29 September, 2003
"Ethics of the profession"
revisited
North Carolina Governor Mike Easley has approved recommendations that will
provide compensation to thousands of North Carolina residents who were
involuntarily sterilized by the state over a period of 50 years. The
sterilizations were consistent with the "ethics of the profession" at the
time. This should remind those who insist that conscientious objectors
must conform to the "ethics of the profession" that there are other
legitimate ethical standards.
French government minister suggests euthanasia
The killing of Frenchman with a drug overdose administered by his
mother has led François Fillon, French social affairs minister,
to suggest a debate about legalizing euthanasia in such cases. This is
not the first time prominent French officials have made such suggestions.
[French
Health Minister considers change to euthanasia law]
Danish professor recommends
eugenics
Professor Helmuth Nyborg, who teaches psychology professor at
the University of Aarhus, Denmark, has suggested that the state should take
steps to create a better Danish society by encouraging childbearing among
the 'intelligent' and discouraging it among the 'unintelligent' to prevent
'degenerates' from being born. Although
his comments were rejected by Integration Minister Bertel Haarder, it
appears that the unfavourable response was evoked by the professor's
focus on intelligence and reference to 'degenerates'. Pre-natal
screening to identify and eliminate physically 'defective' infants by
abortion is so routine that it is, in many places, a 'standard of care' that
causes conflicts of conscience among health care workers opposed to eugenic
practices.
27 September, 2003
Progress slow
for Abortion Non-Discrimination Act
Senate Bill 1397,
which would prevent health care institutions entities from being forced
to participate in abortions, is not expected to reach the floor of the US
Senate until 2004.
25 September, 2003
Protection
of conscience for scientists and engineers
The Fondation Science et Conscience
and the Association
for the Promotion of
Scientific
Accountable Behaviour (APSAB)
held a conference in Geneva, Switzerland on 25-26 September to discuss the
problems faced by scientists
who have
spoken out about the dangers of products produced by their employers.
Members or representatives of UNESCO, OECD, the EU and numerous other
agencies were slated to attend. The
groups are proposing an international convention to recognized and protect
the conscience of salaried scientists and engineers.
Concerns about 'palliative care' form in Australia
An Australian hospital is asking patients to complete a form on which they
state whether life-prolonging treatment can be withheld from them and
whether they are to be resuscitated. They can also use the form to send a
final message to those who survive them. Dr Eric Fairbank of South West
Healthcare, Warrnambool, Victoria, says that the forms are to do with
palliative care, not euthanasia. [Warrnambool Standard, 24 September]
Dr. John Fleming, director of the Southern Cross Bioethics Institute,
Adelaide, South Australia, said: "In the light of a recent case in Victoria,
Australia, [Nutrition and hydration to be withdrawn from Australian woman]
doctors may now regard artificially delivered food and fluids as medical
treatment which may be withdrawn from a non-dying patient. Dr Fairbank's
assurance that his forms are 'not about euthanasia' has to be measured
against the judge-made law which seems to permit, in the state of Victoria,
euthanasia by omission of life-sustaining measures such as food and fluids."
[SPUC]
23
September, 2003
Alternative to IVF
Researchers in Auckland, New
Zealand, have found a simple, inexpensive treatment for some cases of
human infertility. They found that they could significantly increase the
chance of conception among women with "unexplained infertility" or
mild endometriosis by flushing a special liquid through the reproductive
organs. The treatment avoids the ethical concerns about in vitro
fertilization. [CNS
News]
19 September, 2003
"Five Live Report: The
Terminators?" on BBC
A member of the Council of Disabled People, Bill Albert, has denounced
prenatal screening and abortion "state sanctified eugenics". The
practices are exposed in a BBC programme in which reporters found that some
women are pressured to have abortions if the infants they are carrying have
even correctable physical defects. Bioethicist John Harris of
Manchester University argues in favour of eugenic screening, suggesting that
parents opposed to it are misguided. The controversy illustrates the
potential for moral conflicts among health care workers. [BBC]
18 September, 2003
Unprecedented number of letters received by parliamentary committee
James Bogle, a leading medical barrister in the United Kingdom, gave
evidence against the draft Mental Incapacity Bill now before a parliamentary
committee. He warned that the bill would make incapacitated patients
vulnerable to attorneys who would have "power without responsibility".
Dr. Philip Howard of St George's Hospital Medical School, London, stated
that the bill would make suicide notes legally binding advance directives.
The committee has received an "unprecedented" number of letters expressing
similar concerns. This suggests that many health care professionals
would find themselves in conflicts of conscience if the bill passes.
[See
Group argues for withdrawal of nutrition and hydration in UK]
Truth in
advertising in Australia
Pharmaceutical companies in Australia must now label products developed or
tested with human embryonic stem cells. This will facilitate ethical
decision making by those opposed to embryonic stem cell research.
17 September, 2003
Judge orders feeding stopped
A circuit court judge has ordered the feeding tube removed from Terri
Schiavo, a disabled Florida woman. It appears that the case will
continue in a federal court. [See previous report:
Case for
withdrawal of feeding continues in Florida]
Kenyans against abortion
August in Nairobi saw a silent procession by thousands of Kenyan Christians
demonstrating against abortion. According to a recent poll, legalized
abortion is rejected by 81% of Kenyans, but health minister Charity Ngiluo
complains that denying abortion to women is unfair. The
Christian Medical Fellowship has raised concerns that the wording of the
proposed constitution now being discussed may permit abortion. [See
Abortion demanded in Kenya]
Group
argues for withdrawal of nutrition and hydration in UK
In evidence given to the parliamentary committee reviewing the draft Mental
Incapacity Bill, the Making Decisions Alliance (MDA) argued that advanced
directives would permit the withdrawal of sustenance, and would be in the
best interests of patients suffering some some conditions, like advanced
dementia. It recommended that 'quality of life criteria' be used
to make such decisions. [For a contrary view, see
Euthanasia
prevention bill in United Kingdom;
Draft Mental Incapacity
Bill criticized]
15 September, 2003
Euthanasia prevention
bill in United Kingdom
The House of Lords has passed a private member's bill to prohibit euthanasia
by denial of sustenance. The Patients' Protection Bill will be
considered in the House of Commons. The bill addresses the problem
caused by legal rulings to the effect that proxies can deny nutrition and
hydration to incapacitated patients. [For related items, see
Draft Mental Incapacity
Bill criticized;
Food and fluids controversy;
Case for
withdrawal of feeding continues in Florida;
Nutrition and hydration to be withdrawn from Australian woman;
Comatose woman can be starved;
UK
attempt to ban euthanasia by starvation and dehydration]
12 September, 2003
Ethical measles/mumps
vaccine available
The Merck pharmaceutical company is making available single dose
vaccines for measles and mumps that have not been derived from fetal tissue.
The company is now taking limited orders (three boxes per physician, each
with ten doses), the minimum order being one box. Physicians may order
by calling Merck at 1-800-9675 or 1-800-637-2579.
Children of God for Life will assist
physicians concerned that they may not be able to use all ten doses.
11 September, 2003
Draft Mental Incapacity
Bill criticized
The Law Society of Scotland warned a parliamentary committee that a
draft bill would expose incapacitated patients to abuse and was incompatible
with the European Convention on Human Rights. "People First",
representing people with learning disabilities, also spoke against the bill,
and Dr Donald Lyons, medical adviser for elderly services to the Greater
Glasgow Primary Care Trust, said that he would not want to work under the
bill if it became law. Other critics have charged that the bill would
legalize euthanasia by starvation and dehydration.
9 September, 2003
Organ harvesting
concerns in Russia
Russian doctors are reported to be removing kidneys from homeless
people who are still alive, but who, in the words of an anonymous
surgeon, "are done for anyway". The organs may be worth as
much as $40,000 US each. [The
Courier Mail] The operations are not legal, but the
ethical outlook of those involved may be a source of difficulty for
objecting health care workers.
8 September, 2003
Majority of
Canadians polled favour euthanasia
A Polara survey of 1,263 Canadians conducted in August found
that 49% favoured euthanasia and 37% were opposed.
A 1997 poll by the same firm showed 60% of respondents supported assisted suicide.
The numbers are worrisome for health care professionals who do not
want to be involved with these practices. [Ottawa
Citizen]
4 September, 2003
Chinese doctor recommends
euthanasia
Dr. Pu Liansheng, who gave a terminally ill woman a lethal injection 17
years ago and was later acquitted of murder, now argues that euthanasia
should be legalized. [The People Daily]
Legal action
threatened against abortion objectors
Paulina Ramirez was raped in 1999 when she was 13 years old and now
has a three year old child, fathered by the rapist. An obstetrician
refused to perform an abortion, and she was persuaded not to have an
abortion by doctors, social workers and a priest. She was given
$10,000.00 by the government to assist in rearing the child, but is now
suing the government for more compensation, claiming that her life has been
completely destroyed. While it seems reasonable to seek additional
financial assistance, a troubling aspect of the case is that activists want
legal action against those who persuaded her not to have an abortion, which
presumably includes the objecting obstetrician. [Yahoo]
3 September, 2003
Case for withdrawal of feeding continues in Florida
Evidence from doctors and nurses indicates that Terri Schiavo is
responsive to her environment and not in a
persistent 'vegetative' state. One nurse also reported that
her husband, who is attempting to have her tube feeding halted,
often asked when she was going to
die,
became 'visibly excited' when her condition worsened, and talked
about how he would use the money he expected to receive
following her death. The next hearing has been set for
September 11th. [See
previous
report]
2 September, 2003
Belgian euthanasia
statistics in doubt
Belgium legalized euthanasia in September, 2002. 170 cases
of euthanasia have been reported since, but the Belgian Medial
Journal claims that the actual number is two or three times higher.
Assisted
suicide bill introduced in Vermont
A bill based on Oregon's assisted suicide law has been introduced in
Vermont. It would allow patients who are expected to die
within six months to ask for drugs to commit suicide. Some
doctors in the state have formed the Vermont Alliance for Ethical
Healthcare to oppose the legislation.
29 August, 2003
Case of
disabled Florida woman attracts comment
The case of Terri Schiavo, a disabled women who is
unconscious but dependent upon artificial nutrition and hydration
provided by a tube to her abdomen, continues to attract comment.
Her husband wishes to withdraw her feeding tube, but the Catholic
Bishops of Florida have added their protest to that of her family,
whose lawyer has drawn attention to the fact that it would be
illegal to starve one's dog to death. Video evidence showing
Schiavo responding to doctors and family members has been rejected
by the judge hearing the case as "inconsistent". The problem
is one faced all over the world because the provision of nutrition
and hydration has frequently been defined as medical
treatment - which can be withdrawn - rather than
care- which cannot. Situations like this can present
significant conflicts of conscience for health care providers.[For
previous report, see
Food and fluids controversy. For other cases and comment, see
Nutrition and hydration to be withdrawn from Australian woman;
Comatose woman can be starved;
UK
attempt to ban euthanasia by starvation and dehydration]
28 August, 2003
Free in
vitro fertilization proposed in UK
The National Institute for Clinical Excellence (NICE) has
recommended that women between 23 and 39 40 should be entitled to up
to six state-funded IVF cycles. The proposal would create an
expectation of service that would adversely impact conscientious
objectors. Politicians have expressed concern that it would
reduce funds available for other medical treatment.
26 August, 2003
'Wrongful life' claims dismissed
Describing the lawsuits as reminiscent of Nazi Germany, two judges of
the Supreme Court of Kentucky have dismissed claims filed against doctors by
parents of children with physical disabilities. The parents argued
that they would have sought abortions had they been aware of the
disabilities. The threat of such civil suits is used to coerce
physicians who would, for reasons of conscience, reject eugenic practices.
18 August, 2003
Church
leader declines to state views on assisted suicide
In the Isle of Man, where politicians are expected to deal with a bill to
legalise euthanasia, bishop-elect Reverend Graeme Knowles has encouraged
debate on the subject but has declined to state his views on assisted
suicide. Such a position can be of concern to conscientious objectors
of the same faith, inasmuch as they may look to their religious leaders for
support when faced with demands that they compromise their convictions.
[See
Importance of backing from religious leaders emphasized]
16 August, 2003
American College of Pediatricians supports
Abortion Non-Discrimination Act
The American College of Pediatricians
"applauds and supports"
Senate Bill 1397, which would clarify existing law to ensure that
physicians, hospitals, and health care facilities can decline to provide
abortions. The College firmly supports the optimum working environment
for physicians and other health care professionals enabling them to have
the freedom to provide the best care for all patients, especially children.
6 August, 2003
Christian
commentary on AMA ethics articles
The Center for Bioethics and Human Dignity has arranged with the Ethics
Institute at the American Medical Association to post responses to clinical
ethics cases posted on the AMA's "Virtual Mentor" web page. The first
case study and commentary is
Faith-Based
Decisions: Parents Who Refuse Appropriate Care for Their Child.
5 August, 2003
'Ethics of the profession'
in retrospect
Those who would use the 'ethics of the profession' to coerce conscientious
objectors in health care should note that states are considering how to
compensate victims of the eugenics programmes that imposed compulsory
sterilization on those considered to be 'unfit'. Those programmes
functioned with the suppThe American Medical Association's official policy
stipulates that "information about emergency contraception is part of the
comprehensive information to be provided as part of the emergency treatment
of sexual assault victims." However, a recent study found that only 28
percent of the hospitals surveyed routinely offer and provide emergency
contraception to victims of sexual assault. The problem of availability of
emergency contraception is made even more difficult by a recent wave of
hospital closings and mergers, where private and community hospitals are
being taken over by religious-based owners who are opposed to including
birth control and emergency contraception in their treatment regimen.
Every member of Congress, especially those who say they care about stopping
violence against girls and women and helping victims of rape and sexual
assault, should support this legislation. Providing emergency contraception
is not the same as performing an abortion.ort of the 'ethics of the profession' that prevailed
at the time. Recordnet.com tells the story of 73 year old
Charlie Follet of California, who was sterilized when he was 15 years old,
one of 20,000 people victimized by California's eugenics programme.
Dispensing 'morning after pill' to be compulsory
A bill introduced in the U.S. House of Representatives (Compassionate
Assistance for Rape Emergencies Act: CARE Act) would force hospitals to
dispense the potentially abortifacient 'morning-after pill' to patients
complaining of sexual assault. This is just one of a continuing series
of attempts to override freedom of conscience in denominational
institutions.
31 July, 2003
Assisted
suicide bill narrowly defeated in New Zealand
The Death with Dignity Bill, which would have legalized assisted suicide,
has been defeated 60-57 in the New Zealand Parliament, with one abstention.
The narrowness of the vote will likely provide some impetus to continued
lobbying for the procedure, which would have serious consequences for health
care workers. [See
Assisted Suicide: What Role for Nurses? ]
30 July, 2003
Needless hysterectomies
at Irish Hospital
Dr Michael Neary has been struck from the medical register for having
performed unnecessary hysterectomies on more than 60 women at Our Lady of
Lourdes Hospital in Drogheda. The Irish minister of health is now
being pressured to conduct an inquiry into the obstetric unit at the
hospital. It does not appear that enquiries have been made to
determine whether or not health care workers were pressured to participate
in the procedures.
Coercive
family limitation in India
India's Supreme Court has ruled that punitive legal measures against people
who have more than two children do not violate constitutional rights to life
and liberty. At issue was a law passed in the northern state of
Haryana making it illegal for parents to hold public office if they have
more than two children. The central government is considering laws
that would prohibit people with more than two children from holding
government jobs or running for office. [Times
of India] Other punitive measures are being discussed in the media. [Financial
Express] It is difficult to see how such a regime would respect
freedom of conscience among health care workers who do not support the 'two
child' policy difficult when people not connected with health care are
treated in this fashion.
29 July, 2003
Pro-suicide campaign on Isle
of Man
Manx 4 Death with Dignity is sending postcards to all households calling for
legalization of assisted suicide. A similar campaign was organized
earlier this year in Guernsey. (Pro-euthanasia
postcard campaign in Guernsey)
28 July, 2003
Drug-induced
abortions recommended in Britain
The British Pregnancy Advisory Service has asked the Department of Health to
approve a trial of abortifacient drugs like Mifepristone or Misoprostol (Cytotec).
Women could take the drugs to induce an abortion at home. A problem
that arises for conscientious objectors is that women whose abortions are
incomplete arrive at hospital expecting on-duty staff to complete the
procedure.
25 July, 2003
Public support for
artificial reproduction
70% of 800 respondents surveyed by Bristol's University Centre for
Reproductive Medicine favoured in vitro fertilization. This
level of support indicates that health care workers who object to the
procedure for reasons of conscience may find themselves pressured to
participate, especially if it is part of a state health care plan.
23 July, 2003
Comatose woman can be starved
Miss Teresa Innes, hospitalized in West Yorkshire, is in a coma caused by an
allergic reaction to penicillin. The Bradford Health Trust has
obtained a high court judgement that allows it to stop providing her food and
fluids. If the Trust acts on the judgement the woman is likely to die
within two weeks. In its decision, the high court cited the 1993 House
of Lords ruling in the case of Anthony Bland. The ruling is consistent
with those in many other jurisdictions that have defined food and fluids as
'treatment'
which can be withdrawn, rather than 'care',
which must always be provided. Health care workers who consider
nourishment to be care rather than treatment may find themselves in
difficulty in jurisdictions that take the opposite view in law.
18 July, 2003
Limited opportunity to present evidence re: Mental Incapacity Bill
Those wanting to present evidence to Britain's Joint Select Committee on the
Draft Mental Incapacity Bill must do so before 1 September, 2003. The
bill would allow patients, not necessarily terminally ill, to be starved and
dehydrated in order to cause their deaths, a process that has been described
as "euthanasia by neglect". (See Food
and fluids controversy)
17 July, 2003
First trimester eugenic
screening
Trials are underway to test a new form of pre-natal screening that can be
used as early as the fifth week of gestation to detect conditions like Down
Syndrome and cystic fibrosis. Such tests are ordinarily used to
identify 'defective' infants for 'genetic termination' (i.e, abortion.
See
Foothills Hospital Now Forces Nurses To Participate In Genetic Terminations
). Conscientious objectors to eugenics and abortion come
under considerable pressure when such tests are adopted as a 'standard of
care'.
15 July, 2003
Abortion demanded in Kenya
A member of a Kenyan parliamentary health committee has called for the
legalization of abortion; Christian and Muslim leaders are opposed.
Failure to consider the opposition of health care workers to the the
procedure will likely have serious consequences. (See
previous
report on Kenya, with remarks on the situation in South Africa).
Islamic
Council prohibits euthanasia and assisted suicide
The European Council for Fatwa and Research (ECFR), which met in Stockholm
during the first week of July, has ruled that euthanasia and assisted
suicide are forbidden by Islam. The Council distinguished such acts
from the removal of life-support from patients who are clinically dead.
14 July, 2003
Abortion Non-discrimination Act introduced in the US Senate
American Senators Gregg and Nelson and six others have introduced the
Abortion Non-discrimination Act introduced in the US Senate. It is
identified as S.
1397. The bill passed the US House of Representatives after being
examined at committee hearings at which Project advisor Prof. Lynn Wardle
testified. [Testimony
of Lynn D. Wardle, J.D.
]
Food and fluids
controversy
Florida Governor Jeb Bush is being asked to intervene in the case of Terri
Schiavo, who is unconscious but dependent upon artificial nutrition and
hydration. A court has ruled that her husband can order her feeding
stopped in order to cause her death, but other family members have appealed
to the governor, claiming that the husband is motivated by $700,000.00 life
insurance policy and an interest in another woman. The case
illustrates the problem that arises when food and fluids are legally
defined as 'treatment'
which can be withdrawn, rather than 'care',
which must always be provided. Health care workers who consider
nourishment to be care rather than treatment may find themselves in
difficulty in jurisdictions that take the opposite view in law.
12 July, 2003
British Medical Association supports production of embryos for harvesting
cells
At its annual meeting the British Medical Association expressed support for
the Hashmi judgement, which allowed the artificial production of a baby so
that the brother could be treated using blood from its umbilical cord.
A dissenting physician called the procedure "eugenics with a vengeance."
11 July, 2003
Criticism of New York
Catholic Conference
The compromise reached by the New York Catholic Conference (See
Compromise worked out in New York) concerning the 'morning-after pill'
is being criticized in some quarters on the grounds that the drug is 'abortifacient'.
The drug may prevent implantation of a human embryo, thus causing its death,
which conscientious objectors view as morally equivalent to
abortion. On the other hand, if ovulation has not occurred, the
drug may suppress ovulation and inhibit sperm transport and survival, thus
acting as a
contraceptive. The NYCC agreed that the drug could be dispensed to a
woman complaining of rape in the latter situation, assuming the drug is not
otherwise contraindicated. [NYCC
statement] Some criticism seems directed at practical difficulties that
may arise in applying the guideline; other critics may not appreciate the
distinction between the mechanism of
contraception and that of contra-implantation.
Costa Rican official promises elimination of religious influence
Costa Rica's Minister on the Condition of Women, Esemeralda Britton
Gonzalez, has promised that the influence of the Catholic Church in Costa
Rican society will be eliminated in order to facilitate abortion and
contraception. Her remarks were made to the UN Committee on the
Elimination of All Forms of Discrimination Against Women (CEDAW). One
of the committee members asked what steps that government had taken to that
end. It should be noted that a policy that would suppress the freedom
of a church from speaking out on such issues would also suppress the freedom
of any citizen or group motivated by religious, moral or ethical concerns.
[See
There Are No Secular Unbelievers]
10 July, 2003
Eugenic screening for deafness
Embryos may now be screened for deafness using a test developed by
Australian doctors and approved by Victoria's Infertility Treatment
Authority. A report concerning the successful screening of seven
embryos conceived in vitro was presented at the International
Genetics Congress in Melbourne. All seven embryos screened in the
reported case died; six failed to implant in the womb and one was apparently
killed because it carried two genes for deafness. [News
report] The death of the embryos indicates the reason why some health
care workers object to such procedures; others reject eugenic screening
altogether.
9 July, 2003
EU Commission
approves research on human embryos
Embryos 'left over' from fertility treatments may be used for research,
according to funding guidelines published by the European Union Commission.
This means that such research will be funded by tax money from countries and
individuals opposed to it. At the same time, the dynamic likely to
follow from the guidelines may make it more difficult for conscientious
objectors among researchers and health care workers to avoid participation
in the process, whether at the 'production' stage in research or when the
products of such research are demanded by patients.
Judge orders birth
control
Lapeer County Judge Michael Higgins of Michigan ordered a woman addicted to
drugs to use birth control in order to stop her from having babies that she
could not care for. The woman is fighting the order with the help of
the American Civil Liberties Union. The court order could cause
problems for health care workers required to facilitate the imposition of
contraceptive measures who may morally oppose the imposition of such an
order, even if they do not oppose contraception. [Detroit Free Press,
9 July]
2 July, 2003
Artificial reproductive technology and moral controversy
Papers presented at the European Society of Human reproduction and
Embryology's conference in Madrid, Spain, suggested a growing interest in
the use of ova obtained from aborted foetuses in research and in vitro
fertilization. Ovarian follicles from second and third
trimester foetuses were kept alive by Dutch and Israeli scientists in the laboratory, and some follicles began to
develop. Researches from Copenhagen, Denmark, reported that no health
or developmental problems had been noted among children conceived using eggs
that had been matured in the laboratory prior to fertilization.
Apparently the interest in this area arises from claims that not enough
women are willing to donate eggs for artificial reproductive techniques like
IVF. At the same conference,
Dr. Norbert Gleicher of the Foundation for Reproductive Medicine in
Chicago
reported that he had injected male cells into female embryos during
research into single cell gene disorders, generating denunciations from
those opposed to making human "she-males". [CNN]
In the United Kingdom, Baroness Warnock, who drafted the legislation that now governs reproductive technology in the U.K., stated that she had no objections to the use of eggs obtained from aborted girls for artificial reproduction. Though she acknowledged that some women might not want eggs obtained in that manner, she did not understand their objections. On the other hand, the Archbishop of Cardiff compared the enthusiasm for such procedures to "the Nazi experiments performed during the Second World War." [Yorkshire Post, 2 July, ICN, 1 July]
Also in England, a lesbian couple awaits the birth of a child produced by in vitro fertilization using sperm purchased over the internet from a donor selected for his physical characteristics. [The Age]
The procedures and research being pursued in the field of reproductive technology illustrate the potential for conflicts of conscience to arise among researchers and health care workers who may be called upon to facilitate the work.