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.

Bill to give medical staff right to refuse role in abortions condemned

The Guardian

Tim Wyatt

Pro-choice groups have condemned an attempt to create new laws that would allow doctors and nurses to refuse to take part in abortions on moral grounds.

A private bill going through the House of Lords that would expand rights of conscientious objection for healthcare professionals has been dismissed as unnecessary by abortion providers and campaigners.

Those in favour of the bill, sponsored by the Northern Irish crossbench peer Nuala O’Loan, insisted their aim was not to restrict abortion but to uphold freedom of belief and religion they claim is under threat in hospitals since a contentious supreme court ruling in 2014. . . [Full text]

 

New RCM abortion statement is a further assault on freedom of conscience

Christian Medical Fellowship Blogs

Steve Fouch

Fallout from the Glasgow Midwives case continues to roll out. This month the Royal College of Midwives (RCM) released (rather quietly) their new position statement on abortion. The case of Doogan & Wood highlighted an issue with the conscientious objection clause in the 1967 Abortion Act. Specifically this was around what constituted actually being involved in an abortion procedure.

The two senior midwives at a Glaswegian maternity unit made it clear that they did not wish to be responsible for supervising junior staff involved in termination of pregnancy procedures on the basis of a conscientious objection to abortion.

Although the Scottish Court of Appeal upheld their claim, The Supreme Court eventually ruled that they had no right to opt out of supervision, delegation or support of junior staff, as the right to conscientious objection only applied to those involved in direct, clinical procedures. Supervisory roles or other areas of care could not be subject to the right to conscientious objection in the Abortion Act. . . [Full Text]

Catholic midwives must supervise abortions, Supreme Court decides

Catholic midwives Mary Doogan and Connie Wood lose case against being made to supervise other staff carrying out abortions

The Telegraph

Patrick Sawer

Two Catholic midwives who refused to take part in any abortion procedures have lost their legal battle to be treated as ‘conscientious objectors’.

The UK’s highest court overturned a previous ruling made in favour of the two midwives, after a Scottish health authority urged it to overturn last year’s decision of the Court of Session, in Edinburgh, in the case of Mary Doogan and Connie Wood.

The ruling is likely to mean that Ms Doogan and Ms Wood will now have to supervise abortions carried out by other staff, as part of their terms of employment, although they will still be free to refuse to carry out the terminations themselves.

The case centres on the scope of the right to conscientious objection under the Abortion Act 1967, which provides that “no person shall be under any duty … to participate in any treatment authorised by this Act to which he has a conscientious objection”. . . [Full text]

 

Should midwives opposed to abortion have the right to refuse any involvement in cases?

Landmark decision ‘could have severe impact on women’s care’, experts warn

Daily Mail

Lizzie Parry

Midwives who object to abortions could be allowed to opt out of any involvement with women who choose to terminate their unborn babies.

The UK’s Supreme Court will today hear an appeal after two Catholic midwives won a landmark case for the right to refuse any involvement in abortion procedures in 2013.

Mary Doogan, 58, and Connie Wood, 52, argued that being required to supervise staff involved in abortions was a violation of their human rights.

The women had no direct role in pregnancy terminations, but claimed they should also be able to refuse to support staff taking part in the procedures.

If the court upholds that decision it could set a legal precedent, allowing other midwives who object to abortions to take the same stance.

But the Royal College of Midwives and the women’s charity British Pregnancy Advisory Service (bpas) warned today that such a ruling could have severe implications for the care of women choosing abortions.

Ms Doogan and Ms Wood took their case against NHS Greater Glasgow and Clyde to the Court of Session in Edinburgh in 2012, but lost.

But in April last year, three appeal judges at the same court ruled their appeal should succeed.

Judges at the court will tomorrow hear an appeal by NHS Greater Glasgow and Clyde.

A spokesman for the RCM and bpas said the two bodies are ‘deeply concerned’ that the judgement ‘extends the right of conscientious objection beyond the provisions intended by the Abortion Act’. . . . [Full text]

Supreme Court of the United Kingdom to hear midwives’s case on 11 November

The Greater Glasgow Health Board has appealed to the Supreme Court of the United Kingdom to overturn a ruling that two midwives cannot be compelled to participate in abortions by delegating, supervising and supporting those involved in the procedures.  The case is to be heard 11 November, 2014.

The midwives’ legal costs have been in excess of £250,000 ($396,758 USD) to date.  The appeal is expected to cost them a further £130,000 ($206,314 USD). The Society for the Protection of Unborn Children is assisting with their legal costs and has appealed for donations.

Supreme Court of the United Kingdom

Greater Glasgow Health Board (Appellant) v Doogan and another (Respondents) (Scotland)

Case ID: UKSC 2013/0124

Issue

Judicial Review – Abortion – Conscientious objection – Midwives

Does s.4(1) of the Abortion Act 1967, which provides that “no person shall be under any duty… to participate in any treatment authorised by this Act to which he has a conscientious objection”, entitle a Labour Ward Co-ordinator to refuse to delegate to, supervise and/or support midwives providing care to patients undergoing termination procedures?

Facts

From the outset of their employment with the appellant health board, the respondent senior midwives, both Roman Catholics, objected to and were exempted from directly participating in the treatment of patients undergoing terminations. Following a service reorganisation, the numbers of abortions performed at the hospital where they worked increased. They sought confirmation from the appellant that they would not be required to delegate to, supervise or support other midwives providing care to such patients. The appellant declined to give this assurance, rejecting the respondents’ grievance and subsequent appeal. The respondents challenged the latter decision by way of judicial review, contending that it contravened s.4(1) of the Abortion Act 1967. They were unsuccessful at first instance but succeeded on appeal to the Inner House.

Judgment appealed

[2013] CSIH 36

Appellant

Greater Glasgow Health Board

Respondents

  1. Mary Teresa Doogan
  2. Concepta Wood

Interveners

  1. Royal College of Midwives
  2. British Pregnancy Advisory Service

 

 

British Pregnancy Advisory Service head says abortion is just birth control

Sean Murphy*

In a column published in The Independent, Ann Furedi, CEO of the British Pregnancy Advisory Service, argues that the existing English abortion law should be scrapped because abortion is simply another form of birth control.

Today, abortion is understood to be a fact of life. We expect to plan our families using the contraception that is freely available cost-free on the NHS. But we know that contraception is not infallible, and nor are we. We draw comfort from knowing that abortion is available as a back up to our chosen method of birth control. The existing laws are not fit for purpose – and the way abortion is provided today begs a simple question: why have a law at all?

This is consistent with earlier statements she has made.  In 2010 she told New Zealanders that abortion is required as a part of family planning programmes because contraception is not always effective. She noted that abortion rates do not drop when more effective means of contraception are available because women are no longer willing to tolerate the consequences of contraceptive failure.[TVNZ]

Furedi’s comments indicate that pressure to provide abortion is likely to increase even where contraception is readily available, thus increasing potential for conflicts of conscience among health care workers who do not wish to be involved with the procedure.  They also demonstrate a categorical refusal to acknowledge a critical factual distinction: that preventing the conception of an infant by contraception is not the same as killing an infant by abortion.  This distinction central to the reasoning of health care workers and others who refuse to participate in abortion, though they may have no objection to contraception.