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Protection of Conscience Project

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July-September, 2003


29 September, 2003
"Ethics of the profession" revisited

North Carolina Governor Mike Easley has approved recommendations that will provide compensation to thousands of North Carolina residents who were involuntarily sterilized by the state over a period of 50 years. The sterilizations were consistent with the "ethics of the profession" at the time. This should remind those who insist that conscientious objectors must conform to the "ethics of the profession" that there are other legitimate ethical standards.

French government minister suggests euthanasia

The killing of Frenchman with a drug overdose administered by his mother has led François Fillon, French social affairs minister, to suggest a debate about legalizing euthanasia in such cases. This is not the first time prominent French officials have made such suggestions. [French Health Minister considers change to euthanasia law]

Danish professor recommends eugenics

Professor Helmuth Nyborg, who teaches psychology professor at the University of Aarhus, Denmark, has suggested that the state should take steps to create a better Danish society by encouraging childbearing among the 'intelligent' and discouraging it among the 'unintelligent' to prevent 'degenerates' from being born. Although his comments were rejected by Integration Minister Bertel Haarder, it appears that the unfavourable response was evoked by the professor's focus on intelligence and reference to 'degenerates'. Pre-natal screening to identify and eliminate physically 'defective' infants by abortion is so routine that it is, in many places, a 'standard of care' that causes conflicts of conscience among health care workers opposed to eugenic practices.

27 September, 2003
Progress slow for Abortion Non-Discrimination Act

Senate Bill 1397, which would prevent health care institutions entities from being forced to participate in abortions, is not expected to reach the floor of the US Senate until 2004.

25 September, 2003
Protection of conscience for scientists and engineers

The Fondation Science et Conscience and the Association for the Promotion ofScientific Accountable Behaviour (APSAB) held a conference in Geneva, Switzerland on 25-26 September to discuss the problems faced by scientists who have spoken out about the dangers of products produced by their employers. Members or representatives of UNESCO, OECD, the EU and numerous other agencies were slated to attend. The groups are proposing an international convention to recognized and protect the conscience of salaried scientists and engineers.

Concerns about 'palliative care' form in Australia

An Australian hospital is asking patients to complete a form on which they state whether life-prolonging treatment can be withheld from them and whether they are to be resuscitated. They can also use the form to send a final message to those who survive them. Dr Eric Fairbank of South West Healthcare, Warrnambool, Victoria, says that the forms are to do with palliative care, not euthanasia. [Warrnambool Standard, 24 September] Dr. John Fleming, director of the Southern Cross Bioethics Institute, Adelaide, South Australia, said: "In the light of a recent case in Victoria, Australia, [Nutrition and hydration to be withdrawn from Australian woman] doctors may now regard artificially delivered food and fluids as medical treatment which may be withdrawn from a non-dying patient. Dr Fairbank's assurance that his forms are 'not about euthanasia' has to be measured against the judge-made law which seems to permit, in the state of Victoria, euthanasia by omission of life-sustaining measures such as food and fluids." [SPUC]

23 September, 2003
Alternative to IVF

Researchers in Auckland, New Zealand, have found a simple, inexpensive treatment for some cases of human infertility. They found that they could significantly increase the chance of conception among women with "unexplained infertility" or mild endometriosis by flushing a special liquid through the reproductive organs. The treatment avoids the ethical concerns about in vitro fertilization. [CNS News]

19 September, 2003
"Five Live Report: The Terminators?" on BBC

A member of the Council of Disabled People, Bill Albert, has denounced prenatal screening and abortion "state sanctified eugenics". The practices are exposed in a BBC programme in which reporters found that some women are pressured to have abortions if the infants they are carrying have even correctable physical defects. Bioethicist John Harris of Manchester University argues in favour of eugenic screening, suggesting that parents opposed to it are misguided. The controversy illustrates the potential for moral conflicts among health care workers. [BBC]

18 September, 2003
Unprecedented number of letters received by parliamentary committee

James Bogle, a leading medical barrister in the United Kingdom, gave evidence against the draft Mental Incapacity Bill now before a parliamentary committee. He warned that the bill would make incapacitated patients vulnerable to attorneys who would have "power without responsibility". Dr. Philip Howard of St George's Hospital Medical School, London, stated that the bill would make suicide notes legally binding advance directives. The committee has received an "unprecedented" number of letters expressing similar concerns. This suggests that many health care professionals would find themselves in conflicts of conscience if the bill passes. [See Group argues for withdrawal of nutrition and hydration in UK]

Truth in advertising in Australia

Pharmaceutical companies in Australia must now label products developed or tested with human embryonic stem cells. This will facilitate ethical decision making by those opposed to embryonic stem cell research.

17 September, 2003
Judge orders feeding stopped

A circuit court judge has ordered the feeding tube removed from Terri Schiavo, a disabled Florida woman. It appears that the case will continue in a federal court. [See previous report: Case for withdrawal of feeding continues in Florida]

Kenyans against abortion

August in Nairobi saw a silent procession by thousands of Kenyan Christians demonstrating against abortion. According to a recent poll, legalized abortion is rejected by 81% of Kenyans, but health minister Charity Ngiluo complains that denying abortion to women is unfair. The Christian Medical Fellowship has raised concerns that the wording of the proposed constitution now being discussed may permit abortion. [See Abortion demanded in Kenya]

Group argues for withdrawal of nutrition and hydration in UK

In evidence given to the parliamentary committee reviewing the draft Mental Incapacity Bill, the Making Decisions Alliance (MDA) argued that advanced directives would permit the withdrawal of sustenance, and would be in the best interests of patients suffering some some conditions, like advanced dementia. It recommended that 'quality of life criteria' be used to make such decisions. [For a contrary view, see Euthanasia prevention bill in United Kingdom; Draft Mental Incapacity Bill criticized]

15 September, 2003
Euthanasia prevention bill in United Kingdom

The House of Lords has passed a private member's bill to prohibit euthanasia by denial of sustenance. The Patients' Protection Bill will be considered in the House of Commons. The bill addresses the problem caused by legal rulings to the effect that proxies can deny nutrition and hydration to incapacitated patients. [For related items, see Draft Mental Incapacity Bill criticized; Food and fluids controversy; Case for withdrawal of feeding continues in Florida; Nutrition and hydration to be withdrawn from Australian woman; Comatose woman can be starved; UK attempt to ban euthanasia by starvation and dehydration]

12 September, 2003
Ethical measles/mumps vaccine available

The Merck pharmaceutical company is making available single dose vaccines for measles and mumps that have not been derived from fetal tissue. The company is now taking limited orders (three boxes per physician, each with ten doses), the minimum order being one box. Physicians may order by calling Merck at 1-800-9675 or 1-800-637-2579. Children of God for Life will assist physicians concerned that they may not be able to use all ten doses.

11 September, 2003
Draft Mental Incapacity Bill criticized

The Law Society of Scotland warned a parliamentary committee that a draft bill would expose incapacitated patients to abuse and was incompatible with the European Convention on Human Rights. "People First", representing people with learning disabilities, also spoke against the bill, and Dr Donald Lyons, medical adviser for elderly services to the Greater Glasgow Primary Care Trust, said that he would not want to work under the bill if it became law. Other critics have charged that the bill would legalize euthanasia by starvation and dehydration.

9 September, 2003
Organ harvesting concerns in Russia

Russian doctors are reported to be removing kidneys from homeless people who are still alive, but who, in the words of an anonymous surgeon, "are done for anyway". The organs may be worth as much as $40,000 US each. [The Courier Mail] The operations are not legal, but the ethical outlook of those involved may be a source of difficulty for objecting health care workers.

8 September, 2003
Majority of Canadians polled favour euthanasia

A Polara survey of 1,263 Canadians conducted in August found that 49% favoured euthanasia and 37% were opposed. A 1997 poll by the same firm showed 60% of respondents supported assisted suicide. The numbers are worrisome for health care professionals who do not want to be involved with these practices. [Ottawa Citizen]

4 September, 2003
Chinese doctor recommends euthanasia

Dr. Pu Liansheng, who gave a terminally ill woman a lethal injection 17 years ago and was later acquitted of murder, now argues that euthanasia should be legalized. [The People Daily]

Legal action threatened against abortion objectors

Paulina Ramirez was raped in 1999 when she was 13 years old and now has a three year old child, fathered by the rapist. An obstetrician refused to perform an abortion, and she was persuaded not to have an abortion by doctors, social workers and a priest. She was given $10,000.00 by the government to assist in rearing the child, but is now suing the government for more compensation, claiming that her life has been completely destroyed. While it seems reasonable to seek additional financial assistance, a troubling aspect of the case is that activists want legal action against those who persuaded her not to have an abortion, which presumably includes the objecting obstetrician. [Yahoo]

3 September, 2003
Case for withdrawal of feeding continues in Florida

Evidence from doctors and nurses indicates that Terri Schiavo is responsive to her environment and not in a persistent 'vegetative' state. One nurse also reported that her husband, who is attempting to have her tube feeding halted, often asked when she was going to die, became 'visibly excited' when her condition worsened, and talked about how he would use the money he expected to receive following her death. The next hearing has been set for September 11th. [See previous report]

2 September, 2003
Belgian euthanasia statistics in doubt

Belgium legalized euthanasia in September, 2002. 170 cases of euthanasia have been reported since, but the Belgian Medial Journal claims that the actual number is two or three times higher.

Assisted suicide bill introduced in Vermont

A bill based on Oregon's assisted suicide law has been introduced in Vermont. It would allow patients who are expected to die within six months to ask for drugs to commit suicide. Some doctors in the state have formed the Vermont Alliance for Ethical Healthcare to oppose the legislation.


29 August, 2003
Case of disabled Florida woman attracts comment

The case of Terri Schiavo, a disabled women who is unconscious but dependent upon artificial nutrition and hydration provided by a tube to her abdomen, continues to attract comment. Her husband wishes to withdraw her feeding tube, but the Catholic Bishops of Florida have added their protest to that of her family, whose lawyer has drawn attention to the fact that it would be illegal to starve one's dog to death. Video evidence showing Schiavo responding to doctors and family members has been rejected by the judge hearing the case as "inconsistent". The problem is one faced all over the world because the provision of nutrition and hydration has frequently been defined as medical treatment - which can be withdrawn - rather than care- which cannot. Situations like this can present significant conflicts of conscience for health care providers.[For previous report, see Food and fluids controversy. For other cases and comment, see Nutrition and hydration to be withdrawn from Australian woman; Comatose woman can be starved; UK attempt to ban euthanasia by starvation and dehydration]

28 August, 2003
Free in vitro fertilization proposed in UK

The National Institute for Clinical Excellence (NICE) has recommended that women between 23 and 39 40 should be entitled to up to six state-funded IVF cycles. The proposal would create an expectation of service that would adversely impact conscientious objectors. Politicians have expressed concern that it would reduce funds available for other medical treatment.

26 August, 2003
'Wrongful life' claims dismissed

Describing the lawsuits as reminiscent of Nazi Germany, two judges of the Supreme Court of Kentucky have dismissed claims filed against doctors by parents of children with physical disabilities. The parents argued that they would have sought abortions had they been aware of the disabilities. The threat of such civil suits is used to coerce physicians who would, for reasons of conscience, reject eugenic practices.

18 August, 2003
Church leader declines to state views on assisted suicide

In the Isle of Man, where politicians are expected to deal with a bill to legalise euthanasia, bishop-elect Reverend Graeme Knowles has encouraged debate on the subject but has declined to state his views on assisted suicide. Such a position can be of concern to conscientious objectors of the same faith, inasmuch as they may look to their religious leaders for support when faced with demands that they compromise their convictions. [See Importance of backing from religious leaders emphasized]

16 August, 2003
American College of Pediatricians supports Abortion Non-Discrimination Act

The American College of Pediatricians "applauds and supports" Senate Bill 1397, which would clarify existing law to ensure that physicians, hospitals, and health care facilities can decline to provide abortions. The College firmly supports the optimum working environment for physicians and other health care professionals enabling them to have the freedom to provide the best care for all patients, especially children.

6 August, 2003
Christian commentary on AMA ethics articles

The Center for Bioethics and Human Dignity has arranged with the Ethics Institute at the American Medical Association to post responses to clinical ethics cases posted on the AMA's "Virtual Mentor" web page. The first case study and commentary is Faith-Based Decisions: Parents Who Refuse Appropriate Care for Their Child.

5 August, 2003
'Ethics of the profession' in retrospect

Those who would use the 'ethics of the profession' to coerce conscientious objectors in health care should note that states are considering how to compensate victims of the eugenics programmes that imposed compulsory sterilization on those considered to be 'unfit'. Those programmes functioned with the suppThe American Medical Association's official policy stipulates that "information about emergency contraception is part of the comprehensive information to be provided as part of the emergency treatment of sexual assault victims." However, a recent study found that only 28 percent of the hospitals surveyed routinely offer and provide emergency contraception to victims of sexual assault. The problem of availability of emergency contraception is made even more difficult by a recent wave of hospital closings and mergers, where private and community hospitals are being taken over by religious-based owners who are opposed to including birth control and emergency contraception in their treatment regimen.

Every member of Congress, especially those who say they care about stopping violence against girls and women and helping victims of rape and sexual assault, should support this legislation. Providing emergency contraception is not the same as performing an abortion.ort of the 'ethics of the profession' that prevailed at the time. tells the story of 73 year old Charlie Follet of California, who was sterilized when he was 15 years old, one of 20,000 people victimized by California's eugenics programme.

Dispensing 'morning after pill' to be compulsory

A bill introduced in the U.S. House of Representatives (Compassionate Assistance for Rape Emergencies Act: CARE Act) would force hospitals to dispense the potentially abortifacient 'morning-after pill' to patients complaining of sexual assault. This is just one of a continuing series of attempts to override freedom of conscience in denominational institutions.


31 July, 2003
Assisted suicide bill narrowly defeated in New Zealand

The Death with Dignity Bill, which would have legalized assisted suicide, has been defeated 60-57 in the New Zealand Parliament, with one abstention. The narrowness of the vote will likely provide some impetus to continued lobbying for the procedure, which would have serious consequences for health care workers. [See Assisted Suicide: What Role for Nurses? ]

30 July, 2003
Needless hysterectomies at Irish Hospital

Dr Michael Neary has been struck from the medical register for having performed unnecessary hysterectomies on more than 60 women at Our Lady of Lourdes Hospital in Drogheda. The Irish minister of health is now being pressured to conduct an inquiry into the obstetric unit at the hospital. It does not appear that enquiries have been made to determine whether or not health care workers were pressured to participate in the procedures.

Coercive family limitation in India

India's Supreme Court has ruled that punitive legal measures against people who have more than two children do not violate constitutional rights to life and liberty. At issue was a law passed in the northern state of Haryana making it illegal for parents to hold public office if they have more than two children. The central government is considering laws that would prohibit people with more than two children from holding government jobs or running for office. [Times of India] Other punitive measures are being discussed in the media. [Financial Express] It is difficult to see how such a regime would respect freedom of conscience among health care workers who do not support the 'two child' policy difficult when people not connected with health care are treated in this fashion.

29 July, 2003
Pro-suicide campaign on Isle of Man

Manx 4 Death with Dignity is sending postcards to all households calling for legalization of assisted suicide. A similar campaign was organized earlier this year in Guernsey. (Pro-euthanasia postcard campaign in Guernsey)

28 July, 2003
Drug-induced abortions recommended in Britain

The British Pregnancy Advisory Service has asked the Department of Health to approve a trial of abortifacient drugs like Mifepristone or Misoprostol (Cytotec). Women could take the drugs to induce an abortion at home. A problem that arises for conscientious objectors is that women whose abortions are incomplete arrive at hospital expecting on-duty staff to complete the procedure.

25 July, 2003
Public support for artificial reproduction

70% of 800 respondents surveyed by Bristol's University Centre for Reproductive Medicine favoured in vitro fertilization. This level of support indicates that health care workers who object to the procedure for reasons of conscience may find themselves pressured to participate, especially if it is part of a state health care plan.

23 July, 2003
Comatose woman can be starved

Miss Teresa Innes, hospitalized in West Yorkshire, is in a coma caused by an allergic reaction to penicillin. The Bradford Health Trust has obtained a high court judgement that allows it to stop providing her food and fluids. If the Trust acts on the judgement the woman is likely to die within two weeks. In its decision, the high court cited the 1993 House of Lords ruling in the case of Anthony Bland. The ruling is consistent with those in many other jurisdictions that have defined food and fluids as 'treatment' which can be withdrawn, rather than 'care', which must always be provided. Health care workers who consider nourishment to be care rather than treatment may find themselves in difficulty in jurisdictions that take the opposite view in law.

18 July, 2003
Limited opportunity to present evidence re: Mental Incapacity Bill

Those wanting to present evidence to Britain's Joint Select Committee on the Draft Mental Incapacity Bill must do so before 1 September, 2003. The bill would allow patients, not necessarily terminally ill, to be starved and dehydrated in order to cause their deaths, a process that has been described as "euthanasia by neglect". (See Food and fluids controversy)

17 July, 2003
First trimester eugenic screening

Trials are underway to test a new form of pre-natal screening that can be used as early as the fifth week of gestation to detect conditions like Down Syndrome and cystic fibrosis. Such tests are ordinarily used to identify 'defective' infants for 'genetic termination' (i.e, abortion. See Foothills Hospital Now Forces Nurses To Participate In Genetic Terminations )  Conscientious objectors to eugenics and abortion come under considerable pressure when such tests are adopted as a 'standard of care'.

15 July, 2003
Abortion demanded in Kenya

A member of a Kenyan parliamentary health committee has called for the legalization of abortion; Christian and Muslim leaders are opposed. Failure to consider the opposition of health care workers to the the procedure will likely have serious consequences. (See previous report on Kenya, with remarks on the situation in South Africa).

Islamic Council prohibits euthanasia and assisted suicide

The European Council for Fatwa and Research (ECFR), which met in Stockholm during the first week of July, has ruled that euthanasia and assisted suicide are forbidden by Islam. The Council distinguished such acts from the removal of life-support from patients who are clinically dead.

14 July, 2003
Abortion Non-discrimination Act introduced in the US Senate

American Senators Gregg and Nelson and six others have introduced the Abortion Non-discrimination Act introduced in the US Senate. It is identified as S. 1397. The bill passed the US House of Representatives after being examined at committee hearings at which Project advisor Prof. Lynn Wardle testified. [Testimony of Lynn D. Wardle, J.D.]

Food and fluids controversy

Florida Governor Jeb Bush is being asked to intervene in the case of Terri Schiavo, who is unconscious but dependent upon artificial nutrition and hydration. A court has ruled that her husband can order her feeding stopped in order to cause her death, but other family members have appealed to the governor, claiming that the husband is motivated by $700,000.00 life insurance policy and an interest in another woman. The case illustrates the problem that arises when food and fluids are legally defined as 'treatment' which can be withdrawn, rather than 'care', which must always be provided. Health care workers who consider nourishment to be care rather than treatment may find themselves in difficulty in jurisdictions that take the opposite view in law.

12 July, 2003
British Medical Association supports production of embryos for harvesting cells

At its annual meeting the British Medical Association expressed support for the Hashmi judgement, which allowed the artificial production of a baby so that the brother could be treated using blood from its umbilical cord. A dissenting physician called the procedure "eugenics with a vengeance."

11 July, 2003
Criticism of New York Catholic Conference

The compromise reached by the New York Catholic Conference (See Compromise worked out in New York) concerning the 'morning-after pill' is being criticized in some quarters on the grounds that the drug is 'abortifacient'. The drug may prevent implantation of a human embryo, thus causing its death, which conscientious objectors view as morally equivalent to abortion. On the other hand, if ovulation has not occurred, the drug may suppress ovulation and inhibit sperm transport and survival, thus acting as a contraceptive. The NYCC agreed that the drug could be dispensed to a woman complaining of rape in the latter situation, assuming the drug is not otherwise contraindicated. [NYCC statement] Some criticism seems directed at practical difficulties that may arise in applying the guideline; other critics may not appreciate the distinction between the mechanism of contraception and that of contra-implantation.

Costa Rican official promises elimination of religious influence

Costa Rica's Minister on the Condition of Women, Esemeralda Britton Gonzalez, has promised that the influence of the Catholic Church in Costa Rican society will be eliminated in order to facilitate abortion and contraception. Her remarks were made to the UN Committee on the Elimination of All Forms of Discrimination Against Women (CEDAW). One of the committee members asked what steps that government had taken to that end. It should be noted that a policy that would suppress the freedom of a church from speaking out on such issues would also suppress the freedom of any citizen or group motivated by religious, moral or ethical concerns. [See There Are No Secular Unbelievers]

10 July, 2003
Eugenic screening for deafness

Embryos may now be screened for deafness using a test developed by Australian doctors and approved by Victoria's Infertility Treatment Authority. A report concerning the successful screening of seven embryos conceived in vitro was presented at the International Genetics Congress in Melbourne. All seven embryos screened in the reported case died; six failed to implant in the womb and one was apparently killed because it carried two genes for deafness. [News report] The death of the embryos indicates the reason why some health care workers object to such procedures; others reject eugenic screening altogether.

9 July, 2003
EU Commission approves research on human embryos

Embryos 'left over' from fertility treatments may be used for research, according to funding guidelines published by the European Union Commission. This means that such research will be funded by tax money from countries and individuals opposed to it. At the same time, the dynamic likely to follow from the guidelines may make it more difficult for conscientious objectors among researchers and health care workers to avoid participation in the process, whether at the 'production' stage in research or when the products of such research are demanded by patients.

Judge orders birth control

Lapeer County Judge Michael Higgins of Michigan ordered a woman addicted to drugs to use birth control in order to stop her from having babies that she could not care for. The woman is fighting the order with the help of the American Civil Liberties Union. The court order could cause problems for health care workers required to facilitate the imposition of contraceptive measures who may morally oppose the imposition of such an order, even if they do not oppose contraception. [Detroit Free Press, 9 July]

2 July, 2003
Artificial reproductive technology and moral controversy

Papers presented at the European Society of Human reproduction and Embryology's conference in Madrid, Spain, suggested a growing interest in the use of ova obtained from aborted foetuses in research and in vitro fertilization. Ovarian follicles from second and third trimester foetuses were kept alive by Dutch and Israeli scientists in the laboratory, and some follicles began to develop. Researches from Copenhagen, Denmark, reported that no health or developmental problems had been noted among children conceived using eggs that had been matured in the laboratory prior to fertilization. Apparently the interest in this area arises from claims that not enough women are willing to donate eggs for artificial reproductive techniques like IVF. At the same conference, Dr. Norbert Gleicher of the Foundation for Reproductive Medicine in Chicago reported that he had injected male cells into female embryos during research into single cell gene disorders, generating denunciations from those opposed to making human "she-males". [CNN]

In the United Kingdom, Baroness Warnock, who drafted the legislation that now governs reproductive technology in the U.K., stated that she had no objections to the use of eggs obtained from aborted girls for artificial reproduction. Though she acknowledged that some women might not want eggs obtained in that manner, she did not understand their objections. On the other hand, the Archbishop of Cardiff compared the enthusiasm for such procedures to "the Nazi experiments performed during the Second World War." [Yorkshire Post, 2 July, ICN, 1 July]

Also in England, a lesbian couple awaits the birth of a child produced by in vitro fertilization using sperm purchased over the internet from a donor selected for his physical characteristics. [The Age]

The procedures and research being pursued in the field of reproductive technology illustrate the potential for conflicts of conscience to arise among researchers and health care workers who may be called upon to facilitate the work.