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Protection of Conscience Project

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October-December, 2010


22 December, 2010
Belgian proposal attacks conscientious objectors to euthanasia

The European institute of Bioethics [] reports that three members of the Belgian House of Representatives (Myriam Vanlerberghe, Renaat Landuyt and Maya Detiège) have tabled legislation that will increase the availability of euthanasia by making it available to people suffering from dementia and to minors. The bill is also said to attack freedom of conscience by requiring objecting physicians to facilitate the procedure. [BELN Blog]

Protection of conscience bill introduced in US House of Representatives

Representative Fortenberry has introduced a bill called the Respect for Rights of Conscience Act of 2010. It is an amendment to the Patient Protection and Affordable Care Act to "ensure that health care stakeholders retain the right to provide, purchase, or enroll in health coverage that is consistent with their religious beliefs and moral convictions, without fear of being penalized or discriminated against under PPACA" and "that no requirement in PPACA creates new pressures to exclude those exercising such conscientious objection from health plans or other programs under PPACA."

20 December, 2010
European Court of Human Rights decision on Irish abortion law

The European Court of Human Rights decision in the case of A, B, and C vs Ireland is generating concern, anger, jubilation and controversy in Ireland. The Court dismissed the complaints of A and B. In the case of C, it ruled that existing Irish law, which prohibits abortion except when necessary to save a mother's life, is consistent with European human rights law. C was unable to find a physician in Ireland who would certify that her pregnancy put her life at risk. The Court ruled that Ireland must establish a process through which a woman can obtain such an opinion. [Irish Times-01] [Irish Times-02] [Catholic World Report] [Belfast Telegraph] [Huffington Post] It is not clear whether or not such a process could give rise to conflicts of conscience in health care, though such difficulties might arise in the event of disagreement about the prognosis.

Obama Push to Rescind Conscience Rights Upsets Pro-Life Doctors

[Steven Ertelt,]

A national organization of Christian doctors is strongly concerned about the Obama administration's effort to rescind conscience protections the Bush administration put in place for medical professionals.

The regulations provide additional protections and support for those doctors and nurses who don't want to be involved in abortions and may face pressure from medical institutions receiving federal funds.

As recently reported, documents the Obama administration filed in November and December have Obama administration attorneys admitting the administration wants to finalize a rescission of the conscience rules but has been delayed because of other business - likely due to the HHS working on implementing the provisions of the ObamaCare law.

That greatly concerns Jonathan Imbody, the Vice President for Government Relations at the Christian Medical Association. . . [read more]

17 December, 2010
Rights claims threaten freedom of conscience in Costa Rica

In 2000 the Constitutional Court of Costa Rica confirmed that in vitro fertilization is illegal in the country. In 2008, after having exhausted appeals in Costa Rica courts, a number of couples asked the Inter-American Commission on Human Rights to intervene. The Commission, based in Washington, is part of the Organization of American States. It has now warned Costa Rica that it must lift the ban on IVF, claiming that the prohibition violates the American Convention on Human Rights, the United Nations Convention on the Elimination of All Forms of Discrimination Against Women and the Cairo Program of Action of the United Nations International Conference on Population and Development.[CNS] If the claims are accepted, it will likely have an adverse impact on those who are opposed to the procedure for reasons of conscience, since a refusal to provide it or assist with it would be considered a violation of human rights.

16 December, 2010
Washington Pharmacy Board reverses itself, affirms oppressive regulation

In a 5-1 vote, the Pharmacy Board in Washington State has reversed a decision made in July to revise a contentious regulation. The July decision was made two weeks before a trial was to begin in a civil suit brought against the state by objecting pharmacists. The trial was postponed pending the outcome of the proposed rule change. [Associated Press] [See Washington Pharmacy Board to begin hearings on freedom of conscience]

14 December, 2010
Documents confirm Obama administration hostility to freedom of conscience

In November and December, the Obama administration filed documents in federal court stating that the revocation of an HHS Regulation protecting freedom of conscience regulation has been delayed, but hopes to have the process finished by the beginning of March, 2011.[]

7 December, 2010
New Zealand court strikes down proposed guidelines

Justice Alan MacKenzie of the High Court in Wellington, New Zealand, has ruled that guidelines proposed by the New Zealand Medical Council imposed obligations that went beyond those imposed by law. All that is required of a physician who objects to abortion is to decline to begin the process and inform his patient that she may obtain the procedure from another practitioner. The proposed guidelines would have imposed a requirement for referral, and were challenged by a group of physicians. [News release] [New Zealand Herald]

Indian official demands that physicians increase sterilizations

Bhopal Commissioner Manoj Shrivastava has ordered that physicians at Sultania Hospitals be formally warned that they are falling behind in sterilizations and will be expected to set and meet targets to achieve the state's family planning goals. The notices are to be sent to physicians who have performed fewer than 20 sterilizations. [The Pioneer] The order illustrates the threat to freedom of conscience in health care that can arise when the state assumes control of medical practice, and demonstrates the importance of robust protection of conscience legislation in such jurisdictions.

2 December, 2010
Assisted suicide bill defeated in Scotland

The End of Life Assistance (Scotland) Bill has been defeated in the Scots parliament. The bill lacked protection of conscience provisions for health care workers who did not want to be involved with assisted suicide.


30 November, 2010
No consensus on ethically controversial procedure

A group of doctors, ethicists and parents of disabled children asked to study the ethics of stunting the growth of disabled children has been unable to reach a consensus on the issue. A majority of the participants agreed that the procedure should only be considered in extreme situations, but it appears that there has been no attempt to fabricate a consensus on the basis of the majority opinion. [Seattle Post Intelligencer] It is unfortunate that many are unwilling to admit that there is no moral consensus with respect to other controversial procedures.

29 November, 2010
American group reaffirms hostility to freedom of conscience

The American College of Obstetrics and Gynecology has reaffirmed a 2007 statement by its ethics committee that attacks freedom of conscience for physicians who are opposed to abortion.

Court rejects suit brought by nurse forced to assist in abortion

A US federal court has rejected a suit filed by Catherina Cenzon-DeCarlo, a nurse who alleges that she was forced to participate in a late term abortion at Mount Sinai Hospital in New York City despite her stated and well-known objections to the procedure. The court ruled that federal protection of conscience laws do not permit individuals whose rights and freedoms are violated to take legal action against those responsible. [Have US conscience clause protections been eviscerated?]

16 November, 2010
American group cites concerns about freedom of conscience

Jeanne Monahan, director of Family Research Council's Center for Human Dignity, has expressed concern that proposed changes in health care in the United States would "undermine the conscience rights of many in the health care profession" and insisted that "the conscience rights of health insurers, providers and participants who object to contraceptives" be respected. [News release]

10 November, 2010
"Selective freedom of conscience" in war

Writing in the Catholic University of America Tower, Bob Shine advocates for what he calls "selective freedom of conscience" in the American military, by which he means the freedom to selectively refuse to participate in actions that are contrary to one's conscientious convictions. Traditionally, conscientious objection to military service has been accepted when the objection is either to military service in general or to the requirement to kill. Shine argues that it should be possible for soldiers who do not object to combat in principle to refuse to participate in military actions that they deem to be immoral. [Article: Freedom of Conscience] Leaders of a coalition that styles itself the Truth Commission on Conscience in War have now asked the U.S. Congress to expand the definition of conscientious objection [NY Times Blog] The argument is analogous to that made by health care workers who do not believe that they are obliged to disregard their moral convictions when they join a profession: that they should not be obliged to perform morally contentious procedures to which they object, even if the procedures are accepted by the profession as a whole.

Almost half of physicians surveyed willing to what they believe wrong

Of 10,000 physicians surveyed by Medscape, 46% stated that they would perform an abortion in some circumstances "even if it were against [their] beliefs." [WebMD] The response was to one of "21 tough ethical questions" posed in the survey.

9 November, 2010
Activists meet in Ghana to expand abortion in Africa

A four day conference is being held in Accra, Ghana, by activist and others who want to expand abortion services in Africa. A number assert that access to abortion is a "human right," which would have serious repercussions for health care workers and others who object to the procedure.[Ghana News][No Place for Abortion in African Traditional Life]

4 November, 2010
Washington State Pharmacy Board votes to change rule

By a 3-2 vote the Washington State Pharmacy Board has decided to have its staff do the groundwork necessary to remove restrictions on the exercise of freedom of conscience by pharmacists. [Seattle Times].

3 November, 2010
New Brunswick Human Rights Commission may hold secret inquiry

The New Brunswick Human Rights Commission has confirmed that it has been investigating a complaint that the province's abortion policy is too restrictive. The complainant(s) in the case have not been identified. Provincial policy requires two doctors to approve each abortion as "medically necessary." Among the complaints from activists is an allegation that too many physicians in the province are unwilling to do so. It is not clear from the to what extent freedom of conscience is implicated, since physicians who have no moral or religious objection to abortion might judge the procedure to be medically unnecessary in a given case. The Chairman of the Commission has stated that a formal board of inquiry may be appointed and that the inquiry may be held in secret. [National Post] See also


26 October, 2010
Most UK physicians said to be against assisted suicide

Responding to a report concerning assisted suicide in Oregon, Baroness Finlay of Llandaff, professor of palliative medicine at Cardiff University, said, "Most doctors want nothing to do with assisted dying." Were assisted suicide legalized in the United Kingdom, she said, one result would be "doctor shopping" by patients looking for someone willing to approve the procedure. [Christian Institute] Her comments indicate the strong probability of conflicts of conscience arising in the medical profession should euthanasia or assisted suicide be legalized.

The phenomenon of "moral injury"

A letter to the New York Times from a representative of The Truth Commission on Conscience in War refers to the phenomenon of "moral injury" that has been observed among soldiers. It is said to be caused by "witnessing, perpetrating or failing to prevent acts that transgress deeply held moral beliefs," and is reported to have long-term emotional, psychological, behavioral consequences. [See Clin Psychol Rev. 2009 Dec;29(8):695-706. Epub 2009 Jul 29: Moral injury and moral repair in war veterans: a preliminary model and intervention strategy] The observations are relevant to recognizing the harms that would flow from suppression of freedom of conscience in health care.

19 October, 2010
Philippines Senate begins hearings on Senate RH bill

The Philippines Senate Committee on Health and Demography hearings on Senate Bill 2378 opened on 18 October. [ABS-CBN news] The bill is one of two before the Philippines Congress that are highly controversial and that threaten freedom of conscience of employers and in health care in the country. [See Philippines "RH Bills": the shape of things to come?]

18 October, 2010
Reports suggest high potential for conflicts of conscience in Philippines

News reports from the Philippines indicate that the reproductive health bills being considered by Congress are generating significant controversy among government officials, NGO's, Catholic Church representatives and legislators. The tone of the debate seems often rancorous. [US News Las Vegas] Since the bills suppress or undermine freedom of conscience among employers, health care workers and denominational institutions, the current controversy indicates that passage of either bill in their present forms would cause conflicts of conscience in health care. [See Philippines "RH Bills": the shape of things to come?]

UK expert states abortion is necessary element in family planning

Ann Furedi the chief executive of the British Pregnancy Advisory Service, has told New Zealanders that abortion is required as a part of family planning programmes because contraception is not always effective. She noted that abortion rates do not drop when more effective means of contraception are available because women are no longer willing to tolerate the consequences of contraceptive failure.[TVNZ] Furedi's comments indicate that pressure to provide abortion is likely to increase even where contraception is readily available, thus increasing potential for conflicts of conscience among health care workers who do not wish to be involved with the procedure.

14 October, 2010
Chief minister urges health care workers to act according to conscience

The Chief Minister of the Indian state of Tamil Nadu, M Karunanidhi, "appealed to doctors and paramedical staff to render their services to humanity with conscience and not merely as a means of duty." He was speaking at the 125th anniversary of the Kasturba Gandhi Hospital for Women and Children at Chepauk. [News Today]

Catholic Archbishop explains opposition to Philippines RH bills

Caceres Archbishop Leonardo Legaspi of the Philippines has issued a pastoral letter to explain the opposition of the Catholic Church to the reproductive health bills (RH bills) now before the Philippines Congress. It is reported that the Church also plans to use Facebook, Twitter and other social networking sites to oppose the bills. [Manila Times] The bills suppress freedom of conscience of employers and denominational health care facilities and make conscientious objection by individuals impossible or ridiculous. [See Philippines "RH Bills": the shape of things to come?]

13 October, 2010
Philippines President and bishops meet

The President of the Philippines has met representatives of the Catholic Bishops' Conference of the Philippines to clarify their respective positions on the reproductive health bill now before Congress. The meeting was described as "pleasant," and further meetings are to follow. [Manila Times] [See Philippines bishops suggest possibility of civil disobedience] A retiring Cardinal promised last week that he would break the law if it were passed and was willing to go to jail. He was referring to Section 23 in HB96, which will make it a crime to "maliciously engage in disinformation" about the act. [See Philippines "RH Bills": the shape of things to come?]

British health care professionals form assisted suicide lobby group

A group of medical professionals in the United Kingdom who support assisted suicide (which they describe as "assisted dying") has formed Health Care Professionals for Change to lobby for changes in the law. The group also wants to "change medical culture" and "change medical practice." The group has not announced a policy concerning freedom of conscience for colleagues who do not agree with them.

11 October, 2010
Catholic institutions issue talking points for dialogue on reproductive health bills

The Loyola School of Theology and the John J. Carroll Institute on Church and Social Issues in the Philippines have issued a paper with talking points to assist discussion of reproductive health bills now before the Philippines Congress. The paper notes that the bills suppress freedom of conscience of employers and acknowledges some of the shortcomings with the provisions that purport to accommodate freedom of conscience [Talking Points for Reproductive Health Bill], though it does not appear that the latter point has been adequately covered. [See Philippines "RH Bills": the shape of things to come?]

7 October, 2010
Council of Europe rejects recommendations to suppress freedom of conscience

A report that would have seen increased repression of conscientious objection in Europe has been rejected by the Parliamentary Assembly of the Council of Europe. Irish senator Ronan Mullen and Luca Volonte of Italy, led the assembly in passing amendments that converted the report to an affirmation of the legitimacy of conscientious objection. The result was the the author of the report and her supporters were forced to vote against it. [SPUC] Nonetheless, the motion in its new form passed as Resolution 1763.

6 October, 2010
Project submission to Council of Europe

The Protection of Conscience Project has sent a submission to each of the 47 national delegations at the Parliamentary Assembly for the Council of Europe. The submission is a response to recommendations made to the Assembly that would deny freedom of conscience to denominational health care facilities and, in large part, to medical practitioners. [See Council of Europe to consider suppression of freedom of conscience]. A meeting held in the afternoon by those opposed to the measure was attended by half a dozen Members of the Assembly, and about 70 NGO representatives.

The "ethics of the profession" in retrospect

An American researcher has discovered that government and medical authorities in the United States and Guatemala cooperated in a series of unethical experiments performed in Guatemala between 1946 and 1948. Those involved included John C. Cutler, a physician involved in the Tuskegee study. Among other things, Cutler deliberately infected patients at a mental hospital with syphilis or gonorrhea. He and Public Health Service physician R. C. Arnold were aware that the methods were at least ethically questionable and were concerned to keep the study secret. President Obama and two cabinet secretaries have apologized for what was done. [Reverby] News reports note that the study methodology reflected predominant attitudes of researchers at the time. "In Massachusetts, institutionalized children were fed oatmeal laced with radiation as part of nutrition experiments. In New York, elderly patients were injected with cancer cells." Boston Globe] The story demonstrates the risk entailed in assigning an absolute value to "the ethics of the profession" in a particular period, a practice often associated with attempts to suppress freedom of conscience among dissenting professionals.

4 October, 2010
Hearing at the Council of Europe on freedom of conscience

Is there a case for the valid restriction of freedom of conscience in health care? On the eve of an important debate in the Parliamentary Assembly of Europe, freedom of
conscience in health care will be discussed at a hearing in Strasbourg on 6 October, 2010. Dr. Andrew Fergusson, former Chairman, Professional Conduct Committees, UK General Medical Council will speak to freedom of conscience as a fundamental duty. Mr. Javier Borrego, a former judge of the European Court of Human Rights, will consider it as a fundamental right. The conference will take place at 1:00 pm in Room 3 at the Council of Europe.

3 October, 2010
Philippines bishops suggest possibility of civil disobedience

In an interview with the news agency for the Catholic Bishops' Conference of the Philippines (CBCP), CBCP Secretary General Msgr. Juanito Figura said that it is possible that the Church will recommend civil disobedience if a bill now before the Philippines congress becomes law. Several provision in HB96- The Reproductive Health and Population and Development Act/a> would likely cause conflicts of conscience among health care workers. [CBCP News] The wording of the bill makes the exercise of freedom of conscience impossible or ridiculous, and exposes those who claim the exemption to prosecution for human rights violations. It is not clear whether the bill has been deliberately constructed as an obstacle to conscientious objection, or has simply been badly drafted.