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Protection of Conscience Project

Service, not Servitude
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July-September, 2010


29 September, 2010
Council of Europe to consider suppression of freedom of conscience

On 7 October, 2010, the Parliamentary Assembly of the Council of Europe (PACE) will consider a report from the Social Health and Family Affairs Committee that proposes to deny freedom of conscience to denominational health care facilities and, in large part, to medical practitioners. If the report is accepted, regulations will force objectors

  • to prove that their intention is based upon morality, ethics or religion;
  • to prove that they are honest and sincere;
  • to notify employers and others of their intentions;
  • to be formally registered, at least by employers;

Specifically, if asked to do something to which they object, they may refuse to do it, but they must ensure that it is done by someone else. If this is not possible, they must do it themselves. The report also recommends oversight and monitoring of the exercise of freedom of conscience, and effective complaint mechanisms to ensure that objectors comply with the rules. The European Centre for Law and Justice has issued a critique of the report. It is also opposed by Christian Action Research and Education (CARE), which has also submitted a brief on the report. [ECLJ news release]

28 September, 2010
Study indicates most Oregon hospices decline to participate in assisted suicide

According to a Hasting Center Report, despite legalization of assisted suicide in Oregon, hospices in the state refuse to provide lethal drugs for assisted suicide by their patients, and most have only marginal involvement in patient decision making about the procedure. (Courtney S. Campbell and Jessica C. Cox, "Hospice and Physician-Assisted Death: Collaboration, Compliance, and Complicity," Hastings Center Report 40, no. 5 (2010): 26-35.) The reluctance of hospices to participate in assisted suicide suggests the importance of the protection of conscience measures included in the state's assisted suicide law.

25 September, 2010
Defence of religious freedom offered at Irish conference

Speaking at a conference in Dublin organized by the Iona Institute, Prof. Roger Trigg of Kellogg College, Oxford, insisted that freedom of conscience and religion are not opposed to human rights, of which religious freedom was one of the most basic. He argued for reasonable accommodation of freedom of conscience.[Irish Times] Professor Trigg is an Advisor to the Protection of Conscience Project, though he was not representing the Project at the conference.

23 September, 2010
Euthanasia bill defeated

The euthanasia bill before the Western Australia parliament has been defeated 24-11. [AAP]

20 September, 2010
Australian euthanasia bill protection of conscience measures questionable

The Voluntary Euthanasia Bill 2010 (Bill 108), which is to be debated in the Parliament of Western Australia, includes a provision that states: "No person may be compelled to do or omit to do any thing required or permitted under this Act if that act or omission is contrary to that person's conscience or beliefs," and makes it clear that medical practitioners are not obligated to assess euthanasia requests or to refer patients to more willing colleagues. However, the bill does not appear to offer the same protection to conscientious objectors that is offered to those willing to assist in the procedure. [Sydney Morning Herald] [See relevant sections of the bill]

16 September, 2010
Washington Pharmacy Board to begin hearings on freedom of conscience

The Washington State Pharmacy Board is considering a change in its rules to allow pharmacists who object to providing a service for reasons of conscience to refer patients elsewhere. The plan is being hotly contested by opponents of freedom of conscience for pharmacists. The Board suppressed freedom of conscience by issuing rules in that became the subject of a civil suit filed by objecting pharmacists. The suit has been stayed pending the outcome of the Board's reconsideration of the rules. [Seattle Weekly]

[To make public Comment] [Directions to hearings]

Previous Project news items:

15 September, 2010
Scots nurses warn of "ethical dilemmas" if assisted suicide legalized

The Scots parliamentary committee taking evidence concerning a proposed assisted suicide bill was told by the representative of Highland Hospice that her organization opposed the bill, and that if assisted suicide were legalized it would generate "ethical and legal dilemmas" for healthcare professionals. [The Scotsman] The British Medical Association - Scotland is also strongly opposed to the bill. [BMA Scotland] The evidence highlights the fact that the bill lacks a protection of conscience provision. [See Scots assisted suicide bill lacks protection]

8 September, 2010
Pope emphasizes need for sound foundation for human rights

Speaking to the members of the Bureau of the Parliamentary Assembly of the Council of Europe, Pope Benedict XVI emphasized the importance establishing an adequate foundation for human rights in order to establish their universal validity.

. . . it is imperative to develop the universal validity of these rights as well as their inviolability, inalienability and indivisibility.

On different occasions I have pointed out the risks associated with relativism in the area of values, rights and duties. If these were to lack an objective rational foundation, common to all peoples, and were based exclusively on particular cultures, legislative decisions or court judgments, how could they offer a solid and long-lasting ground for supranational institutions such as the Council of Europe, and for your own task within that prestigious institution? How could a fruitful dialogue among cultures take place without common values, rights and stable, universal principles understood in the same way by all Members States of the Council of Europe? These values, rights and duties are rooted in the natural dignity of each person, something which is accessible to human reasoning. The Christian faith does not impede, but favors this search, and is an invitation to seek a supernatural basis for this dignity. [Full text]

The Pope's comments reflect concerns similar to those of Professor Abdulaziz Sachedina, an Islamic scholar and Project Advisor. [See The Clash of Universalisms- Religious and Secular in Human Rights]


31 August, 2010
Scots assisted suicide bill lacks protection of conscience provision

The End of Life Assistance (Scotland) Bill, which is to be debated in the Scots Parliament in the first week of September, lacks any provision to safeguard the freedom of conscience of those who do not wish to be involved with assisted suicide. [Firm Magazine]

23 August, 2010
Saudi court approaches hospitals about punitive surgery

Hospitals in Saudi Arabia have been approached by a Saudi to find out if they would perform surgery to damage a man's spinal cord. The man was convicted of attacking another man with a cleaver and paralyzing him. The family of the victim was dissatisfied with the original sentence and have asked for retributive punishment under Islamic law. At least two of the hospitals approached by the judge refused to provide the surgery. Amnesty International has become involved. The group has had reports of people having teeth pulled out or being sentenced to blindness on the basis of the principle, "an eye for an eye." [Associated Press; Washington Times] However, Saudi authorities have explained that the hospitals were contacted only for the purpose of helping to convince the family to accept the monetary compensation ordered by the court. [Reuters]

20 August, 2010
Becket Fund threatens to sue US government department

The Becket Fund for Religious Liberty, an American public interest law firm, has threatened to sue the Department of Health and Human Services (HHS) if it tries to force religiously affiliated hospitals to perform abortions. The threat was delivered in a letter to the Department in response to a complaint made against Catholic hospitals by the American Civil Liberties Union. [News release]

13 August, 2010
New drug to be marketed as morning after pill

HRA Pharma has announed that the US Federal Drug Administration has approved a new drug, "Ella" (ulipristal acetate) for sale in the United states. It has been sold in Europe since 2009 as "ellaOne." The company news release states that the drug is a prescription-only medication that is effective up to five days after intercourse. It describes the drug as a "progesterone agonist/antagonist that potently inhibits follicular rupture when taken just before ovulation is to occur." However, the company's summary of product characteristics states that "[t]he primary mechanism of action is thought to be inhibition or delay of ovulation, but alterations to the endometrium may also contribute to the efficacy of the medicinal product." This suggests that the drug is a potential embryocide, which would be of concern to some health care workers. [See Clearing Rhetorical Minefields]

12 August, 2010
Catholic institutions in Wisconsin compelled to provide contraceptives

As a result of a budget bill passed in 2009, four of five Catholic dioceses in Wisconsin, USA, began paying for coverage of contraception for employees on 1 August. The law requires that any insurance plan offering coverage for prescription drugs offer coverage for contraceptives; it exempts self-insured employers. The Diocese of Green Bay has adopted a self-insurance plan to avoid the demand, and one of the currently compliant dioceses is considering alternatives. It has been suggested that Catholic employees hired on condition that they abide by Church teaching could lose their jobs if they obtain contraceptives through the insurance plan. However, state privacy laws prevent disclosure of such information, and it does not appear that Church authorities intend to pursue such a policy except in cases of overt and public defiance. [Kansas City Star] [Wisconsin State Journal]

5 August, 2010
Quebec funds in vitro fertilization: demand exceeds supply

The government of Quebec has agreed to fund in vitro fertilization and the demand for the service has overwhelmed existing resources. There are not enough gynecologists in the province to follow normal pregnancies, neonatal units are full very few pediatricians are taking new patients. [Montreal Gazette] Reports do not discuss the possibility that public funding will increase demands that health care workers be forced to participate in the procedure even if they object to it for reasons of conscience.

3 August, 2010
Speaker offers advice on protection of conscience in obstetrics

Speaking at the annual meeting of American Academy of Fertility Care Professionals in Omaha, Nebraska, Sister Renee Mirkes offered advice about responding to current threats to freedom of conscience. She discussed the formation and exercise of conscience, and she urged attendees to follow all reasonable American Congress of Obstetricians and Gynecologists policies on conscientious objection, including notification of patients of restrictions on their practices. Sister Mirkes also encouraged them to engage in political strategies to protect freedom of conscience in health care. [The Criterion]

1 August, 2010
Chemical abortion proposed as effective in developing countries

A column in the New York Times suggests that the drug Misoprostol, originally intended to treat stomach ulcers, can be used effectively as an abortifacient in developing countries because it is cheap and easy to distribute. While its efficacy is in the order of 80 to 85% and it can cause birth defects, proponents of the drug do not consider these issues significant. It is not clear whether or not they recognize any upper gestational limit to the use of the drug. [New York Times] The column does not refer to the problems caused when the drug is not fully effective and a woman with an incomplete abortion arrives at hospital expecting it to be completed by health care workers. [See note on South African survey]

Survey indicates most Nigerian physicians would refuse to perform abortions

Only 13.4% of physicians who responded to a survey in the Delta state of Nigeria would be willing to provide abortions if the law restricting the procedure were liberalized. At present, abortion may be performed only to save the mother's life. 166 surveys were distributed in the study conducted by researchers at Delta State University, Abraka, Nigeria; 134 surveys were returned. 91% of the respondents currently do not perform abortions. The paper concludes with the comment that there is an urgent need to increase use of contraceptives in Nigeria and a need for "induced abortion" - by which the authors apparently mean liberalization of the law. Liberalization would clearly generate serious conflicts of conscience among health care professionals unless accompanied by robust protection of conscience laws. [See also South Africa study; No Place for Abortion in African Traditional Life]


30 July, 2010
British Medical Association guidelines on assisted suicide

The British Medical Association has issued guidelines for physicians faced with patient requests for assisted suicide. The procedure remains a criminal offence in the United Kingdom, but Crown Counsel guidelines have been issued that preclude prosecution in certain circumstances. The BMA advises physicians to "avoid all actions that might be interpreted as assisting, facilitating or encouraging a suicide attempt," such as

  • advising patients what constitutes a fatal dose;
  • advising patients on anti-emetics in relation to a planned overdose;
  • suggesting the option of suicide abroad;
  • writing medical reports specifically to facilitate assisted suicide abroad;
  • facilitating any other aspects of planning a suicide.

The guidelines demonstrate that the BMA acknowledges that such conduct may make physicians complicit in an assisted suicide. This is the same position taken by conscientious objectors to other controversial procedures.

29 July, 2010
Sex selection by IVF offered by physician in Scotland

Dr. Jeffrey Steinberg provides IVF sex selection through clinics operated in New York and Los Angeles in order to circumvent the law against the procedure in Scotland. He foresees expanded use of pre-implantation genetic diagnosis to avoid genetically inherited diseases and choose desired characteristics. [Daily Record] The report does not disclose what is done with surplus or defective embryos; in some jurisdictions they may be destroyed or used for research. The normalization of such procedures and ensuing demand may create problems for health care workers where they are legal.

27 July, 2010
Freedom of conscience advocacy in the USA

The American organization Christus Medicus Foundation has reported on its work related to freedom of conscience in health care in the United States. The Foundation has

  • reconvened the Health Right of Conscience Working Group (HCRCWG)
  • worked with Americans United for Life and the US Conference of Catholic Bishops to organize the Washington Summit on Religious Liberty and Individual Right of Conscience, as a result of which it was agreed
    • that all present would actively support the formation of a National Policy Coalition for the active promotion of Religious Liberty and the Right of Individual Conscience;
  • Secured support among state public policy advocacy leaders in Kansas, Texas and Missouri for federal and state legislation to secure freedom of conscience in health care
  • Obtained approval from the Catholic Medical Association (CMA) to coordinate a conference for CMA physicians and administrators that want to become more active in advancing conscience protection and other initiatives.
Public consultation on abortion/conscientious objection in Northern Ireland

The Northern Ireland Department of Health, Social Services and Public Safety (DHSSPS) has published guidelines on abortion for public consultation that will end on 22 October, 2010. Previous guidelines were withdrawn as a result of court rulings against the Department; the guidelines were misleading with respect to counselling and conscientious objection. The new guidelines require objecting physicians to provide abortions if the life of the woman is in danger and action must be taken immediately to save her life. They also require objectors to refer for abortion, and note that a physician who fails to provide an abortion may be liable to criminal charges if the patient dies as a result. [DHSSPS news release] [DHSSPS Consultation Page] [DHSSPS Cover Letter] [Proposed Guidelines]

26 July, 2010
Discussion of freedom of conscience in health care generates tension

A number of Catholic commentators have taken issue with statements by Father Bryan Hehir of the Archdiocese of Boston during a panel discussion at Boston College on 13 April, 2010, on the subject of freedom of conscience in health care. Father Hehir is Cabinet Secretary of Social Services for the Archdiocese of Boston and an aide to Cardinal Sean P. O'Malley, O.F.M. Cap. The comments illustrate the kind of problem that can arise when clear distinctions are not made between consideration of practical issues involved in accommodating freedom of conscience in health care and consideration of the morality of contentious procedures.[Bryan Hehir Exposed]

25 July, 2010
Man volunteers to die by organ donation

A 62 year old man living in west Cherokee County, Georgia, USA, who has been diagnosed with amyotrophic lateral sclerosis (Lou Gehrig's Disease), has volunteered to donate his organs immediately, though the surgery would cause his death. He would like to see the law changed to permit organ donation under these circumstances, which would amount to euthanasia or assisted suicide for the purpose of organ donation. [Cherokee Tribune] Such procedures have been seriously recommended by some ethicists, notably Julian Savulescu, who is also opposed to freedom of conscience in health care: "If people are not prepared to offer legally permitted, efficient, and beneficial care to a patient because it conflicts with their values, they should not be doctors." [Savulescu, Organ Donation Euthanasia; Conscientious Objection in Medicine]

23 July, 2010
Canberra Declaration

Christian leaders in Australia have published the Canberra Declaration, modelled on the Manhattan and Westminster Declarations. The Canberra Declaration asserts the importance of freedom of conscience and freedom of speech, warning the the suppression of such freedoms marks the beginning of totalitarianism. It includes a statement that signatories "will not comply with any directive that compels us to participate in or facilitate abortion, embryo-destructive research, assisted suicide, euthanasia, or any other act that involves the intentional taking of innocent human life."[Assist News]

Activist proposes assisted suicide in Idaho

Repeating the theme of an article published in June, Kathryn L. Tucker, Director of Legal Affairs for Compassion and Choices, addressed the Idaho Medical Association to persuade its members that they are free to assist in patient suicides. It appears that the presentation generated a strong rebuttal but no noticeable support. [National Catholic Register] Legalization of assisted suicide or euthanasia would likely have an adverse impact on conscientious objectors to the procedures.

20 July, 2010
New Zealand physician proposes euthanasia

Dr. John Pollock, a former general practitioner in New Zealand, has been diagnosed with terminal cancer and has begun to be more vocal in his support of euthanasia. He had previously left the New Zealand Medical Association (NZMA) because of its position against euthanasia, which, he said, was contrary to his own views and those of other physicians. The chairman of the NZMA states that euthanasia would remain unethical even if it were legalized. [Otago Daily Times] The statement indicates the likelihood of conflicts of conscience among health care workers should the law be changed and the medical profession face demands for the delivery of "legal services."

19 July, 2010
UK man seeks protection for euthanasia by wife

A 56 year old man in the United Kingdom is seeking a ruling from a superior court that would protect his wife from prosecution should she kill him at his request. Tom Nicklinson suffers from "locked in" syndrome and does not wish to live. However, he is unable to take any action necessary to commit suicide, so it would be necessary for his wife to kill him herself. This would expose her to prosecution for murder, which Nicklinson wants to prevent through his court application. A similar case launched by Debbie Purdy, who suffers from Multiple Sclerosis, forced the Director of Public Prosecutions to issue guidelines for the prosecution of assisted suicide which effectively legalize it in some cases, but the guidelines do not apply to the law on murder. [BBC] [The Telegraph] The guidelines do not require the participation of health care workers, but likely create an expectation of their involvement.

14 July, 2010
Spanish Archbishop says law does not oblige

The Archbishop of Burgos, Francisco Gil Hellín, has denounced the law legalizing abortion in Spain as contrary to right reason and is thus invalid. [Statement] This is clearly a challenge to the position of the government, since the Minister of Justice said last year that there would be no allowance for conscientious objection to abortion. [Spanish Justice minister says "no room for conscientious objection to abortion"]

7 July, 2010
Washington State reconsiders freedom of conscience for pharmacists

With two weeks to go before the start of a trial in a civil suit brought by objecting pharmacists, the State of Washington has decided to develop new rules to accommodate freedom of conscience for pharmacists. The plaintiffs have agreed to postpone the trial to give the state time to propose new regulations. [Beckett Fund News Release]

1 July, 2010
American Civil Liberties Union demands abortion in Catholic hospitals

The American Civil Liberties Union has written to the U.S. Centers for Medicare and Medicaid Services to complain that religiously affiliated hospitals (specifically identifying Catholic hospitals) are failing to provide "emergency reproductive health care" to women: specifically, abortions. The ACLU claims that this is illegal and has asked the Department to investigate and enforce the law. This amounts to a demand that Catholic hospitals be forced to provide abortions in at least some circumstances. [ACLU News Release; ACLU letter] The letter appears to have been triggered by the excommunication of a Catholic nun who approved an abortion that was subsequently performed at St. Joseph's Hospital in Phoenix, Arizona. [USA Today]