Richard G. Roberts, MD, president of the American Academy of Family Physicians, is reported to have said that physicians do not have a “statutory, constitutional or ethical” duty to perform procedures to which they object, but that the medical profession has an obligation to help patients access necessary legal services. The remarks appear to distinguish between personal and corporate obligations.
A resolution that would allow pharmacists to opt out of dispensing morally controversial products such as the Morning After Pill gained substantial support from pharmacists at the Annual General Meeting of the College of Pharmacists of British Columbia in Vancouver on October 12th. A news release from Concerned Pharmacists for Conscience noted that the loss of the show of hands vote was seen not as a defeat, but as a sign that more work is necessary.
The adoption of a protection of conscience policy not dissimilar to those existing in some pharmacy associations in the United States triggered an attack by the Winnipeg Sun in an editorial titled Pharmological farce. (See Project’s response) Coverage in the National Post and Winnipeg Free Press was more balanced. CBC Radio in Winnipeg hosted an open-line programme on 8 June concerning the issue.
5 June, 2000
Protection of Conscience Project
Pharmacists in Manitoba have decided that they should not be forced to be involved in medical procedures that they find morally abhorrent.
The Annual General Meeting of the Manitoba Pharmaceutical Association adopted a policy that pharmacists may refuse to dispense certain drugs for reasons of conscience. Such policies exist in the United States, but it is believed that this is the first time a pharmacists’ association in Canada has formally recognized the importance of freedom of conscience.
News of the development was conveyed to the Protection of Conscience Project in a letter from Ronald F. Guse, Registrar of the Manitoba Pharmaceutical Association.
The Association rejected a clause that would have forced conscientious objectors to involve themselves by making a referral to another pharmacist.
“Pharmacists in Manitoba who voted for this measure should be congratulated and thanked by their colleagues,” said Sean Murphy, Administrator of the Protection of Conscience Project. “The present concern among conscientious objectors is the so-called ‘morning-after-pill’. However, if non-objecting pharmacists do not support their colleagues on this issue, they should expect no support if they object to dispensing drugs for assisted suicide, euthanasia, and execution by lethal injection.”
“If that seems somewhat far-fetched,” Murphy added, “the College of Pharmacists of British Columbia is already speculating about the expansion of pharmacy services to include such procedures.”
Concerned Pharmacists for Conscience
The professional group Concerned Pharmacists for Conscience supports and applauds the Manitoba Pharmaceutical Association’s courageous inclusion of a model statement in their Standards of Practice, which does not require pharmacists with conscientious objections to refer patients. Patient access to legally prescribed therapy would continue to be available without compromising the health professionals’ right of conscientious refusal.
Ms. Maria Bizecki, spokesperson for Concerned Pharmacists for Conscience, says “Pharmacists in Manitoba can now exercise their freedom of conscience rights without fear for their noble livelihood. Pharmacists are presently objecting to participate as agents of death, not attempting to block access or give moral pep talks at the pharmacy counter.”
Bizecki futher added that as the Canadian Medical Association does not require doctors to participate in or refer for abortions, all pharmacists must also be protected nationally by their associations. “By pushing their morality on health care workers, the public violates a pharmacist’s autonomy, integrity and basic human rights in a country that protects its minorities.”
For further information: Ms. Maria Bizecki, spokesperson Tel: (403) 228-2190 Fax:(403) 228-2249
Testimony before the Joint Committee on the Constitution (Chomhchoiste ar an mBunreacht)
Parliament of Ireland (Tithe an Oireachtais)
3 May, 2000
During hearings considering the abortion law in Ireland, the Joint Committee heard from Dr. Declan Keane, Master of the National Maternity Hospital, Holles Street. This is the biggest maternity hospital in Europe, with over 8,000 births annually. One of the questions put to Dr. Keane elicited comments about the extent of conscientious objection among Irish gynaecologists.
Dr. Keane’s testimony led to the making of a submission by the Protection of Conscience Project to the Irish parliamentary committee. [Administrator]dnesday, May 3rd, 2000. [Testimony of Dr. Keane]
Canadian Physicians for Life
Canadian Physicians for Life calls on the College of Physicians and Surgeons of Alberta to verify the alleged charges of women being bullied by pro-life physicians.
The tone of the statement from College Councillor Dr. Eugene Kretzul is patronizing and dismissive of the conscience rights of doctors. The “nudge-nudge, wink-wink” suggestion that morally troublesome issues need only be referred to a colleague is oblivious to the principled objections of pro-life physicians. Increasingly exotic reproductive technologies may eventually offend even the most laissez-faire physicians. There may come a day where no physician feels free from coercion to violate his or her conscience.
The “pro-choice” Alberta College apparently lacks tolerance for physicians’ choice to be pro-life. The Code of Ethics of the Canadian Medical Association requires physicians to “inform a patient when their personal morality would influence the recommendation or practice of any medical procedure that the patient needs or wants.” The Alberta College suggests pro-life doctors go further: usher abortion requesters into the abortion-on-demand system or face the charge of being unprofessional.
In Alberta, as elsewhere, it is often easier for women to obtain an abortion than support and counseling services. For a woman to make a truly “informed decision” she must be presented with the embryology of her unborn child so that she will know that she is aborting a human being, not just a clump of cells or a piece of her own tissues. She deserves more than the wave-through suggested by the College’s statement.
A number of studies report a close correlation between abortion, especially of a first pregnancy, and breast cancer. Are Alberta physicians telling abortion seekers of this threat to their health? Are women being informed of the risk of post-abortion emotional trauma? Are patients being warned that some physicians’ ardent pro-abortion beliefs bias the “counselling” process?
And if abortion seekers have complained of being bullied, has the College conducted diligent enquiries into such serious accusations? What was the outcome? Or is polemical hearsay the College’s new standard of evidence when the target is pro-life doctors?
In plain English, independent medical professionals have no duty to refer anyone to anyone when the referral would violate the conscience and the medical good judgement of the professional. This elementary conscience protection impartially shields doctors who possess any convictions on any topic at all. Whether the request be for genital mutilation, the amputation of a healthy limb, or an abortion, the true professional will never be coerced into offending his or her basic principles. Canadian Physicians for Life calls on the Alberta College to retract and clarify its venture into professional conscience ethics.
Will Johnston, M.D.
For further information
Canadian Physicians for Life Administration
Phone (604) 794-3772; Fax (604) 794-3960
Int J Gynaecol Obstet. 66 (1999) 55-61
BM Dickens, RJ Cook
The potential and actual applications of reproductive technologies have been reviewed by many governmental committees, and laws have been enacted in several countries to accommodate, limit and regulate their use. Regulatory systems have nevertheless left some legal and ethical issues unresolved, and have caused other issues to arise. Issues that regulatory systems leave unresolved, or that systems have created, include disposal of embryos that remain after patients’ treatments are concluded, and multiple implantation and pregnancy. This may result in risks to maternal, embryonic and neonatal life and health, and the contentious relief that may be achieved by selective reduction of multiple pregnancies. A further concern arises when clinics must or choose to publicize their success rates, and they compete for favorable statistics by questionable patient selection criteria and treatment priorities. [Full Text]
J Law Med Ethics 1994 Fall;22(3):280-5PMID: 7749485
Rebecca S. Dresser
Acess to abortion is becoming increasingly restricted for many women in the United States. Besides the longstanding financial barriers facing low-income women in most states, a newer source of scar city has emerged. The relatively small number of physicians willing to perform the procedure is compromising the ability of women in certain parts of the country to obtain an abortion. Do physicians have a duty to respond to this situation? Do they have a professional responsibility to ensure that abortions are reasonably available to the women who want to terminate their pregnancies? Or, is abortion so morally and socially controversial as to remove any professional obligation to provide reasonable access? [Full Text]