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]

Conscientious Objection, Professional Discretionary Space, and Good Medicine

Practical Ethics

Doug McConnell

Some argue that good medicine depends on physicians having a wide discretionary space in which they can act on their consciences (Sulmasy, 2017). Interestingly, those who are against conscientious objection in medicine make the exact opposite claim – giving physicians the freedom to act on their consciences will undermine good medicine. So who is right here? . . . [Full text]

Eduard Pernkopf: The Nazi book of anatomy still used by surgeons

BBC News

Keiligh Baker

When nerve surgeon Dr Susan Mackinnon needed help to finish an operation, she reached, as she often does, for a mid-20th Century book of anatomy.

Thanks to the complex hand-drawn illustrations – showing the human body peeled back layer by layer – Dr Mackinnon, from Washington University in St Louis, was able to complete the procedure.

The book she had used, the innocuous-sounding Pernkopf Topographic Anatomy of Man, is widely considered to be the best example of anatomical drawings in the world. It is richer in detail and more vivid in colour than any other. . . [Full text]

Australia launches inquiry into safety and ethics of transgender medicine

BioEdge

Michael Cook

A national inquiry into the safety and ethics of transgender medicine will be conducted by the Royal Australasian College of Physicians with the backing of Federal Health Minister Greg Hunt.

At the moment there are no nationally agreed standards, although guidelines issued by Melbourne’s Royal Children’s Hospital gender clinic have been referred to as the “Australian standards”. However, this document, which has been described as the “most progressive” in the world by Victoria’s Minister for Health, has not been approved by the National Health and Medical Research Council.

The RCH model commits doctors to the controversial policy of reducing“mental illness in trans and gender diverse children by affirming and protecting their identity in a world where many judge and hurt them”.

According to an exclusive article in The Australian about the inquiry, “Critics say the 2018 standards encourage risky medical treatment without properly considering safer therapies such as counselling for problems such as depression, anxiety, autism spectrum disorder, bullying and family conflict. The RCH standards overplay evidence for medical treatment and downplay risks, say ‘dissident’ clinicians.”

The opposing sides of the debate over transgender Australian youth differ on fundamental issues.

Michelle Telfer, director of the Royal Children’s Hospital Gender Service in Melbourne, told The Australian that commencing medical intervention as young as 13 or 14 was “not at all controversial within those with expertise because we all know that we have been doing this for years”.

Critics question whether gender dysphoria is really understood.

“Far be it from anybody to say that there are absolutely no people in the world who are genuinely gender dysphoric and who find it impossible to live in their biological sex,” said Dr Dianna Kenny, a psychologist. “What I’m saying is it’s been massively and irresponsibly over-diagnosed … (these children and teens) are going to be irrevocably damaged by the treatment they received.”

And the ethics of irreversible medical treatment have not been settled. “Who gave ethics approval for this treatment (at children’s hospitals) when it lacks any scientific basis and therefore is an experiment?” asks Prof John Whitehall, of Western Sydney University. “We should give the psychiatry and psychology a full run before we start castrating children.”


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Defending freedom of conscience on emergency contraception

CMF Blogs
Reproduced with permission

Philippa Taylor*

The UK’s biggest abortion provider, British Pregnancy Advisory Service (BPAS), has attacked pharmacists who do not sell the ‘morning-after pill’ for conscience reasons. 

After one incident when a pharmacist would not dispense emergency contraception to a woman for ‘personal’ reasons, BPAS condemned both the pharmacist and the conscience protections provided to pharmacists. A petition was set up to prevent pharmacists from claiming freedom of conscience rights. 

Under the current law, covered by guidance from the General Pharmaceutical Council (GPhC), pharmacists with a genuine conscientious objection to selling the pill may refer the customer to another pharmacist.

However, BPAS complained that it is ‘impossible to overstate the significance of even one pharmacist conscientiously objecting to selling the morning-after pill’. 

Fortunately, the General Pharmaceutical Council, in this case, upheld its guidelines and the consequent media coverage has now died down, temporarily at least.

This may seem like a one-off minor incident, but it is an illustration of increasing pressures on freedom of conscience protections. It is often assumed that the role of the conscience in medicine is relevant only to a few specialised and limited areas such as contraception or abortion, but in fact, the concept of the conscience goes right to the heart of what it means to act in a moral way, to act with integrity.

If we do not stand by those who are under pressure, the problems will only get worse and will spread. A well-known quote, often attibuted to Burke though it may have come originally from J S Mill, warns: ‘He should not be lulled to repose by the delusion that he does no harm who takes no part in public affairs. He should know that bad men need no better opportunity than when good men look on and do nothing.’

The Christian Medical Fellowship (CMF) has therefore written to the General Pharmaceutical Council to ensure they are aware of our concerns and to thank them for holding to their guidance. The text of our letter is as follows, with their response after it:

‘I am writing to you following the recent news coverage of a Lloyds pharmacy worker who, according to news reports, conscientiously objected to selling the morning-after pill and directed a customer to another pharmacy instead. I note that a petition has since been set up to prevent pharmacists from claiming conscientious objection rights.

‘The Christian Medical Fellowship is the UK’s largest faith-based group of health professionals and we contributed with both written and oral evidence to your review of your Guidance on Religion, Personal Values and Beliefs. We publicly welcomed the new Guidance and the statement accompanying it, in which the Chief Executive of the General Pharmaceutical Council highlighted the positive contribution that pharmacists’ faith can make in their provision of care. We also welcomed the clear statement that: “Pharmacy professionals have the right to practise in line with their religion, personal values or beliefs”.

‘We all aspire to person-centred care. In any care scenario, there are (at least) two parties – the carer and the one receiving care – each of whom has rights. The General Pharmaceutical Council guidance helpfully achieves a balance between the patient’s right to service access and the pharmacist’s right to freedom of conscience.

Respect for the sincerely held religious and moral beliefs of employees is essential and we are concerned that some of the demands being made, based on this one recent case, would marginalise the beliefs, values and religion of pharmacists disproportionately and unnecessarily, and trivialise their right to freedom of conscience under the law. Despite widespread coverage of this case, we have yet to see evidence of recurring complaints under the present provisions.

‘While we strongly support the right to freedom of conscience for pharmacists, we do also emphasise the importance of openness and sensitive communication with colleagues and employers; any refusal to supply should be made courteously and sensitively.

‘On behalf of CMF, I want to thank the Council for protecting the right of pharmacists to refuse to engage in certain procedures that violate their most profound moral convictions.

‘I also encourage the Council to continue to make it clear, publicly, that all pharmacy professionals have the right to practise in line with their religion, personal values or beliefs.

Yours faithfully

Dr Mark Pickering
Chief Executive, CMF

The General Pharmaceutical Council replied with the following two sentences:

‘Our existing guidance In practice: Guidance on religion, personal values and beliefs (to which you refer) remains in place. We have no current plans to review it. As you are aware, the guidance sits under our standards for pharmacy professionals and relates to standard 1, Pharmacy professionals must provide person-centred care.’

The point here is simple but vital: if we care about liberty and personal integrity, we must make a reasoned defence of it in the public square, from the smallest incident to the biggest.

Physician-Assisted Suicide and the Perils of Empirical Ethical Research

JAMA Netw Open. 2019;2(8):e198628. doi:10.1001/jamanetworkopen.2019.8628

Daniel P. Sulmasy

Al Rabadi et al1 compare statistics on physician-assisted suicide (PAS) available from public databases for the states of Washington and Oregon and find similar profiles and trends, which is unsurprising given the similarity of the laws and demographic characteristics of these states. Among the unanswered questions are what such a study can contribute to medical ethics (about PAS or any other ethical controversy) and what the limits are of such work.

Cautions

First, it should be noted that the medical literature is, in general, favorably disposed toward the empirical and the new. Although this predilection is often advantageous for scientific progress, it introduces a problematic bias when applied to ethical questions. The appeal of the study by Al Rabadi et al1 is that it is empirical, and by comparing data from 2 states for the first time, it can be considered novel. Because there are new reports each year and the practice of PAS is legal in only a few states, descriptive reports about PAS are published frequently. This means, however, that articles defending the ethical status quo (ie, against PAS) tend to be shut out of the medical literature because they are not reporting anything new and, therefore, cannot have any data. The result is an impression of growing acceptance of PAS, but it really represents an artifact of a scientific bias. . . . [Full text]

The SNC-Lavalin affair raises the issue of politicians’ conflict between their conscience and party politics.

There are good reasons to favour conscience.

Policy Options

Brian Bird

The SNC-Lavalin affair, which continues to reverberate, raises many issues in a democracy dominated by political parties — and all these issues take on greater relevance with a federal election approaching. One of them is the conflict that can arise between the conscience of a politician and the strictures of party politics, in a variety of contexts, and how that conflict should be resolved. When our representatives are voting on legislation, there are good reasons to favour conscience. . . [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]

Japanese scientist to use human-animal hybrids to create organs

BioEdge

Michael Cook

A Japanese stem cell scientist has obtained permission to create human-animal chimeras and transplant them into surrogate animals. Hiromitsu Nakauchi, a researcher at the University of Tokyo and at Stanford University, plans to insert induced pluripotent human cells into mouse embryos. His ultimate aim is to grow human organs in animals. . . [Full text]