Canada’s bishops allow Catholic hospitals to host consultations for euthanasia

LifeSite News

Lianne Laurence

OTTAWA, April 18, 2019 (LifeSiteNews) – Canada’s bishops were consulted on and agreed to secret guidelines by Catholic health sponsors that allow third-party euthanasia assessments of medically frail patients in Catholic health care facilities, LifeSiteNews has learned.

And while the Catholic health sponsors who drafted the guidelines in collaboration with ethicists and bishops concluded such assessments were not formal cooperation with evil, they failed to consider there are instances when material cooperation is gravely wrong, as is the case here, says Catholic moral theologian, Dr. E. Christian Brugger. . . [Full text]

Australian Medical Association Updates Advice to Doctors with Conscientious Objections

News Release

Australian Medical Association

The AMA has released its updated Position Statement on Conscientious Objection 2019 (replacing the Position Statement on Conscientious Objection 2013). The policy was reviewed as part of the AMA’s routine, five-year policy review cycle.

A conscientious objection occurs when a doctor, as a result of a conflict with his or her own personal beliefs or values, acknowledges that they cannot provide, or participate in, a legal, legitimate treatment or procedure that would be deemed medically appropriate in the circumstances under professional standards.

A conscientious objection is based on sincerely-held beliefs and moral concerns, not self-interest or discrimination.

AMA President, Dr Tony Bartone, said today that doctors are entitled to have their own personal beliefs and values, as are all members of the community.

“However, doctors have an ethical obligation to minimise disruption to patient care and must never use a conscientious objection to intentionally impede patients’ access to care,” Dr Bartone said.

The AMA advises that a doctor with a conscientious objection should:

  • inform the patient of their objection, preferably in advance or as soon as practicable;
  • inform the patient that they have the right to see another doctor and ensure the patient has sufficient information to enable them to exercise that right;
  • take whatever steps are necessary to ensure the patient’s access to care is not impeded;
  • continue to treat the patient with dignity and respect, even if the doctor objects to the treatment or procedure the patient is seeking;
  • continue to provide other care to the patient, if they wish;
  • refrain from expressing their own personal beliefs to the patient in a way that may cause them distress;
  • inform their employer, or prospective employer, of their conscientious objection, and discuss with their employer how they can practise in accordance with their beliefs without compromising patient care or placing a burden on their colleagues; and
  • always provide medically appropriate treatment in an emergency situation, even if that treatment conflicts with their personal beliefs and values. 

Changes since 2013

The tone and emphasis of the Position Statement has been amended. Rather than taking a prescriptive line, the Position Statement now takes a reflective approach where a doctor is asked to focus on what really should matter the most: the impact of their decisions on the patient in front of them.

A new statement has been included that an objecting doctor should be aware that certain treatments or procedures are time critical.

A new section on institutional conscientious objection has been included. It advises institutions that do not provide particular treatments or procedures due to institutional conscientious objection to inform the public of this so (potential) patients can seek care elsewhere. This section also advocates that a doctor working within such an institution should be allowed to refer a patient (already admitted) who seeks such a service to another doctor outside the facility.

The AMA Position Statement on Conscientious Objection 2019 is at https://ama.com.au/position-statement/conscientious-objection-2019


CONTACT:        John Flannery                     02 6270 5477 / 0419 494 761

                            Maria Hawthorne               02 6270 5478 / 0427 209 753

Assisted dying: Doctors’ group adopts neutral position

BBC News

Hospital doctors have dropped their 13-year opposition to the concept of helping terminally ill patients die.

Following a poll of its members, the Royal College of Physicians has now adopted a neutral stance on the issue of assisted dying.

Some groups have spoken out against the change, saying a respected medical body’s reputation has been damaged. Others called the decision “absurd”. . . [Full text]

U.S. Public Health Service STD Experiments in Guatemala (1946–1948) and Their Aftermath

Kayte Spector-Bagdady, Paul A. Lombardo

Abstract

The U.S. Public Health Service’s sexually transmitted disease (STD) experiments in Guatemala are an important case study not only in human subjects research transgressions but also in the response to serious lapses in research ethics. This case study describes how individuals in the STD experiments were tested, exposed to STDs, and exploited as the source of biological specimens—all without informed consent and often with active deceit. It also explores and evaluates governmental and professional responses that followed the public revelation of these experiments, including by academic institutions, professional organizations, and the U.S. federal government, pushing us to reconsider both how we prevent such lapses in the future and how we respond when they are first revealed.


SpectorBagdady K, Lombardo PA. U.S. Public Health Service STD Experiments in Guatemala (1946–1948) and Their Aftermath. Ethics & Human Research. 2019 Apr; 41(2): 29-34.

Doctors to fight new abortion law

Hawthorn Caller

Mike Billings

A group of doctors opposed to abortion say they will fight any moves in looming reforms to erode their rights to refuse to deal with patients wanting abortions. The issue of referring patients seeking abortions to another doctor has drawn opposition from the group.

Justice Minister Andrew Little says he agrees with a Law Commission proposal for doctors who are “conscientious objectors” to abortion to be made to directly refer a patient on to another doctor who they know will provide the service.

Currently, such doctors only have to advise the patient they can get the service elsewhere without specifying where. . . [Full text]

Abortion and the medical profession

The Irish Times (Letter)
Reproduced with permission

Dr. Noreen O’Carroll

Sir, –

Dr Mark Murphy states that doctors who are opposed to abortion are in no way affected by the new service and their conscientious right to objection is respected.

In fact, doctors who have a conscientious objection are legally compelled to make arrangements for the transfer of care of the pregnant woman concerned to someone who will terminate the pregnancy. For doctors who cherish human life from its origins, that is tantamount to making them accomplices in taking the life of a developing baby.

This is an abuse of conscience and contrary to the practice of medicine in the spirit of the Hippocratic oath which prohibits the direct intentional taking of human life.

Dr Murphy, who you omitted to mention is on the staff of the department of general practice at the Royal College of Surgeons in Ireland, is one of a minority of GPs in Ireland who have signed up to provide abortion services; the vast majority of GPs have not done so – 274 was the figure recently reported by the HSE.

I am not now, nor have I ever been, a member of a pro-life group; although as an ordinary citizen, I have consistently advocated for the life of the developing baby to be legally protected and have voted accordingly.

– Yours, etc, Dr Noreen O’Carroll, (Lecturer in Medical Ethics, RCSI), Blackrock, Co Dublin.

Victoria’s voluntary assisted dying law: clinical implementation as the next challenge

Ben P. White, Lindy Willmott, Eliana Close

The Voluntary Assisted Dying Act 2017 (Vic) (VAD Act) will become operational on 19 June, 2019. . . . While some have written on the scope of, and reaction to, the VAD legislation, there has been very little commentary on its implementation. Yet, important choices must be made about translating these laws into clinical practice. These choices have major implications for doctors and other health professionals (including those who choose not to facilitate VAD), patients, hospitals and other health providers. This article considers some key challenges in implementing Victoria’s VAD legislation.


White BP, Willmott L, Close E. Victoria’s voluntary assisted dying law: clinical implementation as the next challenge. Med J Australia. 2019 Mar;210(5):207-209.e1

Legal and ethical implications of defining an optimum means of achieving unconsciousness in assisted dying

S. Sinmyee V. J. Pandit J. M. Pascual A. Dahan T. Heidegger G. Kreienbühl D. A. Lubarsky J. J. Pandit

Summary

A decision by a society to sanction assisted dying in any form should logically go hand-in-hand with defining the acceptable method(s). Assisted dying is legal in several countries and we have reviewed the methods commonly used, contrasting these with an analysis of capital punishment in the USA. We expected that, since a common humane aim is to achieve unconsciousness at the point of death, which then occurs rapidly without pain or distress, there might be a single technique being used.

However, the considerable heterogeneity in methods suggests that an optimum method of achieving unconsciousness remains undefined. In voluntary assisted dying (in some US states and European countries), the common method to induce unconsciousness appears to be self-administered barbiturate ingestion, with death resulting slowly from asphyxia due to cardiorespiratory depression. Physician-administered injections (a combination of general anaesthetic and neuromuscular blockade) are an option in Dutch guidelines. Hypoxic methods involving helium rebreathing have also been reported.

The method of capital punishment (USA) resembles the Dutch injection technique, but specific drugs, doses and monitoring employed vary. However, for all these forms of assisted dying, there appears to be a relatively high incidence of vomiting (up to 10%), prolongation of death (up to 7 days), and re-awakening from coma (up to 4%), constituting failure of unconsciousness. This raises a concern that some deaths may be inhumane, and we have used lessons from the most recent studies of accidental awareness during anaesthesia to describe an optimal means that could better achieve unconsciousness. We found that the very act of defining an ‘optimum’ itself has important implications for ethics and the law.


Sinmyee S, Pandit VJ, Pascual JM, Dahan A, Heidegger T, Kreienbühl G, Lubarsky DA, Pandit JJ. Legal and ethical implications of defining an optimum means of achieving unconsciousness in assisted dying. Anaesthesia. 2019 May;74(5): 630-637.

Controversy dogs ‘assisted dying’ poll of UK doctors

BioEdge

Michael Cook

A controversial poll by the Royal College of Physicians, in the UK, is expected to result in a change in its position on “assisted dying”. Polling ends on March 1 and the result will be announced later in the month.

If the email poll fails to reach a supermajority of 60% who oppose a change from the status quo of opposition, the official position of the College will change to neutrality.

On the face of it, the procedure for the poll is bizarre. If 59% of the RCP’s 35,000 members support opposition to “assisted dying”, which in any democratic election would be an overwhelming victory with a margin of 18 percent, they still lose.

In fact, a former chair of the RCP’s ethics committee has threatened legal action. Dr John Saunders described the vote as a “sham poll with a rigged outcome”. In a letter to The Guardian he contended that the RCP would change its position to neutral even if the result were the same as a 2014 poll, when 57.5% of the doctors who voted did not “support a change in the law to permit assisted suicide by the terminally ill”.

Another group of doctors wrote a letter to The Times in which they accused a cabal of hijacking the RCP. “We are worried that this move represents a deliberate attempt by a minority on the RCP council to drop the college’s opposition to assisted suicide even if the majority of the membership vote to maintain it.”

The RCP President, Dr Andrew Goddard, insists that the poll is both fair and necessary. “It is important that the RCP represents fairly the views of its full membership. We will go ahead with the survey as planned.”

He is quite aware of the impact that a change would have upon public opinion. “The RCP is frequently asked for its stance on this high profile issue, which may be cited in legal cases and parliamentary debate, so it is essential that we base this on an up-to-date understanding of our members’ and fellows’ views.”

Although some reports assumed that “assisted dying” means “assisted suicide”, the RCP’s definition seems to encompass euthanasia as well: “The supply by a doctor of a lethal dose of drugs to a patient who is terminally ill, meets certain criteria that will be defined by law, and requests those drugs in order that they might be used by the person concerned to end their life.” In Oregon, where only assisted suicide is legal, “a physician prescribes a lethal dose of medication to a patient, but the patient – not the doctor – administers the medication.”


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Assisted dying: 1,500 doctors back campaign against ‘tacit support’ plan

Express

David Maddox

MORE than 1,000 doctors have signed a letter opposing alleged attempts by the Royal College of Physicians to become “neutral” on assisted dying.

The college is locked in a row with members over its position.

Although a poll in 2014 found 58 percent did not support it, the college says unless it has a 60 per cent majority for or against, it will adopt a neutral view. It is conducting a new poll but with a three-way question, which opponents say makes the majority harder to obtain.

This could lead to “tacit support” in favour of assisted suicide. . . . Full Text