Nova Scotia hospital forced to provide euthanasia, assisted suicide

Services to be provided in attached building

Arrangement said to preserve Catholic identity

Sean Murphy*

Hospital

St. Martha’s Regional Hospital in Antigonish, Nova Scotia, will begin providing euthanasia and assisted suicide (EAS). The hospital had refused to provide the services because they were considered to be contrary to the Catholic identity of the hospital. The change of policy appears to have been forced by the threat of a lawsuit by EAS advocates. A campaign to force the hospital to permit EAS services had been ongoing for some time [See 958 days without medical assistance in dying policy, Ban on assisted dying at St. Martha’s hospital should end, says law prof].

St. Martha’s was established by a Catholic religious order, the Sisters of St. Martha. However, in 1996 the order transferred ownership of the hospital to the state. The terms of the transfer were set out in a “Mission Assurance Agreement” that required the state to ensure that “the philosophy, mission and values of St. Martha’s Regional Hospital would remain the same and the hospital would keep its faith-based identity.”1

Notwithstanding the terms of the agreement, from 1996 the hospital was not legally a private or Catholic institution, even though it is popularly known as “Nova Scotia’s only Catholic hospital .”2 EAS advocates argued that state ownership of the hospital made it a state actor obliged to provide euthanasia and assisted suicide.1 Logically, this would also apply to abortion, surgical sterilizations, and other procedures contrary to Catholic teaching.

The Nova Scotia Health Authority states that the change of policy is consistent with “the spirit of the Mission Assurance Agreement,”3 which seems to imply that a way has been found for the hospital to “keep its [Catholic] faith-based identify” while providing euthanasia and assisted suicide.

According to NSHA’s Vice President of Health Services and Chief Nursing Executive Tim Guest, euthanasia and assisted suicide will be provided in the Antigonish Health and Wellness Centre, formerly the Martha Center.4

Built in 1961, the Antigonish Health and Wellness Center is attached to St. Martha’s Regional Hospital. In 2009, still known as the Martha Center, it was described as “primarily a professional building” of 92,000 square feet that had undergone major renovations between 2006 and 2009.5

The Sisters of St. Martha have issued a statement:

The Sisters of St Martha were informed that the Nova Scotia Health Authority continues to uphold our Mission Assurance Agreement, while providing access in Antigonish for individuals who request Medical Assistance in Dying (MAID).

The Nova Scotia Health Authority has assured us that Medical Assistance in Dying (MAID) will not take place in St. Martha’s Regional Hospital. We do not own St. Martha’s Regional Hospital, or the building called the Antigonish Health and Wellness Center. . . 6

It is not clear from the statements if assessments and preliminaries for euthanasia/assisted suicide will occur in the hospital building, with actual administration of lethal medication taking place in the Health and Wellness Center.

1. Downie J, GilbertD. Nova Scotia now a leader in medical assistance in dying [Internet]. The Chronicle Herald. 2019 Sep 19.

2. Willick F. Ban on assisted dying at St. Martha’s hospital should end, says law prof [Internet]. CBC News. 2018 Dec 28.

3. Lord R, Quon A. NSHA quietly changes medically assisted dying policy at Catholic hospital [Internet]. Global News. 2019 Sep 18.

4. 989XFM. Nova Scotia Health Authority allows Medically Assisted Death at St. Martha’s Regional Hospital [Internet]. 2019 Sep 19.

5. Guysborough Antigonish Strait Health Authority. Request for Proposal: Radio Frequency (RF) Wireless Site Survey [Internet]. 2009 Apr 17.

6. Boisvert B. Sisters of St. Martha Media Statement [Internet]. 2019 Sep 19.

Pope Francis on conscientious objection by health care practitioners

La Croix misrepresents papal statement

Sean Murphy*

Pope FrancisAn article in La Croix International, “Pope reminds health workers to put patients first” includes a subtitle, “Conscientious objectors told that human dignity demands exceptions sometimes be made.” (La Croix International, 20 May, 2019)

The subtitle reflects speculation by critics unidentified by the article’s anonymous author(s) that the Pope’s comments were aimed at “pro-lifers who may object to performing an abortion, even though the mother may, for various reasons, risk serious and even life-threatening physical or psychological trauma should she try to conceive.”

La Croix appears to be alone among news agencies in putting this “spin” upon the Pope’s address (Compare reports by Crux, Vatican News, ANSA, and the Catholic Herald, for example).

“[T]o put patients first” accurately conveys one of Pope Francis’ messages to the Italian Catholic Association of Health Care Workers.

“Conscientious objectors told that human dignity demands exceptions sometimes be made” does not.

Nothing in the text of the of the Pope’s address remotely suggests that human dignity sometimes requires health care workers to set aside their conscientious convictions and their objections and do what they believe to be wrong.

Pope Francis said nothing of the kind.  But that is precisely the kind of demand made by activists and even state authorities in a number of countries, even (as in Canada) to the extent of forcing unwilling practitioners to be parties to killing their patients or helping them commit suicide.

The misrepresentation exemplified in the La Croix article supports such attacks on freedom of conscience (and religion) and exacerbates the problems faced by healthcare practitioners attempting to resist them.

What Pope Francis actually had to say warrants attention by anyone who wants to understand the exercise of freedom of conscience by health care practitioners.

He noted that “any medical practice or intervention on the human being must first be carefully assessed if it actually respects human life and dignity (“di ogni pratica medica o intervento sull’essere umano si deve prima valutare con attenzione se rispetti effettivamente la vita e la dignità umana.”) .

When health care practitioners refuse to provide procedures or services, it is typically because they have made that assessment,and consider the interventions contrary to the good of the human person and subversive of the integrity and dignity of human life: in brief, harmful to the patient.

Conscientious objection in such circumstances, the Pope said, does not just reflect the need to preserve one’s personal integrity, but “also represents a sign for the healthcare environment in which we find ourselves, as well as for the patients themselves and their families” ( “ma rappresenta anche un segno per l’ambiente sanitario nel quale ci si trova, oltre che nei confronti dei pazienti stessi e delle loro famiglie. “)

In many situations, this “sign” may well be a sign of contradiction to the dominant ethos, likely to trigger violent emotional reactions and repression by state or professional authorities. Hence, for purely pragmatic reasons, it behooves objecting practitioners to be careful in expressing themselves. Beyond this, Pope Francis offers advice that reflects the actual practice of practitioners who responsibly exercise freedom of conscience:

La scelta dell’obiezione, tuttavia, quando necessaria, va compiuta con rispetto, perché non diventi motivo di disprezzo o di orgoglio ciò che deve essere fatto con umiltà, per non generare in chi vi osserva un uguale disprezzo, che impedirebbe di comprendere le vere motivazioni che ci spingono. È bene invece cercare sempre il dialogo, soprattutto con coloro che hanno posizioni diverse, mettendosi in ascolto del loro punto di vista e cercando di trasmettere il vostro, non come chi sale in cattedra, ma come chi cerca il vero bene delle persone. Farsi compagni di viaggio di chi ci sta accanto, in particolare degli ultimi, dei più dimenticati, degli esclusi: questo è il miglior modo per comprendere a fondo e con verità le diverse situazioni e il bene morale che vi è implicato.

The choice of the objection, however, when necessary, must be made with respect, so that what must be done with humility, so as not to generate an equal contempt, which would prevent the understanding of the true motivations that drive us. Instead, it is good to always seek dialogue, especially with those who have different positions, listening to their point of view and trying to transmit yours, not as someone who goes up in the chair, but as someone who seeks the true good of people. Be the traveling companions of those around us, especially the last, the most forgotten, the excluded: this is the best way to fully understand the different situations and the moral good that is involved.

Source: Libreria Editrice Vaticana, Discorso del Santo Padre Francesco all’ Assocziazone Cattolica Operatori Sanitari (ACOS).  Sala Clementina, Venerdì, 17 maggio 2019.

Photo by Nacho Arteaga on Unsplash

Court reinstates lawsuit against Catholic hospital for refusing transgender patient’s surgery

Los Angeles Times

Michael Hiltzik

Stating that California’s interest in fighting discrimination against LGBTQ residents outweighs the right to impose religious standards on healthcare, an appeals court has reinstated a lawsuit against the Catholic Dignity Health hospital chain for barring a hysterectomy for a transgender patient.

The lawsuit was brought by Evan Minton, whose hysterectomy was abruptly canceled by Dignity’s Mercy San Juan Medical Center of Carmichael, Calif., in 2016 when hospital officials learned he was transgender. The hospital took the action to comply with the church’s Ethical and Religious Directives for Catholic Health Care Services, which prohibit sterilization procedures except in very narrow circumstances. . . [Full text]

USCCB Poll: Americans Support Conscience Protection for Healthcare Professionals

News Release

US Conference of Catholic Bishops

September 18, 2019

WASHINGTON, D.C. – Two new polls have revealed widespread discrimination against healthcare workers of faith, as well as broad public support for conscience rights laws and protections. The findings were released today by the United States Conference of Catholic Bishops (USCCB) Committees on Pro-Life Activities; Religious Liberty; Domestic and Social Development; and the Subcommittee for the Promotion and Defense of Marriage, as well as the Christian Medical & Dental Associations (CMDA), the largest faith-based association for healthcare professionals.
 
The findings come in the wake of enforcement actions taken by the U.S. Department of Health and Human Services (HHS) against the University of Vermont Medical Center, which is alleged to have coerced a nurse into participating in an abortion against her beliefs.

Archbishop Joseph F. Naumann, of Kansas City in Kansas and Chairman of the Committee on Pro-Life Activities; Bishop Robert J. McManus, of Worcester and Chairman of the Committee for Religious Liberty; Bishop Frank J. Dewane, of Venice, and Chairman of the Committee on Domestic Justice and Human Development, and Bishop James D. Conley, of Lincoln and Chairman of the Subcommittee for Promotion and Defense of Marriage offered the following statement on the findings:

“An overwhelming majority of Americans agree: no healthcare professional should be forced to violate deeply-held beliefs in order to keep a job. The practice of medicine depends on those courageous and generous enough to serve all people—especially the poor and marginalized—with the highest ethical standards. If we exclude people of faith from the medical profession, Americans will suffer, especially those most in need.”

For more information, click here: http://www.usccb.org/about/pro-life-activities/conscience-protection-teleconference.cfm

Media Contact:
Chieko Noguchi
202-541-3200

Christian Medical & Dental Associations reveal national survey findings on healthcare and conscience

News Release

Christian Medical & Dental Associations

Washington, D.C., September 18, 2019 — The Christian Medical & Dental Associations (CMDA ), the nation’s largest faith-based association of health professionals, today released findings of a national survey showing that conscience-protecting laws and regulations help protect patient access to health care while addressing rampant discrimination against faith-based health professionals.

The survey, a nationwide poll of faith-based health professionals, conducted by Heart and Mind Strategies, LLC, found that 91 percent said they would have to “stop practicing medicine altogether than be forced to violate my conscience.” That finding holds significant implications for millions of patients, especially the poor and those in underserved regions who depend upon faith-based health facilities and professionals for their care.

The survey of faith-based health professionals also found that virtually all care for patients “regardless of sexual orientation, gender identification, or family makeup, with sensitivity and compassion, even when I cannot validate their choices.” The finding puts the lie to the charge that somehow conscience protections will result in whole classes of patients being denied care.

“Faith-based health professionals actually seek out and serve marginalized patients to provide compassionate care, ” explained CM D A CEO Emeritus Dr. David Stevens. “All we ask as we serve is that the government not intrude into the physician-patient relationship by dictating that we must do controversial procedures and prescriptions that counter our best medical judgment or religious beliefs .”

CM DA is currently represented by the Becket law firm in two related cases: Franciscan Alliance v. Azar , which addresses an Affordable Care Act transgender mandate, and New York v. HHS, which addresses a new federal conscience protection rule.

Detail on the poll of faith-based professionals can be found at CMDA-Poll and Freedom2Care.org

Philippines RH Act: Rx for Controversy

Diatribe by Philippines’ President turns back the clock

Sean Murphy*

Abstract

Turning back the clock

In June, 2019, Philippines President Rodrigo Duterte blamed the Catholic Church for obstructing government plans to reduce the country’s birth rate and  population.  “They think that spewing out human beings by the millions is a gift from God,” he claimed, adding that health care workers should resign if they are unwilling to follow government policy on population control for reasons of conscience.

Duterte’s authoritarian diatribe clashes with a ruling of the Supreme Court of the Philippines and turns the clock back to times of harsh and extreme rhetoric when the current law (commonly called the RH Act) was being developed.  The RH Act was the product of over fourteen years of public controversy and political wrangling. It was of concern when it was enacted because it threatened some conscientious objectors with imprisonment and fines. 

In January, 2013, the Project reviewed the Act in detail.  Project criticisms about the law’s suppression of freedom of conscience were validated in April, 2014, when the Supreme Court of the Philippines struck down sections of the law as unconstitutional.

Given the long history of attempts at legislative coercion in the Philippines and President Duterte’s obvious hostility to freedom of conscience and religion in health care, the Project’s 2013 review of the RH Act is here updated and republished.

Assuming that the Philippines government’s concern about population growth in the country is justified, it does not follow that it is best addressed by the kind of state bullying exemplified by President Duterte’s ill-tempered and ill-considered eruption.  Aside from the government’s enormous practical advantage in its control of health care facilities, it has at its disposal all of the legitimate means available to democratic states to accomplish its policy goals.  Not the least of these is persuasive rational argument, an approach fully consistent with the best traditions of liberal democracy, and far less dangerous than state suppression of fundamental freedoms of conscience and religion.

TABLE OF CONTENTS

Turning back the clock

A history of coercive legislative measures

Background

The “RH Act” of 2012: General comments

The “RH Act” of 2012: Specific provisions

Freedom of conscience and religion

The Supreme Court weighs in

The way forward

Appendix “A”:  Philippines population control and management policies

Appendix “B”: The “RH Act” (2012)  in brief

Project Comments

Professionalism eliminates religion as a proper tool for doctors rendering advice to patients

Udo Schuklenk

Abstract

Journal of Medical Ethics

Religious considerations and language do not typically belong in the professional advice rendered by a doctor to a patient. Among the rationales mounted by Greenblum and Hubbard in support of that conclusion is that religious considerations and language are incompatible with the role of doctors as public officials.1 Much as I agree with their conclusion, I take issue with this particular aspect of their analysis. It seems based on a mischaracterisation of what societal role doctors fulfil, qua doctors. What obliges doctors to communicate by means of content that is expressed in public reason-based language is not that they are public officials. Doctors as doctors are not necessarily public officials. Rather, doctors have such obligations, because they are professionals. Unlike public officials doctors are part of a profession that is to a significant extent self-governing. This holds true for all professions. The …

Responding to religious patients: why physicians have no business doing theology. Jake Greenblum Ryan K Hubbard Journal of Medical Ethics 2019; – Published Online First: 20 Jun 2019. doi: 10.1136/medethics-2019-105452


Schuklenk U. Professionalism eliminates religion as a proper tool for doctors rendering advice to patients. J Medical Ethics. 2019 Sep 12. pii: medethics-2019-105703. doi: 10.1136/medethics-2019-105703. [Epub ahead of print]

Firing Doctor, Christian Hospital Sets Off National Challenge To Aid-In-Dying Laws

Kaiser Health News

JoNel  Aleccia

DENVER — A Christian-run health system in Colorado has fired a veteran doctor who went to court to fight for the right of her patient to use the state’s medical aid-in-dying law, citing religious doctrine that describes “assisted suicide” as “intrinsically evil.”

Centura Health Corp. this week abruptly terminated Dr. Barbara Morris, 65, a geriatrician with 40 years of experience, who had planned to help her patient, Cornelius “Neil” Mahoney, 64, end his life at his home. Mahoney, who has terminal cancer, is eligible to use the state’s law, overwhelmingly approved by Colorado voters in 2016.

The growing number of state aid-in-dying provisions are increasingly coming into conflict with the precepts of faith-based hospitals, which oppose the practice on religious grounds. . . [Full text]

Bergenfield Doctor’s Lawsuit Halts NJ Physician-Assisted Suicide Act

Jewish Link

Bracha Schwartz

Rabbi Yosef P. Glassman, MD, of Bergenfield, has won a lawsuit to temporarily stop the New Jersey Medical Aid in Dying for the Terminally Ill Act that had been scheduled to take effect on August 16. The law would allow physicians, under certain conditions, to prescribe drugs to terminally ill patients for the sole purpose of ending their lives. But the battle has just begun.

In an email interview, Rabbi Dr. Glassman explained why he initiated the lawsuit. “I was motivated to act by the chilling prospect of being a part of the suicide process, which strongly conflicted with both my professional and religious values. I was fortunate enough to engage in meaningful discussions with several concerned Jewish community members on the topic, and I decided to take a firm position, being involved in the field of geriatrics. Some people who may oppose my action may say that I want dying patients to suffer, chas v’shalom. Quite the opposite—we as physicians have ample tools to alleviate the suffering for the living, even for the terminally ill, without the need to license suicide.” . . . [Full text]

Vancouver doctor cleared of wrongdoing in probe into assisted death at Orthodox Jewish nursing home

The Globe and Mail

Kelly Grant

British Columbia’s physician regulator has cleared a doctor of any wrongdoing for sneaking into an Orthodox Jewish nursing home that forbids assisted death and ending the life of a resident who wanted to die in his own bed.

In a letter dated July 5, 2019, the College of Physicians and Surgeons of British Columbia (CPSBC) dismissed an official complaint against Ellen Wiebe, saying the Vancouver doctor did not break any of the regulator’s rules when she helped Barry Hyman, 83, die inside the Louis Brier Home and Hospital. . . [Full text]