Breaking Conscience News April-June 2006

30 June, 2006
Portugal plans to legalize abortion
Despite a promise to hold a referendum on the subject, Portugal's new government has announced plans to legalize abortion in the fall. Currently, abortion is legal only in the first trimester in cases of rape or to save the life of the mother. Reports do not indicate whether or not the government is giving any consideration to the willingness of health care workers to participate in abortion.

29 June, 2006
British Medical Association resumes opposition to assisted suicide
65% of 500 doctors at the annual meeting of the British Medical Association overturned last year's decision by the Association to adopt a neutral position toward assisted suicide. The BMA has thus resumed its previous position against the procedure. [LifeSiteNews.com]

28 June, 2006
Assisted suicide bill stopped in California
The California Senate Judiciary Committee has voted to block a bill that would have permitted physician asisted suicide for the terminally ill. [Reuters 28 June, 2006]

27 June, 2006
Objections raised to organ donation protocol
A Canadian pro-life organization has objected to the a procedure known as donation after cardiac death (DCD), in which organs are removed from a patient whose heart as stopped beating for five minutes, even if the patient continues to have measurable brain function, if the patient is diagnosed to have no hope of recovery. The concern is that by failing to adhere to the criteria for brain death, it is possible that the patient is killed by the removal of organs. Objections were raised following a press conference in Ottawa in which it was announced that the first such procedure had been performed in Canada. There appears to be a factual dispute between proponents of the new procedure and those who have concerns about it. Dr. Cameron B. Guest, Chief Medical Officer for Trillium Gift of Life Network, stated that all cases of auto-resuscitation (spontaneous re-starting of the heart) had occurred within one minute of cardiac arrest. Dr. Moira McQueen, President of the Canadian Catholic Bioethics Centre, said that cases of auto-resuscitation had occurred after more than five minutes. In any case, the key issue for objectors is that death has been established before organs are removed. [LifeSiteNews.com]

23 June, 2006
Objecting storeowner threatened with boycott
Ralph's Thriftway, a grocery store in Olympia, Washington, has refused to carry the morning after pill because of concerns about its mechanism of action. A local woman plans to organize a boycott of the store on the grounds that the community is "very liberal" and concerned about "women's rights." If so, it is ironic to find the liberalism of the community reflected in intolerance for dissenting views about the morality of a product. Nonetheless, a boycott continues to respect the freedom of conscience of the store's owners as well as the freedom of customers to shop where they choose. This is to be distinguished from legislation or professional regulations that are intended to suppress freedom of conscience.

19 June, 2006
Attack on religious believers implies moral superiority of non-religious belief
The Voluntary Euthanasia Society and the sponsor of a bill to legalize euthanasia are attempting to exclude religious believers from public discourse about legalization of the procedure, implying that they are irrational. [ABC News, 19 June, 2006]

New eugenic test- preimplantation genetic haplotyping
Preimplantation genetic haplotyping is a new eugenic screening technique developed by Saudi Arabian fertility specialist Ali al-Hellani in 2004 and perfected by British researchers. In theory, at least, it can increase the number of detectable genetic defects in human embryos from 200 to nearly 6,000. Concerns among conscientious objectors to eugenic screening will be proportionate to the extent that the new technique is used to identify embryos for destruction rather than treatment. [LifeSiteNews.com]

9 June, 2006
British ethicist calls for regulation of involuntary euthanasia
Len Doyal, a professor of ethics at Queen Mary, University of London, argues that "involuntary euthanasia" is occurring in Britain and ought to be legalized and regulated. Writing in the Royal Society of Medicine journal Clinical Ethics, Professor Doyal asserted that withdrawal of life-sustaining 'treatment', including assisted nutrition and hydration, is equivalent to euthanasia, and that a lethal injection would be preferable to the "slow, painful and incomprehensible deaths" inflicted by current practice. Doyal is a consultant to the General Medical Council, the Department of Health, the Royal Colleges of Surgery and Medicine and the Medical Research Council and a member of the ethics committee of the British Medical Association (BMA). Doyal's article supports the assertions of conscientious objectors that withdrawal of food and fluids to cause death is euthanasia, and demonstrates the potential for conflicts of conscience among health care personnel either in such cases, or in the event that euthanasia were legalized. [Timesonline, 8 June, 2006]

30 May, 2006
Amnesty International Canada advocates pro-abortion policy
The Canadian branch of Amnesty International has become the third branch of AI to decide that the international organisation should advocate for abortion as a human right. A final decision will be made by Amnesty International next year. Recognition of abortion as a human right would have profound adverse consequences for health care workers who object to the procedure.[Life Site, 30 May, 2006]

29 May, 2006
Eugenic abortions in the UK
It is reported that over 90% of infants diagnosed in utero with Down's syndrome are aborted. Eugenic testing is said to identify over 60% of these infants. [The Telegraph, 21 May, 2006] More than 24 women had abortions after the 20th week of gestation between 1996 and 2004 because of diagnoses that their infants had club feet, extra digits or webbed feet. The statistics were provided by the Office for National Statistics [The Times 29 May, 2006]

Mifepristone accounts for almost one third of abortions
Almost one third of 32,000 abortions had by British women in the first nine weeks of pregnancy were medical abortions induced by mifepristone (RU486). bpas (formerly the British Pregnancy Advisory Service) states that the drug has become increasingly popular. [The Times 29 May, 2006]

18 May, 2006
Indian nurses compelled to assist with abortion
A three day convention with the theme "Called to be His Healing Hands" was held in Bangalore, capital of Karnataka state, India. It was the first convention of Catholic nurses in the country, and was attended by about 1,200. Participants reported that nurses are being forced to participate in abortions and that some who have refused have been forced to resign. (Spero News)

17 May, 2006
Catholic Medical Association challenges use of vaccines derived from abortions
Citing a Vatican document on the subject, the Catholic Medical Association in the United States noted that several vaccines are morally objectionable because they originated in tissue obtained in voluntary abortions. The organization made specific reference to vaccines for rubella(Meruvax), and Hepatitis A, (VAQTA, HAVRIX). The CMA stated that it is unethical to prepare, distribute, or market such vaccines; their use is a more complex matter. Conscientious objection to such vaccines can occur among patients as well as health care workers.

12 May, 2006
Colombian court permits abortion
The Constitutional Court in Columbia has ruled that a complete ban on abortion is "irrational" and has allowed abortion in the case of rape or incest. The decision was criticized by a spokesman for the Bishops’ Conference of Colombia, who said that the punishment for rape or incest should be imposed on the criminal responsible. The Archbishop of Bogotá reminded Catholics that Catholics who procure or facilitate abortions are automatically excommunicated, and it has been reported that civil disobedience has been suggested. The case was intitated by Monica Roa of the UN funded Women’s Link Worldwide (WLW), which intends to use the courts to force legalization of abortion in countries where democratic means are unsuccessful. The controversy following the ruling indicates that it is likely to lead to conflicts of conscience if health care workers are expected to implement it. [Catholic World News, 12 May, 2006]

Kenyan bishops oppose IVF
In a statement that illustrates the potential for conflicts of conscience among health care workers, the Kenyan Catholic bishops' conference has condemned in vitro fertilization, as well as genetic screening, as morally unacceptable. [Catholic World News, 12 May, 2006]

Lord Joffe's assisted suicide bill defeated
The House of Lords in the United Kingdom rejected Lord Joffe's Assisted Dying for the Terminally Ill bill by a vote of 148 to 100, though 500 peers did not vote. Opposition to the bill was manifested in a petition with 100,000 names. Lord Joffe will bring the bill forward again in the next parliamentary session. The measure was opposed by the Royal College of Nursing; 73% of members of the Royal College of Physicians were reported to be opposed to both physician assisted suicide and euthanasia. Similarly, more than 70% of nearly 200 members of the British Association of Oral andMaxillofacial Surgeons were against the bill [NewsWales, 10 May, 2006] .The Anglican Archbishop of Canterbury, the Catholic Cardinal Archbishop of Westminster and the Chief Rabbi of the Commonwealth jointly spoke against the bill. [The Times, 12 May, 2006] Opposition to the bill was dismissed by Polly Toynbee of the Guardian newspaper as "a cabal of bishops, rabbis, imams, Catholics, evangelicals and other believers" [Guardian, 12 May, 2006].

Health care denied on grounds of political activism
74 year old Ted Atkinson of Norfolk, England, was jailed for 28 days after he persisted in sending images of aborted babies to Elizabeth Hospital, King's Lynn, despite a warning to stop. He received an additional 14 day sentence for failing to pay a £650 fine received for a similar offence in 2002; £500 will be deducted from his pension for court costs. The images were described as "malicious communications." Hospital staff, including the chief executive, who received photos of aborted children and a video of a child being aborted, were reported to have been “quite disturbed" by them; Atkinson agreed that the material was "horrendous, monstrous and sickening," but pointed out that it accurately reflected reality. Atkinson was, at one time, dismissed as a hospital porter when he refused to take a woman to a location where she was to have an abortion [Eastern Daily Press, 12 May] [The Times, 12 May].

In addition to the criminal sanctions, the hospital has removed Atkinson from a wait-list for hip surgery and has also decided to deny him anything other than life-saving treatment. A spokesman for Elizabeth Hospital, King's Lynn, stated, “We exercised our right to decline treatment for anything other than life-threatening conditions.”

Refusing to treat a patient because of his political activism or criminal convictions is is not an example of conscientious objection. The conduct of the hospital is remarkable in view of the fact that that health care workers who decline to facilitate procedures to which they object for reasons of conscience are often condemned for 'abandonment.'

10 May, 2006
Eugenic screening expands in UK
Britain's Human Fertilisation and Embryology Authority has agreed to permit eugenic screening of embyros conceived in vitro for dispositions toward cancer of the breast, ovaries and colon, but declined to allow screening for asthma, eczema or schizophrenia. [BBC, 10 May] [Times, 10 May] Both decisions illustrate the underlying dynamic that tends toward expansion of the service and increased likelihood of conflicts with beliefs of health care providers.

9 May. 2006
Euthanasia in Spain
Spanish police are investigating the death of 53 year old Jorge Leon Escudero, a quadrapalegic for six years who needed a ventilator to breathe. He was found dead, with his ventilator disconnected, and had apparently been given a sedative. Escudero had been seeking help to commit suicide. Although the Spanish government is opposed to legalizing euthanasia, some doctors' groups in the country have advocated legalization, and the United Left party plans to introduce a motion to 'clarify' the law [Guardian, 9 May, 2006].

Production of chimeras
The combination of human and animal genetic materials to produce hybrids continues to excite interest and opposition, as evidenced by an article in the May, 2006 number of Nature Biotechnology. Britain's Ian Wilmut continues to use a technique developed in China in 2003 to produce human-rabbit blastocysts, and Harvard researcher Douglas Melton will use it to study diabetes and Parkinson's and Alzheimer's diseases. According to the article, most scientists do not expect that neural stem cell transplants would give rise to human consciousness in animals. Opposition to the production of chimeras is countered by statements like those of a panel of ethicists convened in 2005 at John Hopkins, who asserted that it is impossible to determine what is natural and unnatural.

8 May. 2006
Another British suicide in Switzerland
Mrs Valerie Sliwinski, of Essex, who had cancer and multiple sclerosis, committed suicide at a Dignitas facility in Switzerland. Her son, who travelled with her, has been charged in Britain for assisting suicide. [Mirror, 8 May, 2006] The incident is part of a general controversy in the United Kingdom concerning the legalization of assisted suicide and euthanasia.

6 May, 2006
Amnesty International moving against freedom of conscience
In a reversal of its longstanding tradition of advocacy for those persecuted for the exercise of freedom of conscience, Amnesty International is reported to have drafted a "Policy statement on Sexual and Reproductive Rights" that includes an attack on conscientious objectors in health care. The organization is seeking comments from its members by 20 May, 2006, and will deal with the issue in 2007 at the Amnesty International 2007 International Council Meeting. The draft is reported to include the demand that governments "must refrain from denying or limiting equal access to sexual and reproductive health services" and "act with due diligence to punish abuses of sexual and reproductive rights by private persons, organizations and other non-state actors." Both statements could be interpreted to justify the active suppression of freedom of conscience by individual health care workers or organizations opposed to abortion. Moreover, the draft is reported to state: "The right of individual health care professionals to object on grounds of conscience to providing certain information and services does not absolve them or the health care system for which they work from taking immediate steps to ensure that the necessary treatment is given without delay." This constitutes a direct attack on freedom of conscience, since it would impose a requirement for referral by conscientious objectors. [AI United Kingdom] [Lifesite re: UK][Lifesite re: NZ]

5 May, 2006
63 year old woman a mother by IVF
Controversy over artificial reproduction erupted in the United Kingdom following an announcement that a 63 year old British psychiatrist has been impregnated using an egg purchased from Russia. The source of the sperm has not been reported, but appears to have been her husband. Critics, including IVF specialist Dr. Mohammed Taranissi and the London Telegraph, have questioned the morality of IVF in such circumstances. The number of IVF pregnancies in the United Kingdom tripled between 1992 and 2002, but the number of IVF births to women between 45 and 49 increased almost sevenfold during the same period (from 15 to 106), while children born to women over 50 increased from 1 to 24 [London Telegraph, 5 May,2006]. Dr. Taranissi's comments demonstrate that there are circumstances in which conflicts of conscience could arise among those working in the field of artificial reproduction.

Washington State Pharmacy Board continues study of conscience clause
After drafting a proposal that would allow pharmacists to refuse to dispense drugs for reasons of conscience if a non-objecting pharmacist is on hand, the Pharmacy Board in Washington state has prepared a second proposal that may provide additional protection for conscientious objectors. The board is expected to consider both proposals at a meeting on 1 June, 2006.

29 April, 2006
Argument about withdrawal of nutrition goes to European Court
Les Burke, of England, who is terminally ill with cerebella ataxia, is going to the European Court of Human Rights to ensure that British doctors following General Medical Council guidelines will not withdraw his nutrition and hydration. A ruling in his favour by the High Court was overturned on appeal, and he was denied leave to appeal to the House of Lords. [BBC News, 29 April]. The case illustrates the argument that freedom of conscience should be protected for health care workers so that patients like Mr. Burke have the opportunity to be cared for by persons who share their convictions.

28 April, 2006
Michigan House approves freedom of conscience measure for insurance companies
A protection of conscience bill approved by the Michigan House of Representatives by a vote of 68-38 will move to the state senate. It will allow health insurance providers and HMO's to decline to provide coverage for services or benefits that contradict their moral or religious beliefs. Planned Parenthood and the American Civil Liberties Union argue that they should be denied freedom of conscience because they are concerned that companies that are not forced to provide coverage for abortion or contraception may be unwilling to do so[ HB4745 & HB4746] [News release].

26 April, 2006
Woman continues action to deny freedom of conscience
The California Supreme Court will hear a civil suit brought against two Christian doctors by a lesbian claming that she had been discriminated against because they refused to artificially inseminate her. The physicians argued that their decision was based upon the fact that she was not married, not upon her sexual preferences. Moreover, they had referred her to a fertility specialist and had agreed to provide all of the pre- and post-natal care as well as absorb any of the costs incurred by the patient as a result of the referral. A lower court had held that the physicians could defend themselves on the basis of their religious convictions [Benitez v. North Coast Women's Care Medical Group].

UK nurses support 'harm reduction' by facilitating self-mutilation
Citing the precedent of 'harm reduction' by providing syringes to drug addicts, some members of the Royal College of Nursing are advocating that patients who mutilate themselves by burning or cutting be allowed to keep their 'tools' with them in hospital. They claim that this helps patients deal with mental trauma and actually reduces suicidal ideation. St. George’s mental health hospital in Staffordshire provided cleaning equipment for blades and similar 'tools' in a pilot project, and has suggested that this should be included in a patient care plan. [BBC]It is likely that the practice would give rise to conflicts of conscience among nurses expected to implement such plans.

UK nurses opposed to assisted suicide
The Royal College of Nursing states that input from its 380,000 members, including a survey of 1,000 and consultation with 50,000, indicates that 70% of its members support its opposition to Lord Joffe's assisted suicide bill. [Medical News Today, 30 April, Dignity in Dying, 23 April] This indicates that legalization of assisted suicide or euthanasia without adequate protection of conscience measures would likely cause problems for many nurses.

22 April, 2006
Washington State pharmacy board drafting policy on conscientious objection
It is not clear whether or not a policy now being drafted by the Washington State pharmacy board will tolerate full freedom of conscience among pharmacists. The Washington State Pharmacy Association had proposed a policy that would have protected conscientious objectors in the profession, but the governor of the state, Planned Parenthood and other advocates of "choice" were opposed to allowing pharmacists any choice on moral issues. The most recent draft of the rule is reported to allow conscientious objection only if another pharmacist is available to fill the prescription.[Olympian]

12 April, 2006
Hawaiian legislators enact ambiguous “rights" law
The governor of Hawaii will be presented by a bill (HB 1242) passed by the legislature that describes "the right to reproductive choice" as "a fundamental right under the Hawaii constitution" while retaining the protection of conscience clause in the statute. There appears to be a contradiction involved in describing "reproductive choice" as a "fundamental right" while permitting conscientious objection to participation in morally controversial procedures related to the the exercise of that 'right'.

11 April, 2006
Catholic Church contests Guatemalan law
Rodolfo Cardinal Quezada Toruño, the Catholic archbishop of Guatemala City, announced that the Catholic Church is going to the High Court to contest legislation now in the Guatemalan Constitutional Court. "This law is manifestly unconstitutional because it does not respect the human embryo, it does not respect the right of parents to teach their kids about sexuality and it even forces private Catholic schools to teach things that go against their consciences." [EWTN] The announcement is indicative of the potential posed by the legislation for conflicts of conscience among health care workers in the country.

7 April, 2006
Flemish Socialist Party proposes euthanasia for children
The Flemish Socialist party, a member of Belgium’s coalition government, now seeks to extend the provision of euthanasia to children and adolescents. Currently, one must be over 18 to qualify for euthanasia. The Netherlands has already moved to permit euthanasia of babies and children under 12 years old. The legalization of euthanasia was accomplished without the general support of the Belgian medical community, but it has led to demands for mandatory referral for euthanasia by objecting physicians, and to a redefinition of palliative care as part of a continuum of care including euthanasia. [Belgium: Redefining Palliative Care and Forcing Physicians to Refer for Euthanasia]

Morning-after pill to be dispensed to 12 year olds without parental knowledge
The morning after pill will be provided by pharmacists in the United Kingdom free to girls as young as 12 years old without parental knowledge. The programme will be implemented in any region where local health officials believe that there is a problem with under-age pregnancies. [Daily Mail, 7 April] A few pharmacists in the United Kingdom have refused to dispense the drug for reasons of conscience. Providing the drug to a 12 year old may be more than some other pharmacists are willing to do, for the same reason.

4 April, 2006
Spanish cloning legislation condemned
Legislation that would allow in vitro fertilization and human cloning has been condemned by the Spanish Catholic Bishops' Conference [Life Site, 4 April]. The statement illustrates the potential for conflicts of conscience among health care workers who may be asked to facilitate the procedures.

3 April, 2006
Conscientious objection raised at Ethics 2006 Conference - British Columbia
One attendee at the annual ethics conference sponsored by the BC College of Physicians and Surgeons has reported very favourably on the conference. The focus of the second day of the conference was the importance of professional integrity. During the panel topic, "Can a Few Individuals Change the World" a woman in the audience asked a question to the following effect: " In view of the fact that you are all speaking about the importance of personal integrity, taking into account that the medical establishment tends to take on the values and the ideologies that are most popular in a given society so that it tends to propagate the performance of certain procedures as being medical procedures when in fact they are more about women's rights- and I am referring specifically to abortion - how do you view those colleagues of yours who are dissidents? Are they being accepted into the medical community as they should be?"

The response, from George Webster, referred to the need to learn how to dialogue with those who do not hold one's views. Pharmacist Cristina Alarcon then stated that she was a dissident pharmacist who will not dispense the morning after pill, and that a year before she had put a problem to Professor Emund Pellegrino. She told him that the BC College of Pharmacists propagates the notion that it is a virtue to efface oneself to the extent of forgetting about one's own values and principles, so as to do whatever the client wants [2001-01: College of Pharmacists of British Columbia: Conduct of the Ethics Advisory Committee]. Pellegrino responded that it is not a question of putting the rights of a client up against the rights of the professional, but rather it is a question of living with integrity and being a coherent person, because the client can always choose freely where to go.

2 April, 2006
Protest march in Bogota, Colombia, demonstrates potential for conflicts of conscience
A case before the Constitutional Court in Colombia that could lead to legalization of abortion in the country generated a protest by over 100,000 people who took to the streets in a peaceful march in Bogota. The protest indicates the likelihood that legalization of the procedure will cause conflicts of conscience among health care workers unless adequate provision is made for conscientious objection.