians' Societies and five Ontario physicians have filed an application in the Ontario Superior Court of Justice asking for an injunction against enforcement of the new policy

In January, the College of Physicians and Surgeons of Saskatchewan (CPSS) had also proposed a policy requiring effective referral for all morally contested procedures. During an interview in early March, the Associate Registrar of the College made it clear that, under the policy, physicians who refused to kill patients and also refused to direct them to colleagues who would be disciplined by the College or forced out of the medical profession.

As the CPSO and CPSS demonstrate, the demand that health care practitioners must participate in or facilitate euthanasia and assisted suicide by effective referral or other means is becoming the most contentious issue. The Protection of Conscience Project has anticipated this from its inception, referring to the problem in letters and submissions for 15 years.

Colombia

The Colombian Constitutional Court declared euthanasia and assisted suicide to be legal in 1997, but the decision was not implemented because the government provided no guidelines for physicians. In February, 2015, the Court ordered the government to issue guidelines, and Health Ministry officials have now done so. In the event of conscientious objection by a physician, the Health Promotion Agency (EPS) is responsible for finding a willing practitioner.

United Kingdom

A Member of Parliament in the United Kingdom intends to press for protection of conscience measures for health care workers who object to abortion. This follows a decision by the British Supreme Court that the protection of conscience clause in the Abortion Act 1967 to allow exemptions only from the direct performance of abortions.

The Abortion Act does not apply in Northern Ireland, but legislation may be introduced there to allow abortion in cases of serious foetal abnormality. While conscience protection is contemplated, the extent of it is not known.

United States

A protection of conscience bill has been introduced in Alabama. There is continuing controversy in Illinois about an amendment to the state's Health Care Right of Conscience Act, which has hitherto been the most robust American statute protecting freedom of conscience in health care. The Catholic bishops of Illinois secured amendments to the bill and then withdrew their opposition, adopting a "neutral" stance concerning it. In contrast, the bill is still strongly oppoosed by a group called "Catholic Citizens of Illinois." The central issue is whether or not the amendments require unacceptable complicity in morally contested acts by requiring referral.

The American Pharmacists' Association has officially adopted a policy prohibiting pharmacists from dispensing drugs used in execution.

2. News Items

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

April

Statement of Catholic Citizens of Illinois on SB#1564, Health Care Right of Conscience Act (Illinois, USA)

Morals in medicine (Illinois, USA)

Dutch court allows family to euthanize incapacitated 80-year-old woman against doctor's protest (Netherlands)

Don't expect law on doctor-assisted suicide before election, MacKay says (Canada)

Over 75- Sign here if you're ready for death- GPs to ask ALL older patients if they'll agree to a 'do not resuscitate' order (United Kingdom)

Illinois Senate approves health-care conscience update (Illinois, USA)

Colombian Physicians Get the Final Go-Ahead for Euthanasia (Colombia)

Bill would make Catholic hospitals tell patients about options elsewhere (Illinois, USA)

Abortion plans include conscience clause for staff (Northern Ireland)

Agreement reached on conscience rights (Illinois, USA)

Northern Ireland abortion law- Legalisation in fatal foetal abnormality cases recommended (Northern Ireland)

Pharmacists discouraged from providing meds for lethal injection (USA)

Canadian medical schools readying doctors to talk to patients about assisted suicide (Canada)

March

Canadian doctor rallies colleagues against 'tyrannical' attack on conscience and sound medicine (Canada)

Saskatchewan policy forcing doctors to violate conscience fails to win enough support- final decision delayed (Canada)

Ontario physicians seek court protection from CPSO policy (Canada)

Doctors make charter challenge on right to refuse care on religious grounds (Canada)

Christian doctors' group says new college policy infringes on freedom of conscience (Canada)

Doctors grapple with organ donation question (Canada)

The doctors' dilemma (Editorial, National Post, Canada)

Bill OK'd by committee would give more information to patients (Illinois, USA)

Trampled rights (Editorial, The Catholic Register, Canada)

Internal memos show how a handful of Canadian lawyers launched a national campaign against doctors' conscience rights (Canada)

In the assisted-dying debate, where's the compassion for doctors? (Editorial, Edmonton Journal, Canada)

CPSS undermines, Supreme Court of Canada affirms conscience rights for Saskatchewan doctors (Canada)

Doctors who refuse to provide services on moral grounds could face discipline under new Ontario policy (Canada)

Ontario College of Physicians approves policy compelling doctors to abort, euthanize in some cases (Canada)

UPDATED- Ontario doctors must refer for abortions, says College of Physicians (Canada)

Wake up to the war on Catholic doctors (United Kingdom)

Unacceptable to force doctors to participate in assisted dying against their conscience- CMA head (Canada)

Giving doctors a choice on assisted suicide (Canada)

Woman acted as surrogate mother for son's IVF baby, court hears (United Kingdom)

MP seeks to safeguard rights of anti-abortion admin staff (United Kingdom)

3. Recent Postings

Protection of Conscience Project

Commentary

Court challenge raises issue of "reasonable apprehension of bias"

Gagging conscience, violating humanity

"The core of a modern pluralism"

News Releases

Uniform coercive policy urged for all Canadian physicians

Submissions

Project Submission to the College of Physicians and Surgeons of Saskatchewan re: Conscientious Refusal (5 March, 2015)

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:

6. Publications of Interest

Murphy S. Tunnel vision at the College of Physicians (Op Ed by Project Administrator in the National Post concerning the adoption of a policy requiring "effective referral" by objecting physicians)

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, B. (2015). Your Morality, My Mortality: Conscientious Objection and the Standard of Care. Cambridge Quarterly of Healthcare Ethics, 24(2), 214-230. doi:10.1017/S0963180114000528

Schuklenk U. Conscientious objection in medicine: Private ideological convictions must not supersede public service obligations. Udo Schuklenk’s Ethx Blog, 26 March, 2015.

7. Video

Doctors make charter challenge on right to refuse care on religious grounds

8. Audio