April-June, 2007
June
A submission by the Catholic bishops of England and Wales illustrates the
potential for conflicts of conscience arising from artificial reproductive
technology. Although opposed to the creation of human-animal hybrid embryos
in the laboratory, the bishops recommend that, if chimeras are conceived,
they should be considered human and their genetic mothers should be able to
raise them as their own children. [Daily Telegraph 27 June]
South African (Nursing) Sister Wilhelmien Charles will go to the Commission
for Conciliation, Mediation and Arbitration with her case against a hospital
that began in 2004. She had been compelled to participate in abortions,
contrary to her religious convictions, and later denied reinstatement on
return from maternity leave. [See
South African nurse denied position]
The control of St. Elizabeth's Hospital in Humboldt, Saskatchewan, is being
transferred from the province's Catholic Health Corporation to thhe
Saskatoon Health Region, and will be re-named the Humboldt District
Hospital. Transfer of control to state authorities followed a controversy
over the hospital's decision to stop tubal ligations because the procedures
are contrary to Catholic teaching. The Health Minister decided to take
control of the hospital into public hands as a result of public controversy,
including the resignation of two physicians over the policy. [Star
Phoenix]
A ruling by the European Court of Human Rights granting a "wrongful birth"
claim will be appealed by the Polish government. Poland was ordered to
pay€25,000.00 tp a 34 year old mother who was unable to abort her third
child. A spokesman for the SPUC of Northern Ireland asserts that the court
ruling held that the woman's rights were violated by the conscientious
objection of the doctors involved.
A bill proposed by the majority Democratic Revolution Party in Mexico would
allow terminally ill patients or a family member to reject medical care that
would prolong life. If this is meant to include the rejection of nutrition
and hydration, and not just the rejection of unduly burdensome or useless
treatment, it would cause conflicts of conscience among health care workers
opposed to euthanasia. Norberto Cardinal Rivera Carrera has spoken out
against the bill. [Zenit 19 June, 2007]
The New Jersey have passed bill
S1195
to compel pharmacies to dispense and refer for drugs despite conscientious
objections by pharmacists. The bill does not apply to individual
pharmacists, so it is still possible, at least in theory, for a pharmacy
owner or manager to accommodate conscientious objectors in a practice.
However, the bill denies freedom of conscience to pharmacy owners, who may
be forced to act against their conscientious convictions.
A woman who had to wait 15 minutes for another pharmacist has complained
publicly about being refused the morning-after pill by a Muslim pharmacist
who objected to the drug for moral or religious reasons. Store officials s.
A spokesman for Sainsbury's confirmed that pharmacists had the right to
refuse to sell morning-after pills for moral or religious reasons. [Evening
Post, Nottingham, 9 June]
May
An amendment to Oregon's
insurance code requires employers to provide coverage for contraceptives
in insurance plans. There is an exemption for religious employers, though
the term is defined to include only employers whose primary purpose is
the inculcation of religious values, whose employees are primarily
persons who share the employer's faith, that primarily serve persons who
share the employer's faith, and that is a non-profit organization. Thus, the
protection is not broad enough to encompass Catholic hospitals, which employ
and serve people who are not Catholic.
Emilio Gonzales, a 19 month old boy, has died at Children's Hospital in
Austin, Texas. [See
Temporary restraining order granted for child]
In a survey of 309 general practitioners in the United Kingdom, 42% of
the respondents reported that they would "help a patient die" if it were
legal to do so, and 30% supported legalization of assisted suicide. The
wording of the questions, not specified in the news report, may have been
ambiguous with respect to the terms used. It does not appear that any
questions were asked about freedom of conscience for health care workers
faced with such a demand. [Pulse]
The case of a Quebec man who hanged himself with the assistance of his
nephew has led to renewed calls for legalization of assisted suicide or
euthanasia in Canada. Yvon Bureau, an advocate of legalization, asserts that
assisted suicide "must be medical, practised in a strict, secure framework."
His expectation of professional medical assistance does not take into
account the fact that not all health care personnel will be willing to
participate in the procedure. [Canadian
Press]
The Governor of Connecticut has signed Senate Bill 1353. It now becomes
Public Law 07-24. The bill requires that all hospitals in the state
dispense the morning after pill to a rape complainant once a pregnancy test
has established that she is not pregnant. However, the bill specifies that
the only acceptable pregnancy test is on that has been "approved by the
United States Food and Drug Administration." This presents a problem for
Catholic hospitals that may use other tests to determine that an embryo has
not been conceived. [See
Controversy
among Catholics over morning-after pill ]
Over 10,000 signatures have been collected on a petition for freedom of
conscience in Belarus. The movement appears to involve many religious
believers in the country. [Charter
97]
In response to a directive it conform to Catholic teaching on
contraception, abortion and artificial reproduction [see
Catholic hospital in Britain ordered to stop abortion referrals,
contraceptive practices and IVF] medical staff at the Hospital of St.
John and St. Elizabeth in North London, are reported to be opposed to the
introduction of a code of ethics consistent with Catholic teaching. A
spokesman for the staff has said that they expect a secular code of ethics
will be adopted instead, and that the Cormac Cardinal Murphy-O'Connor will
resign as hospital patron. Dr Martin Scurr, the chairman of the hospital's
ethics committee, has said that the hospital will become a non-Catholic
institution. [The
Telegraph]
An association of abortion providers based in Washington, DC, that has
members in Canada, has written to the Canadian Medical Association to
protest the CMA policy on referral. The National Abortion Federation claims
that the CMA Code of Ethics requires physicians to refer for abortion, and
that the current CMA policy (which does not require referral) contradicts
the Code [NAF
news release] The Federation's accusation was rejected by the CMA. [Doctors
asked to change national abortion policy]
A number of physicians interviewed by the Cambridge Evening News
expressed support for colleagues who do not wish to facilitate abortion. It
appears that there is some difference of opinion about whether or not an
objecting physician should refer a patient to another doctor. [Cambridge
Evening News] [See
Quarter
of British physicians reported to refuse part in abortion]
The Executive Director of the CMA's Office of Ethics has stated that the
authors of a guest
editorial in the Canadian Medical Association Journal were incorrect in
stating that physicians who object to abortion are obliged to refer patients
to a colleague with a different view. Dr. Jeff Blackmer commented that the
subject continues to be debated "within medicine and bioethics". [CMA
Bulletin]
The number of British citizens travelling to Switzerland each year for
assisted suicide more than doubled from January, 2006. A total of 76 Britons
have committed suicide there. The statistics are being cited as proof of the
need to legalize euthanasia or assisted suicide in the United Kingdom. [This
is London]
A British doctor who has obtained permission to screen embryos to
prevent the birth of a child with a severe squint has said that he would be
willing to screen embryos for other cosmetic reasons, including hair colour,
if the birth of the child with the unwanted condition would cause the family
distress. [The
Telegraph]
Pharmacist Neil Noesen, who objects to dispensing contraceptives and the
morning-after pill, has lost a suit he brought against Wal-Mart. He argued
that he should be relieved of all counter and telephone duties unless
customers were pre-screened to ensure that they were not seeking birth
control. The Wisconsin 7th Circuit Court of Appeals ruled that the
accommodation Noesen was seeking would cause undue hardship to the company.
The company had offered to allow Noesen to assist only male customers and
women not of childbearing age but insisted that he follow pharmacy
guidelines in answering the phone and waiting on customers.
An writer in Canada's National Post has acknowledged that politicians
and the media will ignore the annual pro-life demonstration on Parliament
Hill in Ottawa, but that, despite official silence, "there is considerable
evidence of confusion, passion and an intensity of opinions" on the subject.
The article referred to the controversy caused by a
guest editorial
in the Canadian Medical Association Journal in July, 2006, in which two law
professors asserted that objecting physicians are obliged to refer for
abortion. The Post reports that the CMAJ received hundreds of letters
on the subject. The Journal's editor-in-chief admitted that abortion is "a
very polarizing issue among physicians," while the CMA Director of Ethics
observed that letters represented "extremes of opinion," but not "fringe"
opinion. [See
Responses to "Abortion: Ensuring Access" ] The Post writer
expressed surprise "that such an open and free-flowing discussion on this
topic is happening at all", noting that such open debate is unusual in
Canada. What is of particular interest is that the Post writer recognized
that the two law professors had misstated the Canadian Medical Association's
position. Contrary to the professors' claims, the CMA does not require
objecting physicians to refer for abortion. [National
Post]
Disagreement about dispensing the morning-after pill to rape
complainants has arisen in Catholic circles. The president-elect of the
Catholic Medical Association, Dr. Kathleen Raviele, is quoted by
LifeSiteNews as stating that dispensing the morning-after pill to rape
complainants "is not justified" in Catholic hospitals. Dr. Raviele, notes,
"The Catholic Medical Association passed a resolution at its annual meeting
in 2003 opposing the use of EC after cases of rape because, even if given
prior to ovulation, the drug inhibits ovulation only 50% of the time. Its
main effect is to alter the endometrium, preventing successful
implantation." A
statement issued in 2000 by the Vatican's Pontifical Academy for Life
appears to take a similar position.
Under an inflammatory headline ("Bishops
Conferences Admit to Approving Abortifacient Drugs for Rape at Catholic
Hospitals") LifeSiteNews notes that the Connecticut and
Wisconsin Catholic Conferences have acknowledged that the drug is dispensed
to rape victims at Catholic hospitals in those states. However, the report
fails to note that the Conferences clearly stated their opposition to the
use of the drug when it is likely to result in the death of an embryo, and
its selective quotation of the Connecticut Conference letter is similarly
misleading with respect to the conditions under which the bishops would
approve the bill being discussed. [Connecticut
Conference Letter] [Wisconsin
testimony] While it is agreed that the potentially embryocidal drug may
be dispensed if tests establish that conception has not occurred, there is
disagreement about what kind of test would establish this with sufficient
moral certitude. Dr. Daniel P. Sulmasy, a noted American Catholic ethicist,
has published a paper that can be cited to support the position taken by the
bishops of Wisconsin and Connecticut. [Emergency
contraception for women who have been raped: must Catholics test for
ovulation, or is testing for pregnancy morally sufficient?]
Pulse, a newspaper for British physicians, has reported that a survey of
more than 300 general practitioners found that about one quarter of them
refuse to sign abortion "referral" forms, and about 20% thought abortion
should not be legal. One physician was reported to have
quit his practice over the issue. It appears that the reference to
referral concerns the signing of papers required by law from two physicians
before abortion can be provided, rather than referral to another physician
for treatment.
The accuracy of the survey was questioned by Ann Furedi, chief executive
of the British Pregnancy Advisory Service, who noted that respondents
comprised less than 1% of 40,000 general practitioners in the United
Kingdom. [The
Guardian] However, the survey's results seem consistent with a
government audit reported in 2003 that found one in four practices included
a conscientious objector to abortion, and one in ten practices would not
"refer" for abortion. [Pulse]
Again, the reference to referral appears to mean the signing of papers
authorizing the procedure.
Abortion supporters within the profession, responding to the survey,
demanded that objecting physicians refer patients to willing colleagues. [Pulse]
The head of the Royal College of General Practioner's teenage health
taskforce, said that conscientious objection to abortion should never have
been allowed. [The
Guardian] One columnist demanded that objectors be struck off the
medical register. [Strike
off no abortion GPs]
The demands conflict with the findings of the
Twelfth Report of a joint parliamentary committee on human rights.
Considering the issue of mandatory referral for euthanasia, the committee
wrote, "We consider that imposing such a duty on a physician who invokes the
right to conscientiously object is an interference with that physician's
right to freedom of conscience under the first sentence of Article 9(1),
because it requires the physician to participate in a process to which he or
she has a conscientious objection. That right is absolute: interferences
with it are not capable of justification under Article 9(2)." [See
Conscientious Objection]
Dr Tammie Downes, a general practitioner in West Cornwall, won't
facilitate abortion by signing papers, but considers it her duty to provide
women seeking abortions information and advice. She "won't stand in a
woman's way" if she wants an abortion, but has found that a number of them
change their minds during discussion, saying that eight of her patients
continued their pregnancies and don't regret their decisions. [Daily
Mail]
April
AB298 , a
copy of the earlier
Senate Bill 151
, has been introduced in the Wisconsin legislature. It would allow for
terminally ill competent patients in Wisconsin who are at least18 years old
to request and obtain prescriptions for medication to end their lives. The
bill does not include protection of conscience provisions for pharmacists or
other health care workers. On the contrary: a physician unwilling to fulfill
the request is required to initiate transfer the patient to a willing
colleague. Many objectors would take issue with a requirement to initiate
the transfer process, which goes beyond simply responding when another
physician to whom care has been transferred by the patient requests the
file. (See
Assisted suicide bills require objectors to facilitate assisted suicide)
Responding to the legalization of abortion in Mexico City, the Catholic
Primate of Mexico, Cardinal Norberto Rivera Carrera, has called upon health
care workers to exercise their right to conscientious objection and refuse
to participate in the procedure. The statement, which was read at masses on
Sunday, appears to have been a response to assertions by city hospital
authorities to the effect that doctors had no choice but to perform
abortions. [Associated
Press] The Interior Ministry has started legal proceedings against the
Catholic Church for violating the Law of Religious Associations and Public
Worship.
A Jesuit priest and author of Torture, Religious Ethics and National
Security has made comments relevant to the issue of referral for morally
controversial procedures. His comments following publication of allegations
by the Globe and Mail that prisoners captured by Canadian troops and
turned over to Afghan authorities are being "beaten, starved and otherwise
mistreated." Father John Perry, a professor at St. Paul's College at the
University of Manitoba stated that Canadian soldiers and the Canadian
government "are complicit and morally compromised" if they turn prisoners
over to Afghan authorities "knowing they face torture." [CCN]
A
study conducted in hospitals in West Midlands, England has found that
about one in 30 babies aborted between 20 and 24 weeks gestation survived
the procedure and live an average of 80 minutes. [Daily
Mail] The Royal College of Obstetricians and Gynaecologists
responded with a
statement that recommends "foeticide" by the lethal injection of the
foetus in utero, The statement notes that even this is not 100%
effective and advocates palliative care for abortion survivors. The same
solution was proposed by the Alberta College of Physicians when conflicts of
conscience among nursing staff at Foothills Hospital in Calgary made
headlines in Canada. [Foothills
Hospital Now Forces Nurses To Participate In Genetic Terminations]
Maria T. Sulewski of Sandusky, Ohio, has filed a lawsuit against the Erie
County General Health District on the grounds that she was reassigned due to
her objections to doing a school presentation ''supporting birth control,
safe sex or related matters.'' Sulewski refused to do the presentation
because it conflicted with her Catholic beliefs. The Health District claims
that the reassignment was a form of accommodation. The reassignment included
a reduction in working hours, an increase in the number of schools to be
covered, and an increase from four to five working days each week.[Morning
Journal]
SB151 would
allow for terminally ill competent patients in Wisconsin who are at least18
years old to request and obtain prescriptions for medication to end their
lives. The bill does not include protection of conscience provisions for
pharmacists or other health care workers. On the contrary: a physician
unwilling to fulfill the request is required to initiate a transfer the
patient to a willing colleague. Many objectors would take issue with a
requirement to initiate the transfer process, which goes beyond simply
responding when another physician to whom care has been transferred by the
patient requests the file. (See
Assisted suicide bills require objectors to facilitate assisted suicide)
In the face of a new law in Portugal legalizing abortion up to the the 10th
week of pregnancy, the country's Catholic bishops have spoken against the
change in the law and asserted their support for medical professionals who,
for reasons of conscience, refuse to become involved with the procedure. [Catholic
News Agency]
The head of the Royal College of General Practitioners and a representative
of the Medical Ethics Alliance, a British pro-life group, agree that
physicians should make their views on abortion known to their patients, thus
enabling them to find a doctor whose views are consistent with their own. [Society
Guardian]
Belgium's ruling party, the Vlaamse Liberalen en Democraten (Flemish Liberal
Democrats or Open VLD) has announced that it intends to force every hospital
in the country to provide euthanasia or to refer patients to facilities that
will do so. The party accepts conscientious objection by physicians as long
as they are willing to refer patients to more willing colleagues. [Expatica]
[Belgium:
mandatory referral for euthanasia (December, 2003)]
The Maputo
Protocol, which has been ratified by only 15 of the 53 member-states of
the African Union, appears to have been treated as the norm for the
continent by health ministers from 40 African countries who met in
Johannesburg in the week following Easter Sunday. Article 14 of the Protocol
calls for the provision of abortion in cases of "sexual assault, rape,
incest,
and where the continued pregnancy endangers the mental and physical health
of the mother or the life of the mother or the foetus." The health ministers
approved a
strategy including 'safe abortion services. . . as far as the law
allows." Nigeria and Uganda oppose abortion, which is widely rejected by
traditional African culture. [No
Place for Abortion in African Traditional Life - Some Reflections (2002)]
The Hospital of St. John and St. Elizabeth in North London, which has a
reputation for serving celebrity patients, has been ordered by Cormac
Cardinal Murphy-O'Connor to stop practices inconsistent with Catholic
teaching. Bishop George Stack of Westminster has joined the ethics committee
and will ensure that Catholic teaching is maintained by the facility. A new
code of ethics, expected to come into effect in May, will prohibit in
vitro fertilization, distribution of contraceptives and referrals for
abortion. [Daily
Mail] That a nominally Catholic institution would have been involved
in services that contradict Catholic teaching demonstrates the potential for
conflicts among staff, some of whom may have sought employment at a Catholic
institution in the expectation that they would not have to deal with such
procedures.
The Royal College of Obstetricians and Gynaecologists has identified what it
calls a "slow but growing problem": young doctors refusing to facilitate
abortion. At the same time, it acknowledged that " it is an important right
for any doctor to object to performing abortion."[RCOG
Statement] The statement was issued in response to an article in The
Independent that stated that the RCOG had warned that an unprecedented
number of conscientious objectors "threatens to plunge the abortion service
into chaos." [The
Independent: Abortion Crisis] It appears that the reporter's
claim was based upon statements made by two specialists associated with the
College and did not reflect the RCOG's position. The British Pregnancy
Advisory Service stated that it was unaware of any documented rise in
conscientious objection, and the Department of Health did not believe that
conscientious objection by a minority of physicians is reducing access to
the procedure. [The
Guardian: Intolerant Doctors] [Daily
Mail: No Handshakes] [Daily
Mail; MoreYoung Doctors Oppose Abortions]
A probate judge in Texas has ordered the Children's Hospital of Austin,
Texas, to continue life support for a child, Emilio Gonzales, pending a
court hearing set for 19 April, 2007. The hospital ethics committee had
ordered that life support be ended, judging it to be a cause of suffering
without providing a medical benefit. The boy is believed to have Leigh's
Disease and requires assisted ventilation, nutrition and hydration. [The
Guardian] The case illustrates the potential for conflicts of
conscience among health care workers in such a situation.
The
Washington State Board of Pharmacy has approved rules (WAC
246-869-010) that require pharmacies to dispense all legal medications
that are in stock, deliberately excluding any protection of conscience
measures. It appears that
WAC
246-869-150 could be interpreted to require all pharmacies to stock and
dispense contraceptives and the morning-after pill, since it states that a
pharmacy "must maintain at all times a representative assortment of drugs in
order to meet the pharmaceutical needs of its patients." However, if a
pharmacy were to advertise itself as a business that does not dispense
contraceptives or the morning-after pill, it could be argued that people
seeking such products could not reasonably be counted as being among that
pharmacy's patients. In that case, it might be argued that the drugs do not
have to be stocked. The new rules require that the prescription for such
products be returned to a patient or transferred elsewhere at the patient's
request. The latter would be necessary if the prescription were transmitted
electronically and not in the patient's possession to begin with. Such an
interpretation would allow some room for the exercise of freedom of
conscience.
Planned Parenthood has announced that Wal-Mart has adopted a policy that
will compel objecting pharmacists to dispense the morning-after pill.
[LifeSiteNews.com]
An article in the National Catholic Bioethics Quarterly alleges that a
network of academics, NGOs and supporters in the UN human rights system are
attempting to establish that a right to abortion is part of international
human rights law. Such a ruling would probably eliminate all legal
protection for conscientious objectors to abortion in health care. See
Sylva, Douglas and Yoshihara, Susan (Catholic Family and Human Rights
Institute, New York and Washington, DC)
"Rights by Stealth: The Role of UN Human Rights Treaty Bodies in the
Campaign for an International Right to Abortion." National Catholic
Bioethics Quarterly, Vol. 7, No. 1, Spring, 2007, p. 97-128. [See also
Concluding observations of the Human Rights Committee: Poland. (UN,
Geneva,Switzerland: November, 2004);
United Nations, US officials acting oppressively in East Timor (East
Timor) (2000);United
Nations Committee: Conscientious Objection "an infringement of. . . rights";
]
Doctors who are being sued because they refused to artificially inseminate a
lesbian are being supported by the Thomas More Law Center of Ann Arbor,
Michigan. The Center has filed an amicus brief because it is concerned that
the plaintiff's suit is "a mean-spirited effort to extract a pound of flesh"
from physicians who, from religious conviction, "refuse to bow to the
homosexual agenda." Richard Thompson, President and Chief Counsel for the
Thomas More Law Center, states, "Forcing doctors to violate their conscience
smacks of Nazi Germany. Doctors are not 'needles for hire.'" [News
release]
The United States Department of Justice has announced the
First Freedom
Project, designed to strengthen enforcement of laws against religious
discrimination and hate crimes, and other laws protecting religious freedom.
A married couple in London, England, will have embryos conceived by in
vitro fertilization screened for genes that are believed to predispose
people to Alzheimer's Disease. The procedure raises ethical questions both
with respect to the selection of "fit" embryos and the destruction others.
The couple's doctor dismisses critics of the production of "designer babies"
as "silly." [Sunday Times, 1 April]
Expert evidence from primatologists like Jane Goodall, and Professor Volker
Sommer of University College London will be introduced in an Austrian court
in an attempt to have human rights extended to a 26 year old chimpanzee.
Sommer holds that "there are no clear-cut criteria - neither biological, nor
mental, nor social." to distinguish human beings from chimpanzees. [The
Observer]