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Protection of Conscience Project

Service, not Servitude

Update 2012-05-01

1 May, 2012

Covering the period from 1 March to 30 April, 2012

1.  By Region/Country

Developments relevant to freedom of conscience.

2.  News Items

Links to news summaries.

3.  Recent Postings

Links to resources added to Project site.

4.  Action Items

Support protection of conscience initiatives near you.

5.  Conferences/Papers

Seminars, conferences and workshops relevant to conscience advocacy.

6.  Publications of Interest

Relevant to freedom of conscience issues.

1.  By Region/Country
Visit the Project News/Blog for details.

The Canadian Medical Association Journal has reported that sex selective abortion is being practised in Canada, and accompanied the report with an editorial denouncing the practice.  The report and editorial demonstrate the inconsistency of those in the medical and ethical establishment who criticize health care workers who object to abortion for other reasons and attempt to force them to facilitate the procedure by referral.

European Union

Thomas Hammarberg, Council of Europe Commissioner for Human Rights, has issued a statement supporting the exercise of conscientious objection to military service.  He argues that objectors should be given a "genuinely civilian" alternative to compulsory military service, not imprisoned.

The Parliamentary Assembly of the Council of Europe has passed a resolution that insistst that euthanasia "must always be prohibited." It thus seems less likely that health care workers who object to euthanasia will be pressured to participate in the procedure.  However, the document makes no reference to assisted suicide. 


A panel of 13 'experts' chaired by Mr. Justice Seán Ryan of the High Court of Ireland is to study a European Court of Human Rights ruling on abortion and advise the government what should be done in response.  Four members of the panel have been identified by anti-abortion groups in the country as having previously indicated that they favour legalizing abortion or reducing restrictions on it.  


Sindh, the second largest province in Pakistan, is setting up a Population Council for the purpose of implementing a population control programme.  Among the concerns voiced by supporters of the plan is that most people are reluctant to adopt contraception, and that many medical professionals object to abortion for religious reasons.  The development of a state population control programme with a view to overcoming resistance to contraception and abortion among the population and medical professionals warrants the continuing attention of those concerned to protect freedom of conscience in health care.


The UNESCO Chair in Bioethics at the University of Barcelona told the press that Spain should establish a national registry of physicians who object to abortion.  Registries of sex offenders, parolees, and gun owners are maintained in some jurisdictions.  However, there are strong objections to making citizens who wish to exercise fundamental freedoms register with the government.

Dr. Carmen Rodriguez, the president of  the official physician's association for the region of Asturias in the north of Spain, told a local paper that society can make laws concerning abortion, but cannot force physicians to participate in them.

Dr. Manuel Resa, a physician who has resisted attempts to force him to participate in abortions, has been granted an injunction a Spanish appeal court.  This means that he will not be forced to participate in abortion pending the outcome of his civil suit seeking recognition of his freedom to refuse to facilitate abortion.

The new Spanish government plans to revise the country's abortion law.  It is possible that the changes will include provisions to ensure freedom of conscience for health care workers, something that the previous government attempted to suppress.


A Bill to Enact the Safe Motherhood Law (2012) will be proposed in Tanzania in February for the purpose of enforcing 'rights to access reproductive health care,' a term frequently associated with suppression of freedom of conscience among health care workers.

United Kingdom

A survey published in the British Medical Journal found that more than 10% of British scientists or physicians have witnessed intentional fabrication of data during research, and 6% were aware that research misconduct had not been properly investigated.  The results suggest that conflicts of conscience might arise among those expected to collaborate in such fabrications, or to cover them up. 

Ethicist Anna Smajdor is defending the proposition that artificial wombs should be developed so that women no longer have to bear children.  Her arguments illustrate the kind of moral controversies engendered by technology that can lead to conscientious objection by health care workers.

Scotland's largest health board, the National Health Service Greater Glasgow and Clyde, ordered two Catholic midwives to schedule and supervise other health care workers providing abortion.  When they went to court to resist, the judge ruled that against them.  She ruled that the protection of conscience clause in the Abortion Act (1967) must be interpreted to refer only to direct participation.

Trevor Phillips, the chairman of Britain's Equality and Human Rights Commission, has said that religious believers should not be free to adhere to their own tenets when acting in the public domain.  Applied in health care, this would result in the closure or state expropriation of dissenting denominational health care facilities, and the suppression of freedom of conscience in medical practice.

A report produced by a private Commission on Assisted Dying has recommended that assisted suicide be legalized in the United Kingdom for any competent person over 18 years old who is terminally ill and expected to live less than 12 months.  It also recommends that physicians who refuse to assist with suicide for reasons of conscience be compelled to refer patients to colleagues who will do so. 

Member of the European Parliament Roger Helmer has written in favour of assisted suicide on grounds beyond those recommended by a recent report by a private commission. It is not clear whether or not he would insist that health care workers be obliged to assist, or that he recognizes the probability of conflicts of conscience among health care workers.

The Commons Backbench Business Committee has decided that the House of Commons will debate the assisted suicide guidelines published by the Director of Public Prosecutions in 2010.  There is a chance that the debate could lead to legalization of the procedure in those cases excluded from prosecution by the guidelines, since the British Secretary of State for Justice has stated that  assisted suicide should not be legalized by policy, but by a decision of Parliament enacted in legislation.

United States

The American College of Physicians has acknowledged that physicians who object to "abortion, sterilization, contraception or other reproductive services . . . is not obligated to recommend, perform or prescribe them." 

Addressing American bishops at the Vatican, Pope Benedict XVI warned of "grave threats to the Church's public moral witness presented by a radical secularism."  He voiced special concern about "certain attempts" to limit freedom of religion. 

The birth control insurance controversy

Shortly after the Pope's address, the US Department of Health and Human Services  confirmed that, as of 1 August, 2012, it will force employers who have more than 50 employees to pay for insurance coverage for contraceptives and embryocidal drugs and services even if they object to doing so for reasons of conscience.  It added that the rule will not be applied to non-profit institutions until August, 2013.

The delay appears to have been calculated to put off serious conflict with the Catholic Church and other religious denominations until after the presidential election in November.  However, the tactic was a spectacular failure.

The US Conference of Catholic Bishops characterized the decision as an unprecedented attack on religious liberty.  The 16,000-member Christian Medical Association stated that it was part of "a deplorable pattern of disregard for First Amendment freedoms." The National Association of Evangelicals (NAE) protested that the new regulations "trample on our most cherished freedoms and set a dangerous precedent."

The HHS decision was also criticized by spokesmen for Jewish groups,  Agudath Israel and the Orthodox Union.  Solidarity with the Catholic bishops was experssed by Rick Warren, a prominent Evangelical Christan pastor, and by Albert Mohler, president of Southern Baptist Theological Seminary.  A statement from the Southern Baptist's Ethics and Religious Liberty Commission later denounced the plans. 

In the weeks following the January announcement, Catholic bishops unanimously protested the proposed regulation.  Letters were read from pulpits across the country, and many bishops flatly stated that they would not comply with the law.  US military authorities at first forbade the reading of and then censored the letter from the Archbishop of the Catholic military diocese, adding to outrage about government suppression of religious freedom.  As a direct result of the HHS regulation, the Religious Freedom Protection Act of 2012 was introduced in the US Senate and 154 members of the US House of Representatives  signed a letter of protest to HHS Secretary Kathleen Sebelius.

The White House Press first downplayed the explosion of protest, but on 10 February President Obama was forced to respond to the situation.  He offered what he described as an accommodation that would see insurance companies provide birth control coverage free of charge and assume responsibility for approaching non-profit employees about it.  However, the regulation that prompted the firestorm was promulgated without any change, with only a promise to work on an alternative over the coming year.

The administration's offer generated a suspicious, guarded and critical response from the Catholic bishops.  It has been dismissed as "a cheap accounting trick" and " a grave violation of religious freedom" by a sharply worded open letter signed by over 200 people, including religious leaders of different denominations, college presidents, academics, religious leaders and journalists. 2,500 religious leaders from different denominations have signed a protest against it, while an on-line letter from women opposed to the measure gathered 2,500 signatures in about a week.

The regulation is generating civil actions against the federal government.  Lawsuits have been filed by Ave Maria University in Naples, Florida, Louisiana College in Alexandria, Louisiana, and Geneva College in Beaver Falls, Pennsylvania, the Eternal Word Television Network (EWTN) and Priests for Life, none of whom are considered 'religious employers' as defined by the Obama regulation.

Ten witnesses representing Judaism and Christianity appeared before the US House of Representatives Committee on Oversight and Government Reform to explain the reasons for their opposition to the Obama administration's plan.

Members of legislatures in at least 47 U.S. states are preparing a variety of legislative measures to "limit, alter or oppose" the implementation of the federal Affordable Care Act.  Many states have already passed laws or constitutional revisions for this purpose.

The Idaho State House of Representatives passed a non-binding resolution supporting a federal bill that would stop the imposition of the birth control insurance mandate.  Bills drafted for the same purpose have been introduced in the Michigan state legislature, in Missouri, and Arizona.

Nebraska, Michigan, Ohio, Oklahoma, South Carolina, Florida and Texas have filed a lawsuit against the federal government. The suit alleges violation of the First Amendment and the Religious Freedom Restoration Act through the HHS birth control mandate that will force insurance coverage for surgical sterilization, contraceptives and embryocides.

Attention has been drawn to a study that has revealed that almost half the Catholic hospitals surveyed in seven states performed over 20,000 surgical sterilizations and billed them as "sterilization for contraceptive management."  The results of the study are disputed by Catholic Health Association, but the researcher has challenged the Association to make good its criticism.  The study is of particular interest because of the strong stand being taken by the Catholic bishops against being made to provide insurance for surgical sterilization.

Also of interest is a 1994 bill introduced in the US Senate by Democratic Party Senator Daniel Moynihan, which included the kind of protection of conscience provision now being denied to religious employers by President Obama, also a Democrat.

While the controversy about the birth control insurance mandate is not directly relevant to the exercise of freedom of conscience by health care workers and institutions, it would be naive to think that it will not have an impact on protection of conscience advocacy in the United States.

A protection of conscience bill concerning abortion has been proposed in Kansas, and a bill that passed the South Carolina House of Representatives last year is to be considered by the state senate.  It is a procedure-specific statute that focuses on embryonic and foetal research and acts that cause the death of an individual.

In the New Hampshire, one of only three states that lack protective legislation for health care workers, the House Judiciary Committee has approved a protection of conscience bill.  It has been criticized by Wesley J. Smith, who wants the bill revised so that it cannot be used to justify patient abandonment.

 A national pro-life advocate has warned that protection of conscience laws like the  Illinois Health Care Right of Conscience Act and Mississippi's Health Care Rights of Conscience Act are dangerous because they may permit health care workers to commit euthanasia by withdrawing or refusing to provide medical treatment for reasons of conscience.

The United States District Court has ruled that the Washington State Department of Health designed regulations for the express purpose of forcing pharmacists with religious objections to the morning after pill to dispense the drug.  He permanently enjoined enforcement of the regulations.   

2.  News Items

All news items are now on the Project News/Blog, archived by country.  They can also be searched by topic using the blog search box. 

3.  Recent Postings

All recent postings are now on the Project News/Blog, archived by year and month.

4.  Action Items


5.  Conferences/Papers

The Project will post notices of conferences that are explore and support the principle freedom of conscience, including the legitimate role of moral or religious conviction in shaping law and public policy in pluralist states or societies.


6.  Publications of Interest

 Walter Sinnott-Armstrong (Duke University) and Franklin G. Miller (National Institutes of Health) have published a paper titled, "What makes killing wrong?"  Their conclusion is that killing is wrong because it causes total disability, and that the moral rule against killing is superfluous.   The paper illustrates, at several points, how conflicts of conscience may arise during end-of-life decision making and organ transplantation. 


7.  Video


8.  Audio