A new abortion law has been enacted in Bolivia as part of the revision of the country’s Penal Code. Section 153 of the Penal Code now permits abortion of any girl under the age of 20 for any reason and at any point in gestation, when pregnancy results from rape, incest or involuntary artificial reproduction. Abortion is also allowed at any point in gestation in the case of present or future risk to the life or “overall health” of a woman, and (when pregnancy is under 8 weeks gestation) the woman is a student or has the care of a disabled relative.
The protection of conscience provision prohibits “the national health system” from asserting conscientious objection and insists that conscientious objection is limited to individual medical personnel “directly involved in the accomplishment” of the procedure, and must be stated in advance. “The national health system” is not defined in the law. It would appear from this that private or denominational health facilities (if they exist and are legally part of the national health system) cannot establish policies prohibiting abortion.
The fact that abortion is permitted as an exception to a general prohibition should mean that medical personnel or institutions of the opinion that a women does not qualify for an abortion under one of the legal criterion (such as risk to “overall health”) cannot be compelled to participate. This would not constitute conscientious objection and could not be stated in advance.
Baylor College of Medicine
Canada recently legalized medical assistance in dying (MAiD), which allows patients to receive a lethal drug that they can self-administer, or be administered a lethal drug by an authorized clinician with consent of the patient. As provinces and territories work to create and clarify legal guidelines for providing MAiD, many Catholic hospitals have refused to offer it, citing opposition to physician-assisted suicide and euthanasia in Catholic moral teaching.
This controversy surrounding institutional conscience-based refusals raises an important question: Should a health care institution have the right to refuse to provide a particular treatment for conscience-based reasons? . . . [Full text]
Lethal medication provisions are in a precarious state. Over the past decade, pharmaceutical companies have attempted to stamp out the use of their drugs in executions, creating several economic and regulatory hurdles for access to these medications. As a result, patients seeking physician-assisted suicide (PAS) as well as death penalty states aiming to execute their capital offenders have been forced to turn to unregulated and dangerous alternatives for these drugs. This note attempts to unpack the quality, safety, and access issues emerging from these recent changes and to explore the implications for the future of these practices.
In order to fully grasp the exact mechanisms at work, this note will first offer a brief pharmacological description of the lethal medications and detail many technical aspects of their use. The next section provides a historical account of the past decade, illustrating the emergent quality, safety, and access issues. This note then evaluates the competing notions of ‘botched’ executions and ‘complications’ in PAS while analysing the standards set forward to measure safety and efficacy for each. Finally, this note closes by exploring the future of each practice in light of our discussion.
Riley S. Navigating the new era of assisted suicide and execution drugs. Journal of Law and the Biosciences. Volume 4, Issue 2, 1 August 2017, Pages 424–434, https://doi.org/10.1093/jlb/lsx028
1. The practice of medicine is a service to human dignity and doctors must adhere to the highest standards of professional competence in treating, protecting and advocating for patients.
2. In the course of their work on behalf of patients, doctors have the right not to participate in procedures which, in conscience, they believe to be wrong.
3. Doctors should not, by action or omission, deliberately shorten a patient’s life. Doctors must respect a patient’s fully-informed decision to refuse life-sustaining treatment or to request withdrawal of medical treatment.
4. Doctors have the right to refuse applications for referral for treatments to which they object in conscience.
5. Doctors have an obligation to provide care in emergencies, even if the condition results from a procedure to which the doctor has a conscientious objection.
6. Doctors have an obligation to explain the reasons for their conscientious objection with clarity and courtesy to patients and colleagues. Patients have a right to see another doctor and to be given impartial information as to how they can exercise that right. [Full text]
A new Canadian organization for midwives has been formed. Canadian Midwives for Life describes itself as a not-for-profit group that attempts to speak for Canadian midwives “who recognize the dignity and inviolability of human life from the moment of fertilization.” Among the objectives of CMFL: “Understand their own personal boundaries in midwifery practice and the implications of conscientious objection.”
A 35-year-old man who had been in a vegetative state for 15 years after a car accident has shown signs of consciousness after neurosurgeons implanted a vagus nerve stimulator into his chest. The findings reported in Current Biology on September 25 show that vagus nerve stimulation (VNS)—a treatment already in use for epilepsy and depression—can help to restore consciousness even after many years in a vegetative state.
The outcome challenges the general belief that disorders of consciousness that persist for longer than 12 months are irreversible, the researchers say. . . [Full text]
Corazzol and Lio et al. Current Biology, “Restoring consciousness with vagus nerve stimulation.” DOI: 10.1016/j.cub.2017.07.060
If the events are in fact true, there were many people turning a blind eye and/or being paid off to not say anything about what was happening in these medical centers for years.
The Costa Rica Star
With criminal proceedings underway on a human organ trafficking case involving the trial of four Costa Rican doctors and their alleged accomplices, many interesting details are coming to light.
Intersecting forces of greed, corruption and international black markets are being identified and dissected as evidence is presented in this first of a kind trial in Costa Rica. More details will be forthcoming as prosecutors weigh testimony by numerous individuals over the next two months. . .[Full text]
A euthanasia and assisted suicide bill introduced in the Parliament of Victoria, Australia, includes several provisions that pertain to legal protection of freedom of conscience. Concerning these:
- Freedom of conscience provisions concern only individual practitioners, not health care facilities. Freedom of conscience presumably includes acting upon moral or ethical beliefs grounded in religious teaching.
- Statements of principles that require encouragement and promotion of an individual “preferences and values,” that people should be “supported” in conversations about treatment and care and “shown respect” for their beliefs, etc. can be interpreted to require affirmation of moral or ethical choices.
- While the principles may have no direct legal effect, they could be cited by professional regulatory authorities against those who refuse to encourage, promote, or affirm the acceptability of euthanasia and assisted suicide.
- Registered medical practitioner is not defined, but all would be encompassed by the definition of health care practitioner.
- All health care practitioners are protected by Section 7.
- Section 7(b) allows for refusal to participate in the request and assessment process and Section 7(c) protects refusal to be present when lethal medication is administered, but Section 7
- does not include protection for refusal to participate in the administration of lethal medication, by, for example, inserting an IV line in advance, or by other means
- does not include protection for refusal to participate in dispensing lethal medication
- “Participate” in Section 7(b) is broad enough to encompass referral. However, the bill would be improved by providing protection against coerced indirect participation in administering or dispensing lethal medication.
- The bill does not require falsification of death certificates, but does require the falsification of the cause of death in the registration of deaths. The bill includes no protection for a registrar who, for reasons of conscience, is unwilling to falsify a registry entry.
It is striking how easy it has become for a person to stumble into the status of a symbol – or, these days, a viral meme. Jack Phillips is, or was until fairly recently, a skilled cake artist with a small business, Masterpiece Cakeshop, in suburban Denver. Today, he is a litigant in the Supreme Court of the United States and regarded by many as embodying the tension – increasingly, the conflict – between religious conscience and equality. . . Can he be required, though – should he be required, is it necessary for him to be required – to say something he thinks is not true, to disavow what he believes or to act expressively in violation of his conscience? . . . [Full text]
A furious row has broken out within the Catholic Church over the Belgian Brothers of Charity, who are refusing to comply with a Vatican order to stop providing euthanasia for the people it cares for.
The UK-based Catholic priest Alexander Lucie-Smith has described the behaviour of the Brothers as ‘utterly outrageous,’ and pointed out the crucial fact that the order is lay-run.
In a statement released in Flemish, French and English, the organisation said it ‘continues to stand by its vision statement on euthanasia for mental suffering in a non-terminal situation’ and goes on to make the incendiary claim that it ‘is still consistent with the doctrine of the Catholic Church. We emphatically believe so.’ . . . [Full text]