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Protection of Conscience Project

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July-September, 2009


30 September, 2009
Support for protection of conscience measure in bill

The Christian Medical Association has expressed support for a protection of conscience provision in a bill proposed in the US Congress by Representative Tom Price. The protection offered is limited to abortion.[CMA News Release]

Protection of conscience amendment voted down in US Senate

A committee of the US Senate has rejected an amendment to a health care reform bill which was intended to prevent discrimination against health care workers and institutions unwilling to provide abortion. [AUL]

27 September, 2009
Washington State pharmacists must dispense lethal drugs

During the campaign to legalize assisted suicide in the state of Washington, activists led health care workers to believe that they would not be forced to participate in the procedure. However, a law passed to force objecting pharmacists in to dispense contraceptives will now be used to force them to dispense lethal drugs for assisted suicide. [American Thinker]

23 September, 2009
British Director of Public Prosecutions begins public consultation on assisted suicide

As a result of the decision of the House of Lords in the case of Debbie Purdy, the British Director of Public Prosecutions has published an interim policy that will guide Crown Counsel in deciding whether or not to lay a charge of assisted suicide. The public is invited to respond to the policy by 16 December, 2009. After taking public response into account, the Director will issue a final policy in the spring of 2010. The policy acknowledges that it would be contrary to public policy to prosecute assisted suicide in certain cases, even though the act would continue to be a criminal offence. [News release] Since assisting suicide would remain at least technically illegal, the policy cannot be used to impose an obligation on health care workers to assist, nor does it prevent objectors from speaking against the procedure.

21 September, 2009
Catholic Medical Association against proposed reform bills

The Catholic Medical Association has issued a letter criticizing the approach being taken in proposed American health reform bills as "flawed in principle and ineffective." The organization urges "uncompromising commitment to defend the sanctity of life and the conscience rights of all providers as essential parts of health-care reform." [CMA letter]

Elective C-sections supported by many Canadian obstetricians

Although the Society of Obstetricians and Gynaecologists of Canada supports natural childbirth and opposes Caesarean sections not warranted by medical necessity, 42% of Canadian obstetricians surveyed in a University of British Columbia study believe that women should be able to choose to have C-sections even when they are not medically indicated, even though 58% of the same survey group disagreed that a C-section was safer for the baby. Support for patient autonomy and unwillingness to spend the time necessary to explain the benefits and risks of the procedure were offered as explanations for the finding. [National Post]

Abortion guidelines in Northern Ireland create conflict

While abortion is illegal in Northern Ireland except to save the life of a mother, guidelines for provision of the procedure in other circumstances were issued in 2007 by the Dept. of Health, Social Services and Public Safety. They were rejected by a Committee of the Northern Ireland Assembly because of the conflict with the law. However, guidelines were again issued in March, 2009 and are now the subject of a legal challenge from pro-life groups. The new guidelines state that courts have interpreted "the life of the mother" to include "adverse effects on her physical or mental health," and propose that abortion will be legally justified in Northern Ireland if these adverse effects are "serious" and "permanent or long term." [Guidelines] The problem likely to arise within health care professions is that the evaluation of these effects is subjective, thus inviting disagreement, conflict and pressure on objecting professionals to participate. Relevant to this issue is that fact that, in other jurisdictions, purported restrictions based upon evaluation of maternal "health" have proved impossible to maintain.

16 September, 2009
Christian Medical Association reminds President, Congress about freedom of conscience

The President of the Christian Medical Association, representing a coaliton of 50 groups, has sent a letter and petition with 10,000 signatures from medical professionals and individuals asserting that they want the law to protect freedom of conscience in health care. [Letter]

15 September, 2009
Some Quebec physicians reject regulator's support for euthanasia

Five Quebec doctors who say that they are supported by 100 colleagues have written an open letter rejecting plans by the Quebec College of Physicians to support euthanasia. The College regulates the medical profession in the province and can discipline physicians who refuse to abide by its policies. It has announced that it will release a policy in November advocating a change in the law. [CanWest] [Abridged Translation]

14 September, 2009
Pope calls upon pharmacists to exercise freedom of conscience

Pope Benedict XVI, addressing the World Congress of the International Federation of Catholic Pharmacists in Poland, said that pharmacists must heed their conscientious convictions and not let market forces and legislation cause them to sell products that undermine human life.[Genthique]

11 September, 2009
Concern voiced that American health law reform bills lack consistent protection for freedom of conscience

Current legislative developments in health care reform in the United States are in a state of flux, with concern being expressed that bills being considered in Congress fail to provide adequate protection for freedom of conscience among health care workers. [LifeNews] The complexity of the bills and the legislative process lead to uncertainty about the final form that the bills may take. It does seem apparent that protection of freedom of conscience for health care workers is not a high priority for many members of Congress.

10 September, 2009
Feminist group demands end of freedom of conscience in health care

The National Organization of Women, which describes itself as a group of feminist activists, is demanding that American health care reform should abolish existing US protection of conscience laws. NOW "categorically rejects" the President's promise to a joint session of Congress that he would maintain such laws.[NOW news release]

Freedom of conscience advocates respond to President

A group that claims to represent 30 million constituents has expressed opposition to the Obama administration's proposed health care reforms. In a news release, stated, "We support conscience laws protecting hospitals and healthcare providers from coerced participation in abortion," and said that it would hold Congress accountable to President Obama's promise that protection of conscience laws would remain in place. [News release]

9 September, 2009
President Obama promises to maintain federal protection of conscience laws

Speaking at length to a joint session of Congress on the subject of health care reform, President Barack Obama stated that "federal conscience laws will remain in place." [White House: Remarks]

8 September, 2009
Nurse refused direction to administer overdose

Britain's General Medical Council heard evidence that a physician ordered a nurse to administer a potentially lethal overdose of insulin to an 85 year old woman who said that she wanted to die. The nurse refused, stating that it would be unethical to do so, and left the room. The physician expressed "disappointment and surprise" that the nurse refuse to do what she was told. The case illustrates the kind of situation likely to confront conscientious objectors where assisted suicide or euthanasia are legal. [Telegraph]

2 September, 2009
Bioethicist suggests Montana force physicians to prescribe lethal drugs for suicide

Applying a form of social contract theory popular among many ethicists, bioethicist Jacob Appel suggests that the state of Montana should guarantee a 'right' to physician assisted suicide by making the willlingness to write a lethal prescription a requirement for a license to practise medicine. Appel points out that lawyers are sometimes ordered to provide services for unpopular clients, and that, by analogy, physicians might be ordered to assist patients who want to commit suicide. He concedes, however, that this should be a last resort. He suggests several alternatives that the state should try first. [Huffington Post]

1 September, 2009
Bishop identifies protection of conscience as essential

Commenting on essential elements of health care reform, Bishop of Fargo, North Dakota Samuel J. Aquila has stated, "The right to follow one's conscience, as informed by God, must be guaranteed." [CNA]


29 August, 2009
Montana Court to hear appeal in assisted suicide case

The Montana Supreme Court will begin hearing arguments in an appeal of a lower court decision that declared physician assisted suicide to be a right guaranteed in the state's constitution. [See The Case of the Disappearing Plaintiffs]

26 August, 2009
BMJ deputy editor calls for legalization of assisted suicide

Tony Delamothe, deputy editor of the British Medical Journal, has expressed support for legalization of assisted suicide and called for a secret ballot of members of the British Medical Association on the subject. Delamothe notes public support for the changes and argues that the procedure is justified by the principle of autonomy.[BMJ]

25 August, 2009
Illinois judge grants injunction to protect freedom of conscience

Illinois Judge John W. Belz has issued a preliminary injunction that will permit two pharmacy owners to refuse to dispense the morning after pill pending a trial of their suit against the state. In 2004 the governor of the state issued a regulation ordering pharmacies to dispense the drug even if pharmacy owners objected to it for reasons of conscience.[ACLJ news release]

24 August, 2009
Wisconsin Catholic bishops protest law attacking freedom of conscience

The Wisconsin Catholic Conference has issued a statement protesting the passage of a provision in the state budget that requires Catholic agencies that provide health insurance to pay for coverage of contraception. The bishops voice strong objection to the legislature's "blatant insensitivity to our moral values and legal rights."

20 August, 2009
Objecting Spanish doctors will go to jail rather than do abortions

Responding to statements from the Spanish Minister of Justice, Dr. Esteban Rodriguez of Right to Life (Derecho a Vivir) in Spain said that objecting physicians would go to jail rather than perform abortions. He criticized the "totalitarian intentions" of the government.[CNA]

19 August, 2009
Survey of Canadian OB/GYNs on abortion

An internet survey of 562 Canadian obstetrician/gynaecologists which resulted in 170 returns found that about 60% of the respondents do not perform abortions. About half of these are motivated by "personal beliefs." [Medical Post]

New York hospital claims objecting nurse has no rights under federal law

Mount Sinai Hospital in New York has filed a brief that claims that nurse who was forced to assist in a late term abortion has no right of action under federal law, despite U.S. federal laws against such discrimination. A brief filed by the Alliance Defence Fund contests the claim. [ADF News Release] [Nurse forced to assist in late term abortion] The issue is significant because President Obama plans to revoke a regulation enacted by the previous administration to give practical effect to federal laws in precisely such cases. [Obama administration announces plans to revoke protection of conscience regulation]

15 August, 2009
Wisconsin Medical Society rejects assisted suicide

The ethics committee of the Wisconsin Medical Society has rejected a motion that the Society adopt a neutral position on assisted suicide, and reaffirmed its opposition to the procedure. [Second Hand Smoke; WMS statement] The statement is a clear indication that legalization of the procedure would engender conflicts within the medical profession.

14 August, 2009
Court affirms man can order cessation of food, water

Christian Rossiter of Perth, Australia, has secured a judgement from an Australian court that he can order his nursing home caregivers to stop providing food and fluids through a gastric tube. Rossiter, a quadriplegic, wants to die, although he said that he might be persuaded not to give the order. [ABC]

Spanish Justice minister says "no room for conscientious objection to abortion"

On 13 August, Spanish Minister of Justice, Francisco Caamano said that "there is no room for conscientious objection to abortion" in the country. Collegial Medical Organization President Dr. Juan Jose Rodriguez Sendin has rejected the Minister's assertion, stating that doctors will exercise their freedom to refuse to perform abortions whether the government likes it or not. The Minister's statement also brough a rebuke from the Association for the Defense of Conscientious Objection. [CNA]

10 August, 2009
American Nurses' Association official suggests objectors to abortion find other places to work

Responding to the news of a suit filed by a nurse who was forced to participate in an abortion, ANA programs officer Mary Jean Schumann said that nurses have an obligation to ensure that their moral beliefs do not create a "barrier to care." She added "Typically, you would say 'you need to find a different place to work if it is that hard for you.'" Schumann did note that ethical conflicts could not be completely avoided and that it was also possible to work around them. Schumann was quoted by John Commins in an editorial in Health Leaders Media. Commins asserted that institutions should ensure that "everybody is working off the same set of ethical principles on abortion," a patent impossibility unless those who object to abortion are denied employment.[Health Leaders Media]

4 August, 2009
Conscientious objection to medical abortion

Angelo Cardinal Bagnasco, president of the Italian Catholic Bishops' Conference, is encouraging physicians who have moral objections to abortion to refuse to prescribe the abortifacient drug Mifepristone (RU486). About 70% of Italian physicians are believed to object to abortion for reasons of conscience. [CNA]

3 August, 2009
Nurse ethicist believes conscientious objection should be "rare"

Douglas P. Olsen, RN, PhD, a nurse ethicist at the U.S. Department of Veteran's Affairs' National Center for Ethics in Health Care, stated that conscientious objection by a health care worker implies that "society has made a moral error," and that resort to it should be rare "and for very serious problems." []


30 July, 2009
Conscience protection amendments to American health reform bill offered

The US House of Representatives Energy and Commerce Committee was offered an amendment from Representative Lois Capps to America's Affordable Health Choices Act, one of the health care reform bills being considered in the United States. The amendment includes a provision that prohibits discrimination against individuals and institutions that refuse to "provide, pay for, provide coverage of, or refer for abortions." The provision is important because other parts of the Capps amendment call for public funding for abortion. A similar amendment from Representatives Bart Stupak and Joe Pitts was also adopted. It prohibits discrimination against any physician, medical professional, hospital, health care facility or insurance plan that "does not provide, pay for, provide coverage of, or refer for abortions." [ERLC]

House of Lords orders public policy statement on assisted suicide

In what will be their last decision sitting in the British House of Lords, the Law Lords have ordered the Director of Public Prosecutions to publicly set out the conditions under which someone who assists another to commit suicide abroad will be charged. The appeal was brought by Debbie Purdy following lower court decisions. Purdy wanted assurance that her husband would not be charged if he accompanied her to Switzerland, where she apparently plans to commit suicide. [Guardian][BBC]

29 July, 2009
Catholic Medical Association on US health care reform

The Catholic Medical Association has issued a statement rejecting the health care reform bills currently before the US Senate and House of Representatives, and expressing concern that the rush to reform jeopardizes real progress. The CMA expressed special concern about the need to protect freedom of conscience for health care workers, and about the financing and provision of abortion. The Association offers other criticisms of the bills, and ultimately concludes that it would be best "to scrap them and start again." [CMA Statement]

American Catholic bishops remind Congress of President's promise

Justin Cardinal Rigali, representing the US Conference of Catholic Bishops, has written to members of Congress to reiterate concerns about America's Affordable Health Choices Act (HR3200), the health care reform bill being considered. Among them, he draws attention to the need to ensure protection of conscience. "Several federal laws have long protected the conscience rights of health care providers," he wrote. "President Obama recently stated that he accepts these current laws and will do nothing to weaken them. Congress should make the same pledge, by ensuring that this legislation will maintain protection for conscience rights." [USCCB letter] [See President Obama promises "robust" conscience protection]

UK assisted suicide activist invites prosecution

78 year old Michael Irwin was struck off the medical register in the United Kingdom for unprofessional conduct related to the planned suicide of a friend, who died of natural causes. He is now inviting police to charge him for having helped Raymond Cutkelvin to go to Switzerland to commit suicide.[Guardian] It appears that Irwin is attempting to cause a change the law through civil disobedience.

27 July, 2009
Australian Medical Association criticizes state law

The federal secretary of the Australian Medical Association has criticized a law passed last year in the state of Victoria that demands that physicians who object to abortion refer patients to a non-objecting colleague. "This runs counter to the principles of autonomy and civil liberty that characterise the position promoted by proponents of the Act," he said. [The Age]

24 July, 2009
Royal College of Nursing now 'neutral' on assisted suicide

The British Royal College of Nurses has decided that it will neither support nor oppose legalization of assisted suicide. At the same time, it proposes to develop "detailed guidance" on the subject. It does not explain what kind of guidance it will be able to provide if it takes no position about it. The decision was based upon returns from 1,200 members. 49% supported legalization; 40% were opposed [RCN news release]. The Telegraph reports that the Royal College of Psychiatrists, the Royal College of Anaesthetists and the Royal College of Physicians of Edinburgh have also adopted neutral positions,[Telegraph] while the British Medical Association is opposed.[Medical News Today] The policy change has been rejected by the group Christian Nurses and Midwives [Guardian]. Dr. Peter Saunders of the Christian Medical Fellowship noted that less than half of the RCN's 390,000 members were surveyed, and that the actual returns amounted to less than a third of 1% of the membership.[Christian Institute]

22 July, 2009
New York City nurse forced to participate in late term abortion

Nurse Catherina Cenzon-DeCarlo has commenced legal action against Mount Sinai Hospital in New York City because she was forced to assist in the abortion of a 22-week-old infant in utero despite religious objections that were known to the hospital. [ADF News Release][ADF Fact sheet][New York Post]

20 July, 2009
Assisted suicide/euthanasia activism continues in Britain

What appears to be a steady if not increasing campaign in favour of legalization of assisted suicide and euthanasia is reflected in a series of reports and columns in British papers. If the media attention reflects public attitudes, it is likely that those attitudes will eventually collide with those of medical professionals opposed to the procedures. [Dignitas suicide, father-in-law: Telegraph, 19 July, 2009] [Dignitas suicide, wife: Telegraph, 19 July, 2009] [Hitchens- Mail, 19 July, 2009] [Dignitas suicide, Sir Edward & Joan Downes, Daily Express, 19 July, 2009] [Dignitas suicide, couples: The Guardian, 14 July, 2009][Senior Welsh official favours assisted suicide: Wales on Line, 20 July, 2009]

17 July, 2009
Catholic bishops stress need to protect freedom of conscience

Continued protection for freedom of conscience in health care is among the requirements for health care reform stressed by the US Conference of Catholic Bishops in a letter to members of the US Congress. "For decades, Congress has respected the right of health care providers to decline involvement in abortion or abortion referrals, without exception, and has respected moral and religious objections in other contexts as well," wrote Bishop William F. Murphy on behalf of the Conference. "Health care reform cannot be a vehicle for abandoning this consensus which respects freedom of conscience and honors our best American traditions." [USCCB Letter]

16 July, 2009
Quebec College of Physicians backs euthanasia

The College of Physicians in the province of Quebec intends to issue a statement supporting euthanasia. According to press reports, the statement is being prepared for release in November. [UPI] The College is the regulatory authority for physicians practising in the province. Of special concern is the fact the the Quebec College, alone among regulatory authorities in Canada, requires objecting physicians to refer patients for controversial procedures. Thus, it is probable that any Quebec physician who refused to facilitate euthanasia would be liable to discipline by the College.

14 July, 2009
Wisconsin law attacks freedom of conscience of pharmacists

The Wisconsin state budget (2009 Act 28), which became law at the end of June, includes a provision that forces pharmacies to stock and dispense contraceptives. [LifeSite News] Individual pharmacists are not required to dispense the products, but the law would appear to preclude the ownership of pharmacies by people who object to contraception for reasons of conscience.

13 July, 2009
Christian Medical Association opposes Kennedy conscience amendment

An amendment (#205) proposed by Senator Edward Kennedy to a bill being considered in the US Senate is opposed by the Christian Medical Association. The amendment is apparently intended to offer some protection for conscientious objectors to abortion, but it mentions only the actual performance of an abortion, not referral or other forms of facilitation of the procedure, and it fails to define the term "emergency." The CMA believes that Senator Kennedy's amendment fails to provide adequate protection for objecting health care workers.

10 July, 2009
Pope Benedict and President Obama discuss freedom of conscience

News reports indicate that freedom of conscience was one of the topics discussed privately when President Barack Obama paid a visit to Pope Benedict XVI in Rome.[Zenit]

9 July, 2009
Washington court rules against freedom of conscience

The 9th U.S. Circuit Court of Appeals has struck down an injunction that protected state of Washington pharmacists who refused to dispense the morning after pill for reasons of conscience.[Ruling][Commonweal]

8 July, 2009
HHS Secretary fails to clarify President's position

Health and Human Services Secretary Kathleen Sebelius told the Catholic News Service that President Barack Obama opposes the HHS Regulation that requires certification of compliance with U.S. federal protection of conscience laws, but supports laws that prevent doctors or pharmacists from being forced to perform the procedure or supply abortifacient drugs. Sebelius said that the President believed that the regulation jeopardized "critical health services for women."

Sebelius did not volunteer comments about the President's position on referral or other forms of participation, nor about protection for health care institutions. She also did not explain why the President could support statutes like Illinois' Health Care Right of Conscience Act and Abortion Performance Refusal Act, but not the HHS regulation, which is far less comprehensive. [CNS] [See President Obama promises "robust" conscience protection]

Scepticism about the President's intentions remains in some quarters. [Bowman]

7 July, 2009
Assisted suicide amendment rejected by House of Lords

An amendment proposed by Lord Falconer to the Coroners and Justice Bill being considered by the British House of Lords has been defeated. The amendment would have made it legal to assist a person to leave the country to commit suicide.

6 July, 2009
Former Assistant HHS secretary explains need for regulation

Joxel Garcia, an obstetrician gynaecologist, is a former assistant secretary for health. He helped write the HHS Regulation the Obama administration plans to revoke. Garcia said that the regulation is needed because few objecting health workers are aware of laws protecting them from discrimination. For example, in the late 1980's, when he applied for medical residency, he was told not to apply to some programs if he wouldn't do abortions.

"I didn't know at that time that those facilities that were receiving federal funds were not supposed to discriminate against me because I did not perform terminations of pregnancy or abortions." [NPR]

2 July, 2009
President Obama promises "robust" conscience protection

In an interview with Catholic journalists, President Barack Obama stated, "I'm a believer in conscience clauses. I was a supporter of a robust conscience clause in Illinois for Catholic hospitals and health care providers."

With respect to his administration's plans to revoke an existing Dept. of Health and Human Services regulation, he said, "I can assure all of your readers that . . . there will be a robust conscience clause in place. . . it certainly will not be weaker than what existed before [the HHS Regulation]."

Illinois' Health Care Right of Conscience Act is probably the most comprehensive protection of conscience law in the United States, and the state's Abortion Performance Refusal Act, if less comprehensive, protects hospitals and individuals who refuse to "recommend, perform, or assist in the performance of an abortion."

Taken together, the President's reference to the Illinois statutes and promise of "robust" protection at least as strong as the Bush administration's HHS regulation is remarkable. It would seem to guarantee that President Obama will ensure genuine freedom of conscience for health care workers.

However, the HHS Regulation that his administration is determined to revoke is actually far less comprehensive than the Illinois statutes he states that he supported. Thus, while his support for "robust" protection of conscience laws is heartening, it remains unclear exactly what this means to him. [Washington Post]

British Medical Association rejects assisted suicide

Delegates at the annual conference of the British Medical Association have rejected motions favouring assisted suicide. One motion proposed that people accompanying a patient during assisted suicide would not be prosecuted. The other proposed that assisted suicide be available to competent terminally ill patients. [Medical News Today]There is strong and continuing pressure to legalize assisted suicide or euthanasia in the United Kingdom. The BMA decision indicates that legalization would generate conflicts of conscience within the medical profession.