Torture: sometimes a man’s gotta do what a man’s gotta do, say bioethicists

Michael Cook*

Torture is an issue on which the public might expect bioethicists to be moral absolutists. Never again! Never ever! It was somewhat surprising, then, to read in the New York Times that one of the world’s leading animal rights theorists, Oxford’s Jeff McMahan, support torture. . . .   Full Text 

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

Eva Elizabeth Bolt, Marianne C Snijdewind, Dick L Willems, Agnes van der Heide, Bregje D Onwuteaka-Philipsen

Abstract

Background Euthanasia and physician-assisted suicide (EAS) in patients with psychiatric disease, dementia or patients who are tired of living (without severe morbidity) is highly controversial. Although such cases can fall under the Dutch Euthanasia Act, Dutch physicians seem reluctant to perform EAS, and it is not clear whether or not physicians reject the possibility of EAS in these cases.

Aim To determine whether physicians can conceive of granting requests for EAS in patients with cancer, another physical disease, psychiatric disease, dementia or patients who are tired of living, and to evaluate whether physician characteristics are associated with conceivability. A cross-sectional study (survey) was conducted among 2269 Dutch general practitioners, elderly care physicians and clinical specialists.

Results The response rate was 64% (n=1456). Most physicians found it conceivable that they would grant a request for EAS in a patient with cancer or another physical disease (85% and 82%). Less than half of the physicians found this conceivable in patients with psychiatric disease (34%), early-stage dementia (40%), advanced dementia (29–33%) or tired of living (27%). General practitioners were most likely to find it conceivable that they would perform EAS.

Conclusions This study shows that a minority of Dutch physicians find it conceivable that they would grant a request for EAS from a patient with psychiatric disease, dementia or a patient who is tired of living. For physicians who find EAS inconceivable in these cases, legal arguments and personal moral objections both probably play a role.

[Full text]

Saskatchewan physicians to be forced to participate in killing their patients

For Immediate Release

Maurice Vellacott, MP Saskatoon-Wanuskewin

OTTAWA – “The assault on freedom of conscience that is spreading across our country ought to be of grave concern to every freedom-loving Canadian ,” MP Maurice Vellacott said upon learning of yet another province (this time his own) that plans to force physicians to participate in morally objectionable procedures, including those that kill. “No health care worker should be forced against their will to take part in the killing of another human being. It would be a grotesque violation of their human dignity.”

The College of Physicians and Surgeons of Saskatchewan (CPSS) has adopted in principle a policy[i]  which it basically “cut and paste” from the Conscience Research Group’s (CRG’s) Model Policy on Conscientious Objection in Medicine.[ii]

Mr. Vellcott asked a series of questions that paint a disturbing picture of the process, or lack thereof, that went into CPSS’s adoption of this objectionable policy:

“Was the CPSS aware that the drafters of the Model Policy, notably Professor Jocelyn Downie of Dalhousie University, are abortion and euthanasia activists?

Did the CPSS solicit input from anyone other than Professor Downie and her team at the CRG[iii] before adopting this policy?

Did the Saskatchewan College let on to anyone else that it was even considering this issue?

Is the CPSS aware that this policy was rejected by the Canadian Medical Association (CMA)?”

Mr. Vellacott explained: “Professor Downie and co-author Sanda Rodgers, in a 2006 guest editorial in the CMA Journal, ignited a firestorm of controversy when they falsely claimed that CMA policy requires physicians to make abortion referrals regardless of their conscientious/religious beliefs. As Sean Murphy, Administrator of the Protection of Conscience Project, points out in his recent news release, that claim was repudiated by the CMA and vehemently rejected by physicians. And partly as a result of that negative response, Professor Downie turned her attention to the regulatory Colleges to try to convince them to impose mandatory referral.”[iv]

Earlier this month, Mr. Vellacott spoke out against a similar draft policy of the College of Physicians and Surgeons of Ontario (CPSO). At that time, he expressed concerns that if the Supreme Court of Canada strikes down Canada’s current ban on euthanasia or assisted suicide, then CPSO’s policy would mean Ontario’s physicians would have a ‘duty to refer’ patients for these life-ending procedures. He stressed that no other jurisdiction that currently allows euthanasia or assisted suicide imposes such an obligation. [v]

“While the CPSO policy is not identical to the CPSS/CRG Model Policy, in principle it is the same—a coercive attempt to involve physicians in the killing of some of the most vulnerable members of our human family,” Mr. Vellacott said. “The sheer fact that these Colleges of Physicians and Surgeons feel that a coercive policy of referral for these controversial procedures is necessary, is itself testament to the fact that there is something inherently problematic about these procedures in the first place. If they were procedures just like any other medical procedure, there’d be no need to coerce physicians into sacrificing a fundamental part of who they are—their very consciences—in order to provide them.”

“No good can come from forcing a doctor to practice medicine in a way they find morally reprehensible. Killing the consciences of our medical doctors will cause inestimable harm to the people of Canada and society as a whole.”

“One cannot help but wonder, what is the real motivation of those pushing us down this dangerous path?  And will we have the courage and wisdom and foresight to stop it?”

For information on providing input to CPSS on its draft policy, visit: http://www.cps.sk.ca/CPSS/CouncilAndCommittees/Council_Consultations_and_Surveys.aspx

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 For further information and comment, call (613) 992-1966 or (613) 297-2249; email: maurice.vellacott.a1@parl.gc.ca

[i] The College of Physicians and Surgeons of Saskatchewan (CPSS) is currently seeking input on a conscientious objection policy dubbed “Conscientious Refusal,”  which it has adopted in principle. This policy would require physicians who object to providing certain “legally permissible and publicly-funded health services” to “make a timely referral to another health care provider who is willing and able to accept the patient and provide the service.” In cases where the patient’s “health or well-being” would be jeopardized by a delay in finding another physician, the physician would be forced to provide the service even when it “conflicts with physicians’ deeply held and considered moral or religious beliefs.” See: http://www.cps.sk.ca/Documents/Council/2015%201%2019%20Conscientious%20Objection%20policy%20approved%20in%20principle%20by%20Council.pdf

[ii] http://carolynmcleod.com/wp-content/uploads/2014/05/04_Downie-McLeod-Shaw.pdf

[iii] http://conscience.carolynmcleod.com/meet-the-team/

[iv] “Saskatchewan physicians to be forced to do what they believe to be wrong,” Protection of Conscience Project news release, Jan. 27, 2015

[v] See Jan. 8, 2015 news release  and Backgrounder.

All Saskatchewan doctors must refer for abortions: draft policy

 LifeSiteNews

Steve Weatherbe

Saskatchewan pro-life doctors will soon be forced to act against their consciences and required to refer patients who want treatments such as abortion to other doctors. And if no other doctor is available, doctors could be required to do abortions provided they are technically competent.

So says a draft policy of the Saskatchewan Physicians and Surgeons that the organization’s ruling council approved in principle on January 16.  It will vote again to enshrine the document in the professional code of ethics at its meetings on March 26 and 27, and provides member doctors just until March 6 to give feedback. . . [Full text]

   

Euthanasia is so accepted that doctors must now justify prolonging a life

National Post

Barbara Kay

In 1994, Dutch journalist Gerbert van Loenen’s partner Niek underwent surgery to remove what was thought to be a pea-sized brain tumour. More complicated than predicted, the operation resulted in a brain injury that left Niek permanently disabled, yet still able to enjoy quality of life.

Van Loenen willingly reorganized his life to care for Niek at home. But after four years, his career needs necessitated moving Niek to a wheelchair-accessible unit across the street from a nursing home, where he was content for six more years until the tumour returned, whereupon he died a natural death.

Van Loenen found himself brooding over certain friends’ reactions to their situation. “It would have been better if he had died,” one said at the outset. [Full text]