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Protection of Conscience Project

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October-December, 2009


31 December, 2009
Assisted suicide legal in Montana

The Supreme Court of Montana has ruled that there is no constitutional right to assisted suicide in the state, reversing a decision by a lower court. [See The Case of the Disappearing Plaintiffs: Robert Baxter et al vs. State of Montana (Montana, USA, 2008-2009).] This will prevent physicians and other health care workers from being compelled to facilitate suicide based on human rights claims. However, the court also ruled that assisted suicide was not illegal in Montana, nor against public policy. As a result, health care workers may come under pressure to become involved. [First Things]

24 December, 2009
US Senate passes health reform bill

The US Senate has passed the Patient Protection and Affordable Health Care Act. The final law will have to reconcile the bill with other health care reform bills in Congress.

22 December, 2009
US Catholic bishops identify conscience protection as "key" to health care reform

A media blog from the US Conference of Catholic Bishops insists that health care reform must include protection of freedom of conscience for institutions and individuals. "Forcing someone to violate his or her conscience is an act of violence no civilized society should tolerate," Sister Mary Ann Walsh notes, adding that resistance to writing such protections into law "makes one pause." She asks, "Do government leaders fear we'll be overrun by citizens with consciences?" Sr. Walsh concludes that protection of conscience measures must "be written into the health care reform bill." [USCCB Media Blog] Other statements from the Conference indicate that the bishops find protection of conscience provisions unsatisfactory [PR Newswire].

19 December, 2009
Conscience provisions untouched by amendments to Senate health reform bill

Senator Harry Reid has introduced an amendment to the Patient Protection and Affordable Health Care Act, the health care reform bill now before the US Senate. The provision concerning protection of conscience for health care providers has not been changed. It is limited to abortion. Another part of the bill prohibits discrimination against those who refuse to participate in assisted suicide or euthanasia, but the provision excludes protection of health care providers who object to euthanasia by starvation and dehydration.

18 December, 2009
Controversial moves to increase organ donation

Israel has passed a law that will require that priority for organ donation be given to those who have themselves agreed to be organ donors. [The Independent] Wales is considering a law that would presume consent for organ donation in the absence of explicit instructions to the contrary or objections of the immediate family. [BBC] Both moves are intended to increase the rate of organ donation. The former has generated criticism because it is said that the law indicates that some people are more deserving of organs than others. Concern in the latter case is associated with fear that people will be denied treatment in order to harvest their organs, or that the organs will be harvested before the patients are dead. The latter seems more likely to generate conflicts of conscience among health care workers than the former.

17 December, 2009
Prominent US physician quits American Medical Association

Dr. David Stevens, Chief Executive Officer of the Christian Medical Association in the United States, has resigned from the American Medical Association. Dr. Stevens protested meetings held behind closed doors by Washington legislators and AMA representatives, asserting that the AMA brokered a deal with politicians to secure higher Medicare payments in exchange for support for health care reform. He also stated that the AMA has worked to overturn a federal protection of conscience regulation, in violation of its own ethical position on freedom of conscience within the profession. [Catholic Online]

15 December, 2009
US Senator introduces protection of conscience amendment to health care bill

U.S Senator Sam Brownback introduced an amendment to a health care reform bill before the US Senate to provide strong conscience protection for individuals and institutional health care providers including: health plans, health insurance issuers, purchasers and plan sponsors. [Amendment] [News Release]

8 December, 2009
President Obama appoints heads of bioethics commission

President Barack Obama has appointed Dr. Amy Gutman the Chair of the Presidential Commission for the Study of Bioethical Issues, and Dr. James W. Wagner as Vice-Chair. Gutman is president of the University of Pennsylvania and Wagner is president of Emory University. [Almanac]

7 December, 2009
Canadian journalist proposes universal one-child policy

Diane France, editor-at-large of Canada's National Post, has proposed that all countries adopt a mandatory one-child policy, like that of China, on the grounds that overpopulation will eventually cause worldwide disaster.[Financial Post] Implementation of the proposal would require draconian laws and would certainly involve widespread suppression of freedom of conscience and religion.

Senator introduces protection of conscience amendment

Senator Tom Coburn has filed a protection of conscience amendment to a US health reform bill now before the Senate.

2 December, 2009
Thousands sign Manhattan Declaration

Over 200,000 people are reported to have signed the Manhattan Declaration, published on 20 November by prominent Christian leaders. The declaration affirms an intention to resist demands subordinate conscientious convictions to demands of social policy or law. [CBN News]


30 November, 2009
Northern Ireland abortion guidelines rejected by court

Lord Justice Girvan of Belfast's High Court has ruled that guidelines on abortion issued by Northern Ireland Department of Health, Social Services and Public Safety must be re-written. Girvan accepted arguments that health care workers could not be expected to offer non-directive counselling to women about abortion, which is normally a criminal offence in Northern Ireland. He also agreed that the guidelines were wrong in their expectation of referral or facilitation by objecting physicians.[SPUC news release][Irish Times]

24 November, 2009
US President creates new bioethics commission

President Barack Obama today signed an executive order creating a new presidential bioethics commission. The commission will have 13 members appointed by the President. At least one and as many as three of them may be members of the executive branch of government.[Executive Order] The new commission replaces the body created under the previous administration and abolished earlier this year. [See President Obama dismisses council on bioethics]

20 November, 2009
US Catholic bishops warn Senate that reform bill is unacceptable

The US Conference of Catholic Bishops has advised the US Senate that its health care reform bill [HR3590(A.S.)] does not meet "moral criteria" necessary to secure their support, further specifying that the moral criteria do not refer to "marginal issues or special interest concerns." With particular reference to freedom of conscience, they state that the bill "seriously weakens" existing protections for objectors while offering unbalanced protection favouring abortion facilities and promoters, while neglecting "critically important" problems.

To take just one example, the bill fails to ensure that even religious institutions would retain the freedom to offer their own employees health insurance coverage that conforms to the institution's teaching. On these various issues the new Senate bill is an enormous disappointment, creating new and completely unacceptable federal policy that endangers human life and rights of conscience.

[USCCB letter][HR3590(A.S.) Protection of conscience provisions]

Center for Reproductive Rights supports Senate bill

The Center for Reproductive Rights (CRR), a US based activist group that has been active outside the United States in trying to suppress freedom of conscience in health care [see Colombian court attacks freedom of conscience], has issued a fact sheet supporting the Senate health care reform bill [HR3590(A.S.)]. The CRR claims that the Senate bill "provides more comprehensive protection for conscience rights" than HR3962, the Affordable Health Care for America Act, which passed the US House of Representatives and is to be considered by the Senate.

Attack on freedom of conscience planned in Council of Europe

A resolution that is to be brought before the Council of Europe seeks affirmation that abortion and other controversial medical procedures are "human rights," and proposes to restrict freedom of conscience of medical professionals. [ECLJ News Release]

Manhattan Declaration affirms freedom of conscience, warns of civil disobedience

Christian religious leaders in the United States have issued the Manhattan Declaration, putting government at all levels on notice that they intend to resist attacks on freedom of religion and freedom of conscience, by civil disobedience, if need be. The declaration affirms that they will refuse to comply with "any edict that purports to compel our institutions to participate in abortions, embryo-destructive research, assisted suicide and euthanasia, or any other anti-life act," and that they will not "bend to any rule" that would force them to deny their own moral views. The document is signed by over 150 Christian religious leaders from different denominations, though not all from the United States. [NY Times] [Manhattan Declaration Website]

19 November, 2009
Euthanasia bill defeated in South Australia

A euthanasia bill has been defeated in the Parliament of South Australia. [ABC news] The bill included some protection of conscience provisions.

Health care reform bill introduced in US Senate

The American Constitution requires all revenue bills to begin in the House of Representatives. The US Senate has taken HR3590, a bill unrelated to health care that began in the House, and plans to use its power of amendment to replace the entire text of the original bill with the text of a health care reform bill over 2,000 pages long. The bill includes protection of conscience provisions, limited to abortion. It states that qualified health plans may not be required to provide coverage for abortion, and that neither individual health care providers or institutions may be discriminated against for refusing "to provide, pay for, provide coverage of, or refer for abortions." The bill also states that it is not to be construed to affect federal protection of conscience or anti-discrimination laws.

10 November, 2009
Assisted suicide bill defeated in New Hampshire

A committee of the New Hampshire state legislature has voted down a bill that would have legalized assisted suicide. [Seacoast Online]

9 November, 2009
Catholic bishops offer qualified support for health care reform bill

Francis Cardinal George, President of the US Conference of Catholic Bishops, has issued a statement offering support for the Affordable Health Care for America Act that has just passed the US House of Representatives. He states that the continued support of the bishops is conditional upon the provision that prohibits funding of abortion, and said, "We will continue to insist that health care reform legislation must protect conscience rights."

7 November, 2009
US Houses passes amended health care reform bill

The US House of Representatives has passed HR3962, the Affordable Health Care for America Act, after it was amended to prohibit federal funding of abortion.[Stupak Amendment] The bill includes protection of conscience provisions, but only with respect to abortion. News reports focus almost exclusively on the controversy over the abortion funding provision.

6 November, 2009
Ethicist discusses broader implications euthanasia

Prof. Margaret Somerville of McGill University, in an article that argues against euthanasia, notes that legalization of the procedure would likely make it necessary to train medical students how to administer lethal injections. She also noted that it is important to consider the significant difference in attitudes toward euthanasia within the medical profession and in the public at large. [Ottawa Citizen] The failure to take such differences into account when legalizing abortion has caused conflict in some countries. [South African Survey]

Head of Christian Medical Association says US bills lack conscience protection

Dr. David Stevens, CEO of the Christian Medical Association, states that the health care reform bills now before the US congress fail to protect freedom of conscience for health care workers, and, if passed in their current form, may drive many religious believers out of health care. [OneNewsNow]

US Bishops reject health care reform bills

Citing provision of abortion and lack of protection for freedom of conscience among health care workers, three Catholic bishops writing on behalf of the US Conference of Catholic Bishops have told American Congressmen that the bills now before them are unacceptable. [Zenit]

5 November, 2009
Tasmanian parliament rejects euthanasia bill

A bill that would have legalized assisted suicide and euthanasia has been defeated in the Tasmanian Parliament, but the bill's sponsor has promised to bring it back again and again until it passes. [ABC News] The bill included some protection of conscience provisions.

4 November, 2009
Elderly couple claim assisted suicide is a human right

An elderly husband and wife have committed suicide in Newbury, Berkshire, England. They were not in poor health but decided to kill themselves before their health deteriorated. They wrote a letter to the BBC to complain that the law against assisted suicide denied them "a basic human right."

2 November, 2009
Quebec physician regulatory agency favours euthanasia

The Quebec College of Physicians, the regulatory authority for the province, has published a position paper callling for the legalization of euthanasia in cases of "imminent and inevitable death." A College official stated that "death can be an appropriate type of care in certain circumstances." [National Post] With respect to conscientious objection by physicians, the document is ambiguous. On the one hand it states that doctors must be assured that 'they will not be obliged to practise euthanasia." On the other hand, it quotes that part of the College's Code of Ethics that imposes a duty to ensure that a patient dies with dignity and with "appropriate support and relief." This could easily be interpreted to require participation in euthanasia or assisted suicide in some way, should the procedures be legalized. Moreover, the College foresees only conditional freedom to refuse, without clarifying the nature of the conditions.[College Statement]


23 October, 2009
Colombian Constitutional Court rejects suspension of ruling

The Colombian Constitutional Court has rejected as suspension of its ruling that all hospitals must provide abortion and insists that its ruling be obeyed.[Columbia Reports]

22 October, 2009
Colombian State Council suspends court decree suppressing freedom of conscience

Acting at the direction of the First Section of the Colombian High Court, the State Council of Columbia has suspended a ruling by the Columbian Constitutional Court that would have forced all hospitals, secular and religious, to provide abortions.[Colombia Reports]

19 October, 2009
Colombian court attacks freedom of conscience

The Colombian Constitutional Court has ruled that medical professionals may refuse to provide abortions for reasons of conscience, but only if they provide written reasons for their refusal and refer the patient for the procedure. Moreover, the ruling prohibits health care institutions from refusing abortion and demands that all health care institutions -denominational or secular - ensure that medical staff are available to provide abortions. Individuals or institutions that fail to comply with the ruling are to be punished. The Center for Reproductive Rights is celebrating the ruling as a "tremendous victory." [CRR news release]

14 October, 2009
Ontario court ruling acknowledges duty to infant in utero

A judge of the Ontario Superior Court of Justice has ruled that physicians have a duty of care to infants in utero. The ruling was made in a case brought against the Guelph Hospital and physicians, alleging that negligence in monitoring led to handicaps caused by oxygen deprivation. The ruling has significant implications for physicians who refuse to provide services or procedures on the grounds that they may harm the unborn child.[Legate news release]

Researchers claim advanced dementia a terminal illness

An article published in the New England Journal of Medicine claims that advanced dementia is "a leading cause of death in the United States." Since it was acknowledged that actual causes of death were infections like pneumonia or eating problems, it appears that the goal of the paper is to justify, if not encourage, the withdrawal of food and fluids from patients suffering from advanced dementia but who are not dying.[NEJM, Reuters] This would likely lead to conflicts of conscience for health care workers opposed to euthanasia by dehydrations and starvation.

Pneumonia patient starved to death in UK

A man wrongly diagnosed with cancer was denied food and fluids for two weeks and died of pneumonia at Marie Curie hospice in Liverpool. The hospice has refused to admit liability but has paid £18,000 compensation to his widow, who accepted the settlement only because she would otherwise have lost her legal aid. The treating physician was Dr. Alison Coackley, a palliative care specialist who apparently espouses "futile care theory." [Mail] The case illustrates the potential for conflicts of conscience among health care workers where such theories are applied.

13 October, 2009
Nurse reinstated in United Kingdom

A nurse who was struck from the register after exposing severe neglect of patients at the Royal Sussex Hospital in Brighton, England, has been reinstated. She was disciplined for breaching patient confidentiality as a result of a complaint from the National Health Services Trust, the organization responsible for what one critic called "the subhuman conditions" in which patients were kept. The High Court ordered her reinstatement, substituting a one year caution for the original penalty. The case illustrates the kind of adverse circumstances that may complicate conscientious objection in health care.[The Independent]

11 October, 2009
New South Wales pharmacist declines to sell contraceptives

A pharmacist in Griffith, New South Wales, has stopped selling contraceptives, including condoms, in accordance with his religious convictions. Trevor Dal Broi is a Catholic. The government has acknowledged that pharmacists are not obliged to sell contraceptives. The Pharmacists Guild has pointed out that the town of 16,000 has other pharmacies, and that condoms can be purchased anywhere. Another unidentified Catholic pharmacist in the town who does provide contraceptives did not directly comment on the matter, but implied that the Catholic Church would be wrong to oppose the sale of contraceptives. The report notes "outrage" expressed by others in the community.[Sydney Morning Herald][Over the counter conscience vote]

Pneumonia patient nearly starved to death in British hospital

An 80 year old East Sussex woman with pneumonia survived her stay at the Conquest Hospital in Hastings, East Sussex, as a result of determined intervention by her daughter. Physicians acting under the "Liverppool Care Pathway" and the Mental Capacity Act denied the woman food and fluids and stopped antibiotic treatment. Her daughter reported that she had to "fight hospital staff for weeks" to prevent her mother from being starved and dehydrated to death. [Telegraph] It is not difficult to imagine such cases generating conflicts of conscience among health care workers.

8 October, 2009
US Conference of Catholic Bishops voices opposition to US Senate reform bill

The US Conference of Catholic Bishops has warned US Senators that the Conference will oppose a major health care reform bill proposed by Senator Baucus unless it is amended. Among the unacceptable features of the current bill the bishops identified a failure to ensure protection of conscience measures for health care workers.[USCCB letter]

4 October, 2009
Coroner rules physicians acted properly in not preventing suicide

A young woman with a history of mental illness and self-injury and who is reported to have been depressed was allowed to die by physicians after she took poison to kill herself. They did not treat her because she gave them a letter signed in the presence of a lawyer stating that she did not want to be treated. Critics are blaming the Mental Capacity Act for for her death. [Telegraph] However, previous to the passage of the Act, the common law had forbidden physicians to treat patients without their consent unless the patient was deemed incompetent. A more accurate reading of the circumstances indicates that the physicians judged that her desire to kill herself was a rational response to her depressive condition rather than evidence of incompetence arising from it.

2 October, 2009
Lesbian suit against objecting physicians settled out of court

A woman who identifies herself as lesbian who was refused artificial insemination by Christian doctors at North Coast Women's Care Medical Group in Oceanside, California, has accepted an out-of-court settlement for an undisclosed amount of money. The case began eight years ago. [Christian Post] Many physicians are concerned that cases like this will lead to suppression of freedom of conscience in health care and drive religious believers out of the profession of medicine. [OneNewsNow]