News Commentary 2004
The Columbian, 16 December,
Reproduced with permission
Columbian staff writer
Should a private health care provider or hospital be forced to perform
abortions, even if he, she or it believes abortions are unethical?
Regardless of your view on the legal right to have an abortion, the
answer should be, "Absolutely not."
Some pro-choice lobbyists and lawmakers disagree. And despite all their
"right to choose" rhetoric, pro-choice forces have filed a lawsuit
challenging a much-needed amendment signed into law by President Bush last
week. The Hyde-Weldon Conscience Protection Amendment says that federal
funding cannot be withdrawn from providers who, because of their beliefs,
choose not to perform abortions. Before now, federal law protected Catholic
doctors from the penalties. The new law protects all doctors, hospitals and
This nation continues to support the legal right to an abortion, despite
technology that shows without any doubt that human life begins at
conception. (In fact, the human central nervous system is already forming in
a 3-week-old fetus. By fetal-age week four, a baby's heartbeat can be seen
on ultrasound. This is before the vast majority of abortions happen and
before a lot of women even know they are carrying a child.)
Legal abortions will be with us always, as will doctors and hospitals
willing to perform them. Even ardent pro-lifers acknowledge that mass chaos
and harm to mothers would result from taking the legal right away. What most
pro-lifers want and rightly continue to demand, however, is more reasonable
policies concerning abortion. Just as a woman is able to decide for herself
if she will abort a child, a doctor or private hospital should have the
right to steer clear of having anything to do with the life-ending procedure
Rep. Nita Lowey, D-N.Y., told The Chicago Tribune of the Hyde-Weldon
amendment, "The conservatives have been emboldened and the moderates have
been minimized, and this is a real wake-up call."
It sure is. The wake-up call, however, is that no one should be forced to
provide an abortion not that common-sense legislation is finally getting
passed. It is sad that the concept of a right to conscience seems foreign to
pro-choicers such as Lowey. Judith DeSarno of the National Family Planning
and Reproductive Health Association is also at odds with the amendment.
She's telling people that it "is meant to deny abortion information and
referral to women who receive care that is subsidized by any program funded
by" the government.
U.S. Rep. Dave Weldon, R-Fla., counters that the law carrying his name
does nothing of the sort. It is meant to "not force people to do abortions
or assist in abortions or allow abortions in their hospitals if they don't
want to," he told reporters.
Pro-choice extremists contradict themselves. They cannot convincingly say
that the public and government have no right to tell a woman she can't have
an abortion and at the same time tell a private health care provider that he
or she must perform one.
Keep parents clueless
Another area in which some pro-choicers are off the deep end is parental
rights. While we hold parents responsible for the destructive actions of
their children and won't let them take aspirin in school without parent
permission, we continue to limit their ability to help teens make the major
medical decision to have an abortion. Washington and other states don't even
have parental notification laws.
Angering parents' rights advocates this month is California Attorney
General Bill Lockyer's recent legal opinion that says California schools are
prohibited from informing parents if a child leaves campus to receive
medical services, including an abortion, AIDS treatment or psychological
analysis. Heck, many schools, even here in Clark County, have staff members
who refer teens to abortion providers during the school day without parent
knowledge. The exact opposite ought to be policy in any public school.
Parents should be notified whenever a child leaves campus.
Leaders of the pro-choice crowd won't hear of it. Their passion for
legalized abortion trumps parents' rights and common sense. That is why they
believe health care providers don't have a right to follow their own
consciences and that schools supplant parents when an abortion is at stake.
September 28, 2004
Reproduced with permission
Senior policy analyst for the Christian Medical Association
The House of
Representatives recently voted to prohibit government authorities from
requiring any health care professional or institution to perform or pay for
Our Founding Fathers obviously would applaud this protection of
individual liberties and conscience. Yet when D.C. officials faced this hot
brewing battle a few years ago, they pushed free speech and freedom of
religion aside and nearly plunged the capital into a health care crisis.
In July 2000, the D.C. Council thumbed its nose at faith-based hospitals
and other conscientious objectors by passing a bill to force D.C. employers
to provide health-insurance coverage for contraceptives and abortion-causing
drugs -- regardless of providers' ethical or moral objections. The council's
unscrupulous decision left conscience-driven hospitals and charities with no
other choice than to shut down rather than violate vital religious and
The imperious mandate raised the specter of sick and dying patients
lining up at City Hall demanding to know why pro-choice legislators had
taken away their doctors' choice and imperiled their own life-saving health
care. Only a pragmatic pocket veto by the mayor, under threat of
congressional intervention, stopped that measure and averted the potential
shutdown of faith-based hospitals and charities.
Dissenting at-large Council member Harold Brazil, who had lobbied to add
a "conscience clause" exemption to the mandate, reminded the council at that
time, "James Madison once said, 'Conscience is the most sacred of all
property.' " [i]
Since the D.C. debacle, abortion activists have hotly pursued their
conscience-crushing campaign to make others provide and pay for their
abortions and birth control.
Of course, they can't easily explain why employers' health-insurance
plans, designed to help employees defray the cost of treating illness and
disease, should suddenly be made to pay for preventing or ending a healthy
pregnancy. Nor can they justify why providing relatively easily obtained
contraceptive and abortifacient drugs requires violating the conscience
rights of those who remain morally opposed to such practices.
Pushing reproductive rights toward reproductive mandates seems certain to
backfire in the court of public opinion. The irony of trampling individual
liberties and conscience rights while marching under the banner of "choice"
will not be lost on the American public.
[i] Brazil, Harold, Letter to the Editor, Washington Post, August 5,
2000; Page A18
22 May, 2004
Your report about plans to make the morning-after pill available without
prescription claimed that pharmacists who refuse to dispense it for reasons
of conscience are expected to refer for the drug ("'Abortion pill' rules
loosened: Morning-after tablet to be available without a prescription,"
National Post, 19 May 2004). This is an oversimplification.
The policies of pharmacy regulatory authorities vary from province to
province. For example, the College of Pharmacists of British Columbia
demands referral,1 but
authorities in Manitoba and Nova Scotia do not.2
Constitutional lawyer Iain Benson suggests that the kind of intolerance
displayed by the BC College would not be accepted in other professions, and
hopes that, eventually, greater professional maturity will lead to a more
The claim that mandatory distribution or referral is necessary hangs
tenuously on the myth that, somewhere in Canada, there is a small town with
only one pharmacist and no other health care provider. And contrary to the
impression created by your story, Denton, Texas, is not such a mythical
town. When the Denton pharmacist declined to fill the prescription for
religious reasons, the woman obtained the drug at a pharmacy across the
street.4 Leaving out such
details does not do justice to the issues that arise in conflicts between
religious or moral conviction and the ethics of the bottom line.
In this regard, calling the morning-after pill an 'emergency' drug is
clearly a masterful marketing strategy, but statistics provided by the
pill's advocates tell another tale. Michael Valpy reported that 4,600
prescriptions for the 'morning-after-pill' in BC were believed to have
prevented 300 pregnancies,5
figures consistent with a study reported earlier in the Canadian
Doing the math, one finds that 94% of the women didn't actually need the
drug sold to them. This is not the kind of 'emergency' that justifies
suppression of conscientious objection.
Sean Murphy, Administrator
Protection of Conscience Project
Project Report 2001-01 (26 March, 2001) College of Pharmacists of
British Columbia- Conduct of the Ethics Advisory Committee,
2. Protection of Conscience Project
News Release, 5 June, 2000:
Freedom of Conscience Recognized. Nova Scotia College of
Pharmacists, Code of Ethics, Value V.
3. Greg J. Edwards,
Pharmacy Colleges Quash Conscientious Objection.
"Pharmacy draws protest:Demonstrators speak out against refusal to fill
'morning-after' pill." Dallas News, 3 February, 2004.
5. Michael Valpy "The Long Morning
After", Globe and Mail, 15 December, 2001
6. "In 16 months of ECP services,
pharmacists provided almost 12,000 ECP prescriptions, which is estimated to
have prevented about 700 unintended pregnancies." Cooper, Janet, Brenda
Osmond and Melanie Rantucci, "Emergency Contraceptive Pills- Questions and
Answers". Canadian Pharmaceutical Journal, June 2000, Vol. 133, No.
5, at p. 28.
14 May, 2004
Should doctors be forced to abandon their faith? by Terry O'Neill
draws attention to the problem of freedom of conscience in health care.
A bit of history is instructive. The first protection of conscience
clause debated in the House of Commons was introduced by M.P. Robert
McCleave as an amendment to the Omnibus Bill that legalized abortion in
Canada in 1969. Mr. McCleave believed that abortion should be
legalized, but also believed that 'freedom of choice' should be extended to
health care workers.
Compare Mr. McCleave's notion of 'choice' with that espoused by Joyce
Arthur. Speaking for the "Pro-choice Action Network," she refuses to respect
the choices of health care professionals who do not wish to participate
morally controversial procedures. She seems to believe that freedom of
conscience is a problem to be solved by abolishing it, at least in the case
of those who don't agree with her. Arthur's position is doubly ironic, since
Henry Morgantaler justified his defiance of Canadian abortion law in a 1970
article titled, A Physician and His Moral Conscience.1
Referral is not a satisfactory solution for many physicians who have
grave moral objections to a procedure. Objecting physicians hold themselves
morally culpable if they facilitate an abortion by referring a patient for
that purpose. Nor is this an unusual view. Consider the controversy in
Canada over the deportation and torture of Maher Arar. This suggests that
few believe that one can avoid moral responsibility for a wrongful act by
arranging for it to be done by someone else.
Certainly, Joyce Arthur does not consider abortion to be a wrongful act.
However, she has not explained why others should be forced to abide by her
Unfortunately, between the writer's desk and publication, a couple of
factual errors were introduced into the story.
In the first place, the Project followed the case from the outset, and
the student was provided with the same kind of service extended to others in
similar situations. His relationship with the Project has been cordial, but
it is incorrect to describe me as "a friend of the would-be doctor." We have
More important, the final paragraph attributes to me statements that I
did not make. While I am, nonetheless, in agreement with a number of the
points made, I did not suggest that a devout Muslim doctor might refuse to
treat women, nor make any statement to a similar effect.
It would be most unfortunate if this falsely attributed statement were to
contribute to the already adverse social pressures experienced by Muslims in
North America. Muslim health care workers and students are welcome to
contact the Protection of Conscience Project. One of the Project advisors is
Dr. Shahid Athar, a regent and former vice-president of the Islamic Medical
Association of North America and the Chair of its Medical Ethics Committee.
Sean Murphy, Administrator
Protection of Conscience Project
1. The article appeared anonymously in
The Humanist. Quoted in Pelrine, Eleanor Wright, Morgantaler: The
Doctor Who Couldn't Turn Away. Canada: Gage Publishing, 1975, P. 79 [Back]
5 April, 2004
Rebecca J. Cook and Bernard M. Dickens state, "Physicians who feel
entitled to subordinate their patient's desire for well-being to the
service of their own personal morality or conscience should not practise
The statement is unsupported by their own legal references, and it has
little to recommend it as an ordering principle in the practice of medicine.
In their original article2
and in their response to a letter from Dr. Howard Bright3the
authors purport to ground their advice in law and in ethics. But the only
case cited to support the claim that courts continue to demand
referral is a 23 year old case from the Alberta Court of Appeal. Moreover,
referral was not even discussed in Zimmer,4
which addressed the failure to obtain informed consent to silver nitrate
sterilization, and failure to provide adequate follow-up care.
Their second legal claim, that the fiduciary duties of physicians require
them to subordinate their conscientious convictions to those of their
patients, rests upon a more recent Supreme Court of Canada case. But
absolutely nothing to do with conflicts of conscience. It concerned the duty
of a physician to release a patient's medical records upon request. While
the court noted that the fiduciary relationship between physician and
patient obliged the physician to disclose the records, the nature of
fiduciary relationships was not discussed at length.
Moreover, the Supreme Court ruled that fiduciary relationships and
obligations are "shaped by the demands of the situation"; they are not
governed by a "fixed set of rules and principles". Mr. Justice La Forest,
writing for the court, stated,
"A physician-patient relationship may properly be described as'fiduciary'
for some purposes, but not for others."6
In other words, the physician patient relationship is fiduciary for the
purpose of disclosing patient records, but that does not imply it is
fiduciary for the purpose of suppressing the conscientious convictions of
Finally, the court in McInerney accepted the characterization of
the physician-patient relationship as "the same . . . as that which exists
in equity between a parent and his child, a man and his wife, an attorney
and his client, a confessor and his penitent, and a guardian and his
ward."7 Yet no one has ever
suggested that the fiduciary obligations of parents, husbands, attorneys,
confessors, and guardians require them to sacrifice their own integrity to
the "desires" of others.
Neither case cited by Cook and Dickens supports their claims, and
McInerney arguably contradicts them. What of their reference to
'transcendent ethical duties'?
Dr. John R. Williams is now Director of the Ethics Unit of the World
Medical Association. He was Director of Ethics for the Canadian Medical
Association in 2000, when he advised the Protection of Conscience Project
that the CMA's policy of mandatory referral for abortion was dropped because
there was no ethical consensus to support it.8
As to the conclusions they draw from monozygotic twinning and cloning,
Cook and Dickens fail to understand that these processes prove nothing about
the individuality of the original zygote. If one zygote becomes two through
the process of regulation, it does not mean that the first zygote was not an
More to the point, it was clear from the context of Dr. Bright's letter that
he was putting in issue the moral significance of the existence of the early
human embryo, something quite distinct from the vitality of sperm or ova.
The distinction cannot be evaded by the meticulous refinements suggested by
Cook and Dickens.
The beliefs of many conscientious objectors, while 'personal' in one
sense, are actually shared with tens of thousands, or even hundreds of
thousands or hundreds of millions of people, living and dead, who form part
of great religious, philosophical and moral traditions. If theirs is a
'private' morality, the morality that Cook and Dickens are attempting to
impose is not less so. Nor can its imposition be justified because it is
achieved by "building momentum" rather than "lobbying", the distinction
between which the authors leave unclear.
One hopes that future contributions to the Journal on the subject
of freedom of conscience will have more of substance to offer its readers.
Sean Murphy, Administrator
Protection of Conscience Project
1. Cook RJ, Dickens BM, "In Response".
J.Obstet Gyanecol Can, February, 2004; 26(2)112
2. Cook RJ, Dickens BM, Access to
emergency contraception. J. Obstet Gynaecol Can 2003;25 (11):914-6
3. Bright, H. Access to emergency
contraception [letter]. J. Obstet Gynaecol Can 2004; 26(2)111
4. Zimmer v. Ringrose (1981),
124 Dominion Law Reports (3d) 215 (Alberta Court of Appeal)
5. McInerney v. MacDonald
(1992), 93 Dominion Law Reports (4th) 415 (Supreme Court of
6. Recalling an earlier case (Canson
Enterprises Ltd. v. Boughton & Co.  3 S.C.R. 534)
7. Quoting LeBel, J. in Henderson
v. Johnston,  O.R. 789 at p. 799.
8. Telephone conversation between Dr.
John R. Williams and the Project Administrator, April, 2000
9. O'Rahilly R, Muller F. Human
embryology and teratology. New York: Wiley-Liss; 2001. p.37
10. Carlson BM. Human embryology and
developmental biology. St. Louis: Mosby;1999. p. 49
Mr. Robert J. Remington,
Assistant Editorial Page Editor, The Calgary Herald
Some corrections and clarifications
When Rights Collide