July-September, 2002
September
MaterCare International will hold its second international workshop of
Catholic obstetricians and gynecologists in Rome, from October 23 to 27. The
conference has been organized along with the World Federation of Catholic
Medical Associations (FIAMC). One of the primary goals of the meeting will
be to address how MCI can function in the face of strong bias among
international agencies against physicians who refuse to perform abortions
for reasons of conscience.
Members of the House of Deliberation of Guernsey, a Channel Island, has
voted to investigate the legalization of voluntary euthanasia, an action
that indicates that they are in favour of changing the law. Guernsey is not
part of the United Kingdom. It is subject directly to the British sovereign,
and is not subject to laws passed by the British Parliament unless the laws
specifically include such a provision. The Privy Council must approve
Guernsey's statutes.
By a vote of 229 to 189, the US House of representatives has passed the
Abortion Non-Discrimination Act (H.R. 4691). The bill will allow health
providers and insurers who object to abortion for reasons of conscience to
refuse to perform, pay for, counsel or refer patients for abortion services.
It must pass the US Senate in order to become law.
On Wednesday, September 25, the U.S. House of Representatives will vote on
the
Abortion Non-Discrimination Act (H.R. 4691).
A deaf couple in Victoria, Australia, will be allowed to conceive embryos by
in vitro fertilization and have them screened using pre-implantation genetic
diagnosis to identify embryos that might carry a gene for deafness. The
couple wishes to avoid having a deaf child. An Australian ethicist described
the decision as "horrible on a number of levels".
Belgium has legalized euthanasia for terminally-ill patients who request it.
A permanent committee has been established to monitor the operation of the
new law. Opinion polls last year found that 72 percent of respondents
supported the law under certain conditions.
A petition containing 50,000 names calling for legalization of assisted
suicide/euthanasia has been presented at the Prime Minister's official
residence at No.10 Downing Street by the widower of Diane Pretty, a
motor-neurone disease sufferer whose legal suit seeking legalization of
assisted suicide was dismissed.
Governor Gray Davis of California has signed legislation that allows the use
of state funds for destructive embryo research programmes and requires IVF
fertility clinics to inform clients about the option of donating their spare
embryos to research. Davis hopes to see California become a world leader in
the field. Such developments signal problems for researchers and health care
workers who have moral objections to such research.
Green Party member Robin Chapple has introduced a bill to legalize
euthanasia in West Australia. The bill is unlikely to come up for debate
before next year.
Laura Hawryluck, an assistant professor of medicine at the University of
Toronto, has circulated new
guidelines to
Canadian hospitals that are intended to make clearer the distinction between
'terminal sedation' and euthanasia or assisted suicide. Terminal sedation
would be defined as palliative care if the doctor's intent to relieve pain
were clearly documented, so that it could be easily understood by families
and identified by coroners and other authorities reviewing a case. The
guidelines make the customary statement that if drugs are necessary to
relieve pain and suffering, they may be administered even if they may hasten
death. It may be two to three years before some form of the guidelines are
formally adopted as 'standard of care' statements by medical colleges and
authorities.
The National Post (Canada) news report stated as a fact - without
attribution - that "close to 300 Canadians die in agony" every day. It also
referred to the case of Dr. Nancy Morrison, a Halifax physician charged for
first-degree murder, asserting that she administered drugs to 'hasten the
demise' of a patient who was not responding to painkillers. In fact, she
administered potassium chloride. This is not a pain-relieving medication,
but a chemical that used for killing. [See
CMAJ Commentary] The news report's reference to her case hardly
contributes to the clarity that the guidelines themselves are intended to
provide.
Dr. Margaret Somerville, director of the McGill Centre for Medicine,
Ethics and Law in Montreal, takes the position that patients should have a
legal right to adequate pain relief, but would like to see parts of the
document reworded to ensure that it cannot be used as a springboard for
euthanasia. The Euthanasia Prevention Coalition has expressed its support
for the guidelines.
The head of MaterCare International (MCI), a group of Catholic obstetricians
and gynecologists dedicated to the care of women in the developing world,
charges that the Canadian International Development Agency (CIDA) has
refused to fund MCI's new birth trauma center in the African country of
Ghana because MCI does not perform abortions. [See
story]
The Bourn Hall fertility clinic in Cambridgeshire is refusing to offer
routine pre-implantation genetic diagnosis (PGD) on embryos babies conceived
through in vitro fertilization. Such testing is increasingly demanded
in order to identify genetic anomalies, such as Down's syndrome, so that the
embryos can be destroyed or an abortion performed. Health care workers who
object to eugenic testing for moral reasons are frequently subjected to
enormous pressures to provide them, including the threat of 'wrongful birth'
and 'wrongful life lawsuits'. [Cambridge Newspapers]
Dr. Rudolf Jaenisch, professor of biology at the Whitehead Institute for
Biomedical Research at Massachusetts Institute of Technology (MIT), has
found that up to 4% of the genes in a clone's placenta appear to be
abnormal. Jaenisch believes that all clones have genetic abnormalities, and
that those that survive do so only because their abnormalities are less
severe. It is suggested that this may present a biological barrier to
cloning. If the difficulties do not prove insurmountable, they may slow the
push for human cloning and allow time for reflection about the impact that
artificial reproductive technologies may have on conscientious objectors.
The 14th Conference of the World Federation of the Right to Die Societies
met from 5 to 8 September, 2002, in Brussels. Speakers advocated
legalization of euthanasia, as well as expansion of existing laws that
permit it. The former minister of Health of the Netherlands suggested
consideration of the situation of "people who are not ill, but have lost the
meaning for life." Pieter Admiraal of the Netherlands asserted that there is
only a "semantic difference" between terminal sedation and euthanasia. Of
particular note were comments to the effect that the refusal of a group of
hospitals in Belgium to perform euthanasia was "problematic". Reports from
the United Kingdom and France indicated a continuing public interest in
legalizing euthanasia. All of this indicates that health care workers who
object to euthanasia and assisted suicide are likely to face increasing
pressure to participate.
The Roman Catholic bishops of 25 Latin American countries have warned that
the United Nations, the European Union and international non-governmental
organizations are pressuring their countries to legalize abortion and
legislate against family life. The statement is a reminder of the need to
ensure that health care workers in developing countries are not deprived of
freedom of conscience by policies or laws instituted in response to
international pressures.
The Irish group Doctors for Choice, which represents 100 Irish physicians
who are in favour of abortion, have asked Ireland's Medical Council to allow
them to refer women for abortions, and to stop regarding abortion as
professional misconduct.
Dr Fiona Smith, a Scots general practitioner, is suing the Dundee Royal
Infirmary (Tayside Universities Hospital Trust), alleging that medical staff
advised her family that she was in a persistent vegetative state (PVS) and
had suggested that food and fluids be withdrawn to "let nature take its
course." The hospital maintains that a diagnosis of PVS had not been made,
and that any talk of withdrawing nourishment and hydration was simply
intended to prepare the family for making difficult decisions. Dr. Smith
emerged from the coma after she was moved to St Mary's Hospital in Lanark,
run by the Daughters of Charity of St Vincent de Paul. Whatever the legal
merits of the case, it indicates how health care workers attending such
patients may find themselves in conflicts of conscience should their moral
or medical judgement differ from that of the team or instititution. This is
particularly so when a patient is to be starved and dehydrated by withdrawal
of assisted nutrition and hydration.
August
An article in The Medical Post (July 16,2002) states that the new abortion
law in Switzerland will require Catholic hospitals to provide abortions.
The legislative assembly of Australia's Capital Territory (ACT) has formally
legalized abortion, the first state in Australia to do so. The bill to amend
the
Medical Practitioners Act included a clause that is intended to
prevent conscientious objectors from being forced to participate in
abortions. However, the assembly also repealed the Health Regulation
)Maternal Health Information) Act, which ensured that health care workers
could not be compelled to counsel, advise or refer for abortion. The net
result is a reduction in the legal protection available for conscientious
objectors.
The United Kingdom's General Medical Council has prepared new guidelines
that affirm the right of patients to refuse life-sustaining treatment and
care; health care workers must respect the refusal.
Washington Attorney General Christine Gregoire has ruled that employers
cannot refuse to provide birth-control pills and other prescription
contraceptives for moral or religious reasons. The ruling followed an
attempt by Catholic-operated Sacred Heart Hospital to assert a religious
objection to paying for contraceptive coverage for employees. Insurance
Commissioner Mike Kreidler claimed that he recognized a right to
conscientious objection, but immediately contradicted himself by asserting
that conscientious objection cannot stand in the way "of a woman's right to
this vital and legal coverage." According to the news report, Washington is
the 17th state to require state-regulated insurance plans with comprehensive
drug policies to provide contraceptives, including birth-control pills,
intrauterine devices, diaphragms, implants and injectable contraceptives.
These continuing attacks on the exercise of religious freedom have been
fuelled by a federal Equal Employment Opportunity Commission ruling that
excluding birth-control coverage is discriminatory, and a similar ruling by
U.S. District Judge Robert Lasnik in Seattle a year ago. [Seattle
Post Intelligencer]
A bill proposed in California would require all accredited medical schools
to teach abortion to ob/gyn residents. The bill was passed in the state
assembly in June and is to be debated in August in the state senate. While
doctors or schools would be able to opt out for moral or religious reasons,
it would require the objecting medical schools to see that residents could
get the instruction elsewhere. There are 22 accredited ob/gyn residency
programmes in the state, but the news report did not indicate whether or not
any of these programmes are in institutions that would find such referral
objectionable.
The
Mercury News
Banding Drammeh, president of the Supreme Islamic Council in Gambia,
denounced indiscriminate distribution of birth control devices to youngsters
and unmarried couples as "completely un-Islamic or irreligious". This
illustrates the potential for conflict with local health care workers whose
cultural, moral and religious traditions conflict with the anti-population
agenda of international agencies and developed nations.
The Mpumalanga health department announced that a nurse from the
Philadelphia hospital has been formally charged with gross violation of
patients' rights. The nurse is to appear at a disciplinary hearing on 14
August. The charge resulted from the broadcast of secretly recorded video
footage in June. [See
Controversy erupts in South Africa] Among other things, the tapes showed
that patients had to remove the foetuses from their bodies themselves and
put them in waste bins because the nurses did not want to touch them. It is
possible that more nurses will be charged. The situation appears to have
arisen at least in part because the government failed to take into account
the widespread opposition to abortion among health care workers. See the
letters from Dr. Harvey Ward of Cape Town, and the text of a
survey he conducted in the Western Cape in 1997. Other relevant
background information is found in the article
No Place for Abortion in African Traditional Life - Some Reflections .
A news report in Australia states that Australian scientists have been
using tissue from aborted foetuses in research for 20 years. Professor
Bernie Tuck of the Diabetes Transplant Unit at Sydney's Prince of Wales
hospital, interviewed for the report, acknowledged that some people
initially experience nightmares after handling the tissue, but said that the
effects wore off over time. He stated that if a researcher in the group did
not wish to use foetal tissue "we would not put them on that particular
programme." [The
World Today]
Meanwhile, ES Cell International of Melbourne, Australia, which now
exports embryonic stem cell tissue cultured on tissue from mouse foetuses,
plans to use tissue from aborted foetuses in the commercial production of
embryonic stem cells. Exports may begin next year. Chief Executive Robert
Klupacs hopes to develop a way to produce billions of stem cells in
fermentation tanks. [Herald Sun]
The Prime Minister's office has stated that proposed Australian
legislation to legalize destructive embryonic stem cell research would
neither prevent nor facilitate the use of aborted foetuses. [The Mercury]
Baroness Warnock, whose report led to the legal regulation of IVF and embryo
experimentation in the UK, has asserted that euthanasia should be permitted
and that the present law against it is irrational. Writing in Counsel, a
professional journal for barristers in England and Wales, she argued that it
is not reasonable to permit the abortion of handicapped infants while
denying euthanasia to someone who, "unlike the foetus, is able to
make her own judgement that her life is intolerable." The article
demonstrates that pressure for the legalization of euthanasia and assisted
suicide is unlikely to diminish. Once legalized, pressure to participate
will almost certainly be increasingly applied to health care workers, just
as pressure is now too often applied to force them to participate in
abortion or other morally controversial procedures.
The
Alliance for Human Research Protection urges Californians to oppose bill
AB2328, which would allow surrogates to consent to medical experiments
upon incapacitated persons. Health care workers and institutions opposed to
such experimentation may find themselves in a difficult position if the law
is passed without protection for them.
July
American Senators Harry Reid (Nevada Republican) and Olympia Snowe (Maine
Republican) are reported to be planning to attach a "contraceptive mandate"
to a prescription drug bill recently passed by the House of Representatives.
This would force bodies covered by prescription drug insurance to include
coverage for contraceptives and abortifacient drugs. [News
link]
An English High Court judge accepted arguments that there is no evidence
linking third generation contraceptive pills to increased risk of blood
clots, and has dismissed a test case brought by 100 women against the pills'
manufacturers.
A report commissioned by the National Health Service Board of Glasgow,
Scotland, and prepared by the Family Planning Association, which supports
abortion, states that doctors whose only duty is to perform abortions would
become depressed. The finding surprised the honorary secretary of the Royal
College of Obstetricians and Gynaecologists, but would not surprise
physicians who object to abortion for reasons of conscience. [Sunday Herald]
Reacting to the European Parliament's wish that abortion and the morning
after pill be made freely available in all member countries, and that sex
education be provided from "early in life", Malta has asserted that the
European Union is incompetent to legislate on domestic issues. Malta's
Permanent Delegate to the EU, Ambassador Victor Camilleri, stated that
abortion will continue to be illegal in Malta. [Times
of Malta] [Previous
report]
Mifepristone (mifegyne) use in Germany increased 21% in the first three
months of 2002, according to the German federal statistics institute
Destatis. Conscientious objectors may encounter problems when women come to
hospitals expecting physicians to complete abortions that they initiated
with the drug.
Tony Tan, Singapore's deputy prime minister, has promised that conscientious
objectors will not be forced to participate in embryonic stem cell research.
His comment followed news that Singapore will authorize human cloning for
research purposes on condition that cloned embryos are killed after 14 days.
Similar guarantees have not been forthcoming from other countries
contemplating legal regulation of artificial reproductive technologies.
Russel Ogden, a Vancouver criminologist, has recently asserted that an
underground network exists to help terminally ill people commit suicide.
Ogden's 1994 Master of Arts thesis Euthanasia and Assisted Suicide in
Persons with AIDS or HIV led him to argue that euthanasia and assisted
suicide should be legalized because people "are dying in conditions akin to
those of a backstreet abortion."
The U.S. House of Representatives heard testimony about a new protection of
conscience bill that would prevent private and religious hospitals and other
medical facilities from being forced to provide abortions. News reports have
described the measure as a "pro-life" bill rather than a "human rights"
bill; the appellation is likely to generate opposition from some parties,
including the American Civil Liberties Union. [Audio
recording of hearing]
Mifepristone (often called RU-486) is to be made available free to girls
and women by the British National Health Services. The drug is used to
chemically induce abortions. [BBC News online, Daily Telegraph] While this
might seem to be one way of alleviating pressures on conscientious
objectors, it creates two new complications. First: it may place demands on
pharmacists or others who may not previously have been involved with
abortions. Second: women who take the drug may arrive on hospital emergency
wards with complications that may include incomplete abortions. In cases in
which there is a chance to save the baby, health care workers who object to
abortion may find themselves in conflict with women who demand that the
objectors complete what they or other physicians have begun. Ironically,
this problem was one of the reasons given for legalizing abortion.
The European Parliament has accepted a report by Anne Van Lancker, a
Socialist member of the EU Committee on Women's Rights and Equal
Opportunity. The report demands that abortion and the morning after pill be
made freely available in all member countries, and that sex education be
provided from "early in life". The report makes no mention of parental
authority in the education and treatment of their children, and is an attack
on the sovereignty of member nations like Ireland, Spain, and Portugal,
which place restrictions on abortion. The adoption of the report might also
be used to blackmail nations that wish to join the European Union.
Contrary to earlier speculation, the new Dutch government will
review the euthanasia law, but does not appear to be interested in revoking
or restricting it. [News]
Despite pressures arising from the case of Dianne Pretty, whose campaign
for assisted suicide took her to the European Court of Human Rights, the
annual conference of the British Medical Association rejected changes to its
policy against the practice. [The Western Mail]
A 71 year old woman of Langford, British Columbia, Canada, has been charged
for assisting in the suicides of two women, one of them a former nun.
Predictably, the news has generated calls legalization of assisted suicide.
Such a change would significantly impact conscientious objectors within
health care professions, but this problem is being ignored. [Globe
and Mail;
Victoria Times Colonist]
Nearly 90% of those who ask for assisted suicide later change their
mind, according to a recent American
study
of Oregon's Death With Dignity Act.