Labour Court clarifies freedoms of religion and conscience in healthcare sector

Wistrand International Law Office

Jörgen Larsson

Introduction

Sweden is one of the most secular countries in the world with full freedom of religion. Further, freedom of conscience is a right protected by the European Convention on Human Rights (ECHR). However, domestic law recognises no right to conscientious objection. In this respect, Sweden differs from most other European countries.

In 2017 the Labour Court clarified from an employment law perspective whether freedom of conscience gives healthcare professionals a right to conscientious objection.

Facts

A midwife expressed that her religious beliefs forbid her from performing abortion services. When she expressed her opinion, three different healthcare regions in Sweden refused to employ her. The midwife brought the case to the Equality Ombudsman, which found that her refusal to perform abortion services was a manifestation of her religious beliefs and was thus protected by Article 9 of the ECHR. The Equality Ombudsman also found that the healthcare regions’ requirement that the midwife perform abortion services was reasonable and motivated by social interests in order to secure women’s effective access to abortion services. Therefore, the midwife’s freedom of religion had not been violated. . . . Full Text

New hope for Ontario doctors’ conscience fight

The Catholic Register

Michael Swan

New evidence heard in court has given Ontario’s medical conscientious objectors renewed hope.

Two days of hearings before the Ontario Court of Appeal Jan. 21-22 has provided Christian Medical and Dental Society (CMDS) executive director Deacon Larry Worthen a dollop of confidence as he waits for a decision from the three-judge panel. . . Full Text

Discrimination isn’t always wrong

America

John J. Conley

Is discrimination always wrong?

To listen to the current national debate on the topic, it would appear to be so. Virtually all international human-rights covenants categorically reject discrimination on the basis of race, religion and gender. Even contemporary professional philosophers tend to treat discrimination as an unalloyed evil. The University of Chicago’s Brian Leiter has led a very public philosophical campaign to eliminate religious exemptions to anti-discrimination laws and to declare unethical religious practices that appear to be discriminatory, especially in the area of gender and sexual orientation.

But our crusade against discrimination seems to rest on a fundamental confusion. There is a difference between discriminating against someone because of the group to which he or she belongs and discriminating against someone on the basis of his or her actions. . . . [Full text]

Conscience claims, metaphysics, and avoiding an LGBT eugenic

Abram Brummet

Abstract

Novel assisted reproductive technologies (ART) are poised to present our society with strange new ethical questions, such as whether lesbian, gay, bisexual, and transgender (LGBT) couples should be allowed to produce children biologically related to both parents, or whether trans-women who want to experience childbirth should be allowed to receive uterine transplants. Clinicians opposed to offering such technologies to LGBT couples on moral grounds are likely to seek legal shelter through the conscience clauses enshrined in U.S. law. This paper begins by briefly discussing some novel ART on the horizon and noting that it is unclear whether current conscience clauses will permit fertility clinics to deny such services to LGBT individuals. A compromise approach to conscience is any view that sees the value of respecting conscience claims within limits. I describe and critique the constraints proposed in the recent work of Wicclair, NeJaime and Siegel as ultimately begging the question. My purpose is to strengthen their arguments by suggesting that in the controversial situations that elicit claims of conscience, bioethicists should engage with the metaphysical claims in play. I argue that conscience claims against LGBT individuals ought to be constrained because the underlying metaphysic—that God has decreed the LGBT lifestyle to be sinful—is highly implausible from the perspective of a naturalized metaphysic, which ought to be the lens through which we evaluate conscience claims.


Brummett A. Conscience claims, metaphysics, and avoiding an LGBT eugenic. Bioethics. 2018;00:1–9.

Thousands step up in support of doctors’ conscience fight

The Catholic Register

Michael Swan

An Ontario campaign to pressure politicians over the protection of health care conscience rights is “democracy in action,” said an organizer.

The Coalition of HealthCARE has so far collected 19,000 names and e-mail addresses in its “Call for Conscience Campaign.” That does not include results from the Archdiocese of Toronto.

The non-partisan campaign was launched to oppose and raise awareness about regulations that force doctors to refer for assisted suicide and euthanasia against their moral convictions.

By the end of March, people who have signed up during the campaign should receive instructions about how to e-mail all the candidates in their ridings in the run-up to Ontario’s June 7 provincial election. . . [Full text]

Nova Scotia: make a call for conscience

Nova Scotia Call for Conscience 2018

Coalition for HealthCARE and Conscience

Over recent months, it has become increasingly clear that the conscience rights of Nova Scotia doctors are not being adequately protected.

A leading Nova Scotia medical regulator recently told doctors they must participate in euthanasia by making an “effective referral” even if this would require them to violate their conscience. It was made clear that the penalty for refusing to comply could be discipline for “unprofessional conduct”. Performing or referring for assisted suicide and euthanasia involve killing a patient. This is directly opposed to the teachings of many faiths and the traditional Hippocratic oath. Most health care professionals embarked on their careers to heal people, not kill them. No Nova Scotian should be required to be involved against their will.

Other provinces have found ways to provide access without forcing people to act against their moral convictions.

We need to let the Minister of Health of Nova Scotia know that we need legislation to protect conscience rights in our province. In November, Manitoba legislators passed a Bill which said that Manitoba health care professionals could not be compelled to participate in assisted suicide. We need a similar bill here in Nova Scotia. Please write the Minister of Health using the form below. The letter will automatically be sent to the Premier and the leaders of the opposition parties. Conscience rights are an all party issue. We need our legislators to show their support for Nova Scotia health care professionals.

Take action here. Write to the Government of Nova Scotia.

Catholic Medical Association Joins with 25,000 Physicians Fighting Proposed Global Abortion Policy to Strip Conscience Rights Protections

News Release

Catholic Medical Association

PHILADELPHIA, PA – FEBRUARY 12, 2018 – Conscience rights protections for health care providers in the U.S. and abroad are once again under attack. The World Medical Association (WMA) representing 10 million physicians worldwide is poised to approve a policy that would demand doctors refer for abortion, even against their conscience.

Although current federal statutes in the U.S. protect health care provider’s conscience rights and prohibit recipients of certain federal funds from discriminating against health care providers, WMA ethics policies greatly impact future regulations of the medical profession globally.

The WMA was founded in 1947 in response to Nazi atrocities during WW II. The organization promotes itself as “evaluating and codifying ethics in healthcare.” Currently the WMA policy requires doctors ensure continuity of care for patients who choose abortion, but not force doctors refer for the procedure. However, the WMA’s proposed revision threatens the conscience rights of all physicians and health care professionals by proposing the following amendment:

“Individual doctors have a right to conscientious objection to providing abortion, but that right does not entitle them to impede or deny access to lawful abortion services because it delays care for women, putting their health and life at risk. In such cases, the physician must refer the woman to a willing and trained health professional in the same, or another easily accessible health-care facility, in accordance with national law. Where referral is not possible, the physician who objects, must provide safe abortion or perform whatever procedure is necessary to save the woman’s life and to prevent serious injury to her health.”

The proposed changes in policy would also eliminate the provision that “requires the physician to maintain respect for human life.”

“We do not believe abortion is healthcare. The international impact on this global abortion policy is incalculable,” said CMA President Dr. Peter T. Morrow. “We join with the representatives of over 25,000 physicians, nurses, health care providers and patient advocates who provide excellent, scientific, ethical and moral healthcare in accordance with the principles of the Oath of Hippocrates. Collectively we request that the WMA’s revision be rejected, it is subversive of physician freedom of conscience concerning abortion in the short term, and euthanasia and assisted suicide in the long term.”

The American Medical Association (AMA) is an associate member of the WMA and can recommend rejections and or revisions.  The CMA supports conscience rights of all healthcare professionals with regards to abortion as well as physician assisted suicide, and is jointly sending a letter co-written by: American Association of Pro-Life Obstetricians and Gynecologists, American College of Pediatricians, Christian Medical & Dental Associations, National Association of Catholic Nurses-U.S.A. and The National Catholic Bioethics Center to the AMA strongly denouncing the WMA’s proposed change forcing physicians to violate their conscience rights.

The WMA’s proposed changes could become a global policy. The general assembly is scheduled to vote in October.

Contact:

Susanne LaFrankie, MA
Diector of Communications
email: lafrankie@cathmed.org


The Catholic Medical Association is a national, physician-led community of over 2,400 health care professionals. CMA’s mission is to inform, organize, and inspire its members, to uphold the principles of the Catholic faith in the science and practice of medicine.

The midwife hounded out of her job after 30 years (and 5,000 babies) because she refused to supervise abortions

Daily Mail

Jenny Johnston

Mary Doogan sees herself like the driver of the getaway car in an armed robbery.

‘Would the police say that because he wasn’t actually in the bank, brandishing the gun, he isn’t guilty? Of course, they wouldn’t.’

This retired midwife, demurely dressed in a coral cardigan and smart court shoes, is the least likely of criminals, and it is sad that she carries even a hint of guilt about her ‘crime’.

After all, it was committed only in her own eyes (and God’s, she would say) and was a matter of conscience.

In the course of her duties in an NHS hospital, Mary, a devout Catholic, supervised colleagues as they participated in abortions. Although never hands-on herself, she admits she always felt implicated.

‘It’s why I later took the stance I did,’ she says, referring to the court case that ultimately cost her job as a labour ward co-ordinator at the Southern General Hospital in Glasgow. . . [Full Text]

Apparently it’s OK to violate doctors’ Charter rights

National Post
Reproduced with permission

Raymond J. de Souza

What happens to fundamental rights when a free and democratic society ceases to be one? That’s the question raised by a decision of the Ontario Superior Court last week.

The court was petitioned by doctors who want nothing to do with “medical assistance in dying,” namely they do not want to use their expertise and professional status to procure the death of their patients. The College of Physicians and Surgeons of Ontario (CPSO) has a policy that requires physicians who do not want to administer lethal treatment to their patients to arrange for their patients to see someone who will. It’s called an “effective referral.” Doctors are therefore mandated to “effect” something that they object to.

Consider a patient who, after a bit of intensive internet research, asks his doctor for a particular drug or course of therapy. The doctor refuses. In her professional judgment the treatment is not in the best interests of the patient. The patient then asks the doctor to arrange for that same treatment from another physician, to “effect” that treatment despite her judgment that it is not appropriate.

The doctor would likely remind the patient that he is free to seek a second opinion, or even seek out another doctor altogether. But the patient’s wish does not override her professional opinion; the doctor is not a waiter taking an order.

What if the patient instead asks to be killed? Then, according to the CPSO, the doctor becomes a service provider, not a professional with a different judgment, much less a citizen with conscientious objections. A doctor can refuse to prescribe the latest weight-loss drug, but must “effect” a lethal injection.

The court, in a unanimous decision, found that the CPSO policy violates doctors’ charter right to religious freedom. (It did not rule on freedom of conscience, but presumably the same would apply.) It further found that the infringement was neither “trivial” or “insubstantial.”

So the court found a serious infringement of a fundamental freedom guaranteed by the charter, and yet upheld the “effective referral” policy, finding that it was a “reasonable limit on religious freedom, demonstrably justified in a free and democratic society.”

Reasonable to whom? Not to the physician who finds abortion abhorrent, and now must to some degree facilitate it. Not to the doctor who wants her infirm patients to know that she would never hasten their deaths, but now is required to co-operate in just that.

The charter permits infringements on rights that are “demonstrably justified in a free and democratic society.” But what happens when society is no longer keen on certain freedoms or certain democratic rights? Or at least when the judges hearing the case think fundamental freedoms not quite so fundamental after all?

The Ontario judges simply decided that they did not think (in this case) that the right to religious freedom was that important. How do we know that? Because the judges accepted that there is “no evidence that conscientious objection results in a failure of access.” So even though a religious or conscientious objection does not impede what a particular policy is attempting to provide, it still can be infringed upon.

Indeed, what makes the Ontario decision all the harder to fathom is that in other provinces there is no equivalent of the CPSO “effective referral” policy. In the internet age, it is not hard for willing doctors to make themselves known. In some provinces the government itself keeps a registry that patients can access. There is no need — as currently demonstrated in other parts of Canada — to force doctors to effect that to which they object.

The only logic that holds the Ontario decision together is that freedom of religion and freedom of conscience are relatively unimportant in a “free and democratic society.” Indeed, the CPSO decision sets the bar of “reasonable limits” so low that it is hard to imagine what would constitute an unreasonable limit.

The answer to that of course is clear, though left unstated. An unreasonable limit is one the judges don’t like. A reasonable one is one that they do.

A palliative-care physician in Ontario who does not wish to participate in assisted suicide now has very good reason to move to Alberta, where she will not be required to effect it. How that helps patients in Ontario is not clear.

It is all quite unreasonable. At least it would be in a free and democratic society.

 

Canadian court rules that state can compel participation in homicide and suicide

News Release

For immediate release

Protection of Conscience Project

Three judges of the Ontario Superior Court of Justice Divisional Court have unanimously ruled that, notwithstanding religious convictions to the contrary, Ontario  physicians can be forced to help patients access any and all services and procedures, including euthanasia and assisted suicide.

“In the end,” observed Project Administrator Sean Murphy,  “the ruling effectively gives the state the power to compel citizens to be parties to homicide and suicide, even if they believe it is wrong to kill people or help them kill themselves.”

The Protection of Conscience Project jointly intervened in the case with the Catholic Civil Rights League and Faith and Freedom Alliance on the issue of freedom of conscience.  The court acknowledged the submission, but explicitly limited its ruling to the exercise of freedom of religion.  It did not address freedom of conscience.

The court approved the reasoning of the College of Physicians and Surgeons of Ontario, the state medical regulator.  The College argued that “physicians must be prepared to take positive steps to facilitate patient access” to euthanasia and assisted suicide, and that there is “no qualitative difference” between euthanasia and “other health services.”

With respect to options of objecting physicians, the court observed that they are free to change their field of practice in order to avoid moral conflicts.  The judges added that those who fail to do so are to blame for any psychological distress they might experience if compelled to violate their convictions.  It appears that they were unconcerned that this might further reduce the number of family and palliative care physicians, noting that there was “no evidence” that coercive policies would adversely affect physicians “in any meaningful numbers.”

Dr. Shimon Glick, advisor to the Project and Professor Emeritus of the Faculty of Health Sciences at Ben Gurion University of the Negev in Israel, described the ruling as “sad.”  Commenting on the decision, Project Advisor Professor Roger Trigg of Oxford said, “once the perceived interests of the State override the moral conscience of individuals  – and indeed of professionals- particularly in matters of life and death, then we are treading a slippery slope to totalitarianism.”

“Even the first steps- that may not seem important to some,” he warned, “are taking us in that direction.”

Professor Trigg’s warning was echoed by Professor Abdulaziz Sachedina, a leading Islamic scholar and philosopher who also serves on the Project Advisory Board.  Professor Sachedina asked, “Are we  going to submit to “totalitarian ethics” reflected in such court decisions, making suicide a tempting option without any regard to conscientious objection?”

The decision concluded legal proceedings launched jointly by five Ontario physicians, the Christian Medical and Dental Society of Canada, Canadian Physicians for Life, and the Canadian Federation of Catholic Physicians’ Societies.  They are considering the possibility of appeal.

Contact:
Sean Murphy, Administrator
Protection of Conscience Project
E-mail: protection@consciencelaws.org


The Protection of Conscience Project is a non-profit, non-denominational initiative that advocates for freedom of conscience in health care. The Project does not take a position on the morality or acceptability of morally contested procedures. Since 1999, the Project has been supporting health care workers who want to provide the best care  for their patients without violating their own personal and professional integrity.