April-June, 2008
June
An 11 year old girl said to have been the victim of a rape by a 19 year
old has been flown to Britain for an abortion in her 21st week of pregnancy.
Romanian law permits abortion only up to the 14th week of pregnancy, and
only when the mother's life is endanger or in cases of fetal deformity. One
Romanian medical panel had approved the procedure, but the second rejected
it because there were no medical grounds for it, and the law did not provide
for it. A spokesman for the Orthodox Church in Romania expressed support for
the family's decision to send the girl to the United Kingdom for an abortion
on the grounds that it was an "exceptional case". The situation is reported
to have "divided the country"[The
Telegraph] and illustrates the potential for conflicts of conscience
among health care workers in such circumstances.
84-year-old Samuel Golubchuck has died of natural causes in hospital. He
was at the centre of a civil suit between the family and Winnipeg Grace
Hospital, which had attempted to remove nutrition, hydration and a
ventilator against their wishes. One physician had taken over his care,
supported by two colleagues also willing to care for him. They replaced
three physicians who had quit the intensive care unit rather than continue
to provide care for Golubchuk [See
Doctors refuse shifts at hospital to avoid care for elderly patient].
The physicians who withdrew were supported by the Manitoba College of
Physicians and Surgeons, and by Arthur Schafer, an ethicist at the
University of Manitoba. Schafer said that they acted correctly in following
their consciences [CBC].
Schafer's position is of interest because he has, at other times, spoken
against freedom of conscience for health care workers [See reference in
Project Letter
to the Editor (Edmonton Sun)]
Bloc Quebecois MP Francine Lalonde has introduced private member's
Bill C562 in the House of Commons, which would legalize euthanasia in
Canada. The bill has no provision to protect health care workers who would
refuse to facilitate euthanasia for reasons of conscience.
Two doctors have withdrawn their critical care services at Grace Hospital
in Winnipeg because they disagree with the court order that 84 year
old Samuel Golubchuk must continue to receive assisted ventilation,
nutrition and hydration pending the outcome of a trial that scheduled for
September. The injunction was obtained by Golubchuck's family to prevent the
hospital from disconnecting his respirator and cutting off assisted
nutrition and hydration. Dr. Anand Kumar had previously withdrawn his
services because he considered the court order "in violation of my medical
ethics," that the services provided in accordance with it conferred no
medical benefit, and are actually harmful because they are uncomfortable and
painful. The most recent withdrawals of service appear to go beyond the
parameters of conscientious objection, since they are not limited to
treatment or care of Mr. Golubchuk but also potentially affect the services
available to other patients in the intensive care unit. The lawyer for the
Golubchuk family has accused the doctors of attempting to "stigmatize the
family for their insistence on keeping the man alive." Alex Schadenberg,
Executive Director of the Euthanasia Prevention Coalition, suggests that the
withdrawal of services is an attempt to create a crisis "in order for them
to get their way and stop providing treatment." [Globe and Mail, 18 June,
2008] [CBC]
A
statement on abortion released by the Ecuadorian Federation of
Societies of Gynecology and Obstetrics (FESGO) asserts that the procedure
should not be legalized under any circumstances, and that it is always
ethically and medically "unacceptable." The statement illustrates the need
to consider the consequences of legalization of abortion for the medical
profession and the need to include robust legal protection for conscientious
objectors if legalization considered.
The decision to open pharmacies that do not carry contraceptives is being
characterized as "dangerous" by opponents of freedom of conscience in health
care who are unwilling to admit that the United States has room for health
care professionals who do not adhere to establishment ethics in all
respects. The Washington Post reports that the new initiatives are
the result of prosecution, fines and employer pressure on pharmacists who
refuse to dispense drugs like the morning after pill for reasons of
conscience. Some of the new pharmacies also refuse to sell pornography,
tobacco, or rolling papers. [Washington
Post]
The annual meeting of the Board of Trustees of the American Medical
Association is to consider a motion that would endorse the statutory
suppression of freedom of conscience for pharmacists by requiring them to
fill all legal prescriptions or refer immediately refer patients elsewhere
to have the prescriptions filled. [LifeSite News]
Speaking at a conference at the University of Manitoba in Winnipeg,
Jocelyn Downie, the Canada Research Chair of Health Law and Policy asserted
that doctors do not have the legal right to withdraw life-sustaining medical
treatment against a patient's wishes. The comment has been lauded by some as
an unexpected and welcome remark from someone who supports euthanasia and
assisted suicide. However, it is not surprising in view of Downie's belief
that patient autonomy always trumps freedom of conscience for health care
workers. This view led to a controversial joint guest editorial in the
Canadian Medical Association Journal asserting that objecting physicians
are ethically and legally obliged to refer patients for abortion. [See
Responses to "Abortion: Ensuring Access"]
May
Marie Stopes International in Britain has expressed "outrage" that a
Muslim pharmacist at a Sainsbury chemist shop (pharmacy) in Manchester has
been permitted to exercise freedom of conscience. The pharmacist refused to
provide the morning after pill on the grounds that it was contrary to his
religious convictions to provide a drug that could cause the death of an
embryo by preventing implantation. He directed the couple to another
Sainsbury shop where they could obtain the drug. The customer asserted that
if the pharmacist wanted to work according t his religious beliefs he should
find another job. [Manchester Evening News] [See
Man convicted for berating Muslim pharmacist]
During and interview by David Hodges, Margaret Somerville, founding
director, McGill Centre for Medicine, Ethics and Law, affirmed that
physicians have a right to decline to perform certain procedures for
religious or moral reasons. [Medical Post]
Attorney General Edgardo Maya of Columbia has asked the Health Ministry
to investigate San Ignacio Hospital, a Catholic facility that has refused to
do abortions. The hospital is being sued [Catholic
hospital sued to force it to perform eugenic abortion]. Maya is reported
to be dissatisfied that only 40 abortions have been provided in the two
years since the Constitutional Court legalized the procedure in cases of
rape, incest, fetal deformity or threats to a mother's life or health. He is
said to be planning to force even private hospitals to provide the
procedure, despite conscientious objection by health care workers. Woman's
Link Worldwide has also complained that physicians are refusing to perform
the procedure for reasons of conscience.
The Nurses Association of Jamaica has promised the government that it
will engage in "extensive agitation and opposition" if it attempts to
legalize abortion in the country. Strong opposition has already been
expressed by Jamaican religious leaders. The statements illustrate the
potential for conflicts of conscience should legalization proceed, and
demonstrate the importance of protection of conscience legislation.
Mr Thomas Hammarberg, human rights commissioner for the Council of
Europe,
has said that Ireland must introduce legislation for abortion based on the
1992 "X case" and on the 1983 pro-life amendment to the constitution. Mr
Hammarberg wants Irish law changed to allow abortion. He said that if
abortion legislation is not passed, Ireland may face [further] cases in
the European Court of Human Rights which has already ruled against Irish
abortion law in the past. Mr Hammarberg claimed that vulnerable women such
as under-age girls and migrants were suffering "serious consequences."
[Irish Independent, 1 May] Evidence taken by an Irish parliamentary
committee indicates that the majority of physicians in Ireland would refuse
to perform abortions [Conscientious
objection in Ireland]
April
Pharmacist Neil Noesen is appealing a reprimand and limitations on his
license to practise pharmacy imposed by the Wisconsin Pharmacy Examining
Board. The appeal will go to the state Supreme Court following decisions by
a Wisconsin Circuit Court and the Wisconsin Court of Appeals that upheld the
decision of the Board. [Daily
Cardinal]
Iain Benson, executive director of the Canada-based
Centre for Cultural Renewal,
has recommended that Canada follow the lead of South Africa in developing a
charter to ensure respect for freedom of conscience and religion in Canada.
The issue has become particularly important in the country because of the
legal effect given by the Supreme Court of Canada and other superior courts
to Canada's relatively new Charter of Rights and Freedoms (1984), and
because of the broad powers of provincial and federal human rights
commissions to suppress words and/or deeds that the commissions deem
discriminatory, or which they believe may encourage discrimination. Attacks
on freedom of expression and freedom of religion through the human rights
commissions have become increasingly frequent, particularly since court
decisions and the Civil Marriage Act made it possible for persons of
the same sex to legally register marriages to each other. The Supreme Court
of Canada invoked the Charter of Rights when it struck down all
restrictions on abortion in Canada in 1988, and activists are increasingly
citing the Charter and human rights decisions in an attempt to
establish a "right" to abortion and other morally controversial medical
services, and a corresponding obligation on health care professionals to
facilitate such procedures by referral, or to provide them themselves.
After consulting Benson, some South African Christian leaders drew up a
four-page
Charter of Religious Rights and Freedoms, which was later reviewed,
amended and unanimously approved by representatives of 50 different South
African religions. In 'Taking
a Fresh Look at Religion and Public Policy in Canada,' Benson proposes
that something similar should be done in Canada. [Canadian
Christianity]
Maurice Vellacott, a Canadian Member of Parliament, has again introduced
a protection of conscience bill in the Canadian House of Commons.
Bill C-537 replicates earlier bills he had proposed that failed to pass.
A committee of the European parliament has called for compulsory sex
education for young people and unrestricted access to abortion. Ireland,
Malta and Poland were criticized because of legal restrictions on abortion
in those countries. [Times of Malta, 15 April] The removal of restrictions
would have a significant impact on conscientious objectors to the procedure.
The American College of Obstetricians and Gynecologists has issued a
statement to the effect that it will review a demand from its ethics
committee that physicians who object to a procedure for reasons of
conscience must facilitate it by referral or provide it themselves when
referral is not possible. The ethics committee opinion generated strong
opposition [American
College of Obstetricians and Gynecologists attacks freedom of conscience;Pro-Life
OB-GYN association defends freedom of conscience ], and further alarm
was raised when it appeared that the American Board of Obstetrics and
Gynecology would make compliance with the ACOG committee opinion a
requirement for certification [ACOG
attack on freedom of conscience challenged by US Health Secretary].
However, ABOG Executive Director Norman F. Gant, MD denied that abortion
would be an issue in any of its requirements or exams. The report does not
refer to the ABOG position on contraception. News from the ACOG and ABOG
satisfied the American US Health and Human Services Secretary, but was
insufficient to relieve the concerns of Dr. Joe DeCook, vice-president of
the American Assn. of Pro-Life Obstetricians and Gynecologists, nor Gene
Rudd, MD, vice president of the Christian Medical & Dental Associations. [American
Medical News]
A 30 year old man paralysed as a result of an accident is petitioning the
President of India for a cure or for euthanasia. He states that he is no
longer able to support his mother, wife and children. [New Kerala, 9 April,
2008]
A survey by the Human Sciences Research Council reveals that 90% of South
Africans oppose abortion, though it has been legal in the country for 12
years. [IOL, 9 April, 2008] The survey demonstrates the probability of
conflicts of conscience among health care workers in the country.
The health manager for a Pisa public health clinic and hospital will
question two doctors as a result of complaints from two women. One
complained about a notice on the clinic door to the effect that the
morning-after pill was not prescribed there. A second complained that she
was refused the drug by a doctor on an emergency ward. The health manager
claims that dispensing or prescribing the morning after pill "has got
nothing to do with the issue of conscientious objection." A regional
councillor described access to the morning after pill as a "right" that
physicians must respect. Others have defended freedom of conscience for
health care workers. [CNS]
Responding to a request for a royal commission on assisted suicide, the
Scots Minister of Health agreed that a parliamentary committee could study
the issue. [Southern Reporter, 3 April]