Doctors can object to procedures, not specific patients, under revised religious discrimination bill

RACGP President Dr Harry Nespolon cautiously welcomed the revisions, saying the college will ‘carefully consider’ the revised bill.

News GP

Doug Hendrie

Under the revisions, conscientious objectors could refuse to provide treatments to which they objected on religious grounds, as long as the refusal is a blanket ban.

Speaking at a press conference, Attorney-General Christian Porter said the revised bill means it would be acceptable for a GP to, for example, refuse to ‘engage in hormone therapies’ for transgender patients broadly, but not for an individual patient only.

The revisions are intended to rule out discrimination, Mr Porter said. . . [Full text]

Woman suing two pharmacies after being denied emergency contraception

The US case brings to light concerns around conscientious objection at a time when a federal religious discrimination bill is being debated in Australia

AJP

Sheshtyn Paola

A woman has filed a lawsuit against a Thrifty White Pharmacy and a CVS Pharmacy in Minnesota in the US, alleging the two pharmacies illegally kept her from accessing emergency contraception.

Andrea Anderson, a 39-year-old mother of five, says she asked the pharmacist at her drugstore in Minnesota more than once why he couldn’t fill her prescription for emergency contraception, according to the Star Tribune.

“I then realised what was happening: he was refusing to fill my prescription for emergency contraception because he did not believe in it,” Ms Anderson said on Tuesday. . . [Full text]

Doctors call for end of conscience rights bill up for discussion today

‘We don’t support abandoning our patients,’ Edmonton doctor says

CBC News

Anna McMillan

A controversial conscience rights bill that critics say would reduce access to health care is back up for discussion in the legislature Monday — and Edmonton doctors are urging the government to vote it down. 

On Nov. 21, the standing committee on private bills and private members’ public bills determined Bill 207 should not move forward for debate. The legislature will vote Monday on whether to accept the all-party committee’s recommendation.

“This bill needs to die,” said Dr. Shelley Duggan, a critical care physician who works at Covenant Health facilities in Edmonton. . . [Full text]

Bill removes checks on doctors who put conscience over patients’ well-being

174 Alberta physicians sign letter against protection of conscience bill

Edmonton Journal

Michelle Jung

Please consider this letter of concern regarding Bill 207 Conscience Rights Protection Act. As practising physicians, we have significant concerns with this legislation.

Physicians have numerous responsibilities, of which the most important is protecting the interests of our patients. Section 4(a) states that “Despite any provision of the Health Professions Act, a regulatory body may not impose a requirement on a health care provider that may result in the health care provider being compelled, directly or indirectly, to perform a health care service that they determine would infringe their conscientious beliefs.” . . .[Full text]

Consultation, possible changes after pushback against conscience rights bill

Edmonton Journal

Lisa Johnson

Backbench UCP MLA Dan Williams continued to take heat from the NDP Opposition Monday for introducing conscience rights legislation and offered changes to the controversial bill meant to protect health-care access.

“My intention with offering these amendments is a genuine olive branch, a genuine attempt to say ‘the purpose of this bill is to protect conscience rights, and in no way has any desire to limit access,’” said Williams, MLA for Peace River, in a committee on private member’s bills. . . [Full text]

Alberta’s conscience rights bill

Western Standard
Reproduced with permission

John Carpay

Bill 207 enshrines “freedom of conscience and religion” – protected by the Canadian Charter of Rights and Freedoms– for Alberta’s health care providers. For many years, Premier Jason Kenney has consistently and publicly supported protecting freedom of conscience, so nobody should be surprised if he supports this Private Member’s Bill.

Bill 207 will not limit patient access to abortion. Firstly, abortion does not require a referral, as any abortion clinic will tell you when you call and ask. Secondly, even if abortion did require a referral, if one physician refuses to provide such referral then the patient would simply go to another doctor. Inconvenient? Yes, absolutely. In a free country, the right to honour one’s conscience trumps someone else’s interest in not being inconvenienced.

Forcing someone to do something that they believe to be wrong is serious business. It is also a hallmark of totalitarian states. But in free and democratic societies, the government will bend over backwards to avoid coercing citizens to participate in what they see as evil. This is why the Charter describes freedom of conscience and religion as “fundamental,” and mentions it ahead of the freedoms of expression, association and peaceful assembly.

When a democracy is at war, the pacifists who oppose killing another human being will not be required by government to serve on the front lines and shoot at foreign troops. A democracy can continue with its war efforts without requiring every citizen to be willing to kill enemy soldiers.

Just because pork is legal and popular does not mean that all butchers should be forced, by law, to sell it. Some Muslim and Orthodox Jewish butchers will refuse to handle or sell pork, and no doubt this refusal will inconvenience some customers. The disappointed customers will need to go elsewhere, upon learning that the store they travelled to does not carry what they want.

The BC Human Rights Tribunal recently issued a pro-freedom ruling that female estheticians could refuse to wax the male genitalia of Jessica (Jonathan) Yaniv, for religious and other reasons. Yaniv will be inconvenienced by having to locate a waxologist who is willing and able to provide a Brazilian bikini wax for male genitals. But not forcing women to handle male genitalia is more important than sparing someone the inconvenience of going elsewhere.

Put simply: in a free society, you do not have the right to require other people to do things that they do not wish to do. In a free country, nobody has a legal right to be free from the inconvenience of needing to look elsewhere for a product or service. This respect for freedom is consistent with – or is supposed to be consistent with – the philosophy of the United Conservative Party.

Bill 207 protects doctors from being required to assist their patients in committing suicide, as one example of a medical service that some doctors see as wrong. Many non-religious doctors believe on conscientious grounds that suicide is not a valid or legitimate medical treatment.

Providing a referral is active participation. This is why the Colleges of Physicians and Surgeons of Ontario prohibits doctors from performing female genital mutilation (FGM) and also prohibits doctors from referring for this medical service. If it’s wrong to remove portions of a young girl’s genitals, then it’s also wrong to refer her to another doctor who will provide that same service.  As in Ontario, Alberta’s College states that “no physician should perform such procedures, irrespective of cultural norms in other societies, and no physician should be complicit in allowing such procedures to go ahead.” To refer for FGM is to be complicit in FGM. Requiring doctors to refer for a service they believe to be wrong is to violate the conscience of doctors.

And yet the Alberta College of Physicians and Surgeons requires doctors to refer for assisted suicide. Bill 207 addresses this problem by protecting the fundamental Charter freedoms of doctors and other health care providers. A vote for Bill 2017 is a vote for freedom.

Is conscience rights bill the first shot in a culture war?

Calgary Herald

Robe Breakenridge

The mere existence of a private member’s bill that potentially addresses some hot-button moral issues does not mean that Premier Jason Kenney has broken his vow to not reopen or legislate on such matters.

However, we won’t really know for sure until we see how Kenney decides to respond to Bill 207. Social and religious conservatives are likely watching closely to see how much of their agenda they can convince this premier to adopt. Everyone else should be watching closely, too.

Albertans elected a government that would get our finances in order and help spur investment and job creation in this province. Waging a culture war is not high on the list of priorities. . . [Full text]

World Medical Association Reaffirms Opposition to Euthanasia and Physician-Assisted Suicide

News Release

World Medical Association

The World Medical Association has reaffirmed its long-standing policy of opposition to euthanasia and physician-assisted suicide.

After an intensive process of consultation with physicians and non physicians around the world, the WMA at its annual Assembly in Tbilisi, Georgia, adopted a revised Declaration on Euthanasia and Physician-Assisted Suicide.

This states: ‘The WMA reiterates its strong commitment to the principles of medical ethics and that utmost respect has to be maintained for human life. Therefore, the WMA is firmly opposed to euthanasia and physician-assisted suicide.’

It adds: ‘No physician should be forced to participate in euthanasia or assisted suicide, nor should any physician be obliged to make referral decisions to this end.’

The Declaration says: ‘Separately, the physician who respects the basic right of the patient to decline medical treatment does not act unethically in forgoing or withholding unwanted care, even if respecting such a wish results in the death of the patient.’

The revised Declaration defines euthanasia as ‘a physician deliberately administering a lethal substance or carrying out an intervention to cause the death of a patient with decision-making capacity at the patient’s own voluntary request.’

It says that physician-assisted suicide ‘refers to cases in which, at the voluntary request of a patient with decision-making capacity, a physician deliberately enables a patient to end his or her own life by prescribing or providing medical substances with the intent to bring about death.’

WMA Chair Dr. Frank Ulrich Montgomery said: ‘Having held consultative conferences involving every continent in the world, we believe that this revised wording is in accord with the views of most physicians worldwide.’

Kalgoorlie GP calls for euthanasia ‘kill clinics’

Kalgoolrie Miner

Jason Mennell

A longstanding Kalgoorlie-Boulder GP says the State Government should introduce “kill clinics” if proposed euthanasia laws receive the parliamentary seal of approval.

Dr Mal Hodsdon believes it would be “immensely unfair” of politicians to put the onus on GPs to sign off on people’s deaths.

Instead, Dr Hodsdon feels the State Government should take full responsibility by establishing what he calls “kill clinics”, providing a one-stop shop for terminally ill patients wanting to end their lives. . . [Full text]

Abortion law in New South Wales a global first

Freedom of conscience conditional upon gestational age

Sean Murphy*

The Abortion Law Reform Act 2019 No. 11 has become law in New South Wales, Australia. It is obviously modelled on Queensland’s Termination of Pregnancy Act 2018.

The law permits abortion up to 22 weeks gestation for any reason; no medical indications are required (Section 5).  Abortion after 22 weeks gestation may be performed for any reason that two specialist practitioners find sufficient, including current and future “social circumstances” (6(3)b).

A provision for conscientious objection requires disclosure of objections to abortion by a practitioner when asked by someone (not necessarily a patient) to perform or assist in the performance of an abortion on someone else, to make a decision about whether an abortion should be provided for someone else who is over 22 weeks pregnant (Section 6), or to advise about the performance of an abortion on someone else.

The law requires disclosure of objections to abortion by a practitioner when asked by someone (not necessarily a patient) to perform or assist in the performance of an abortion on someone else [(9(1)a(i) and (ii)], to make a decision about whether an abortion should be provided for someone else who is over 22 weeks pregnant [(9(1)a(iii)], or to advise about the performance of an abortion on someone else [(9(1)a(iv)].

When a woman up to 22 weeks pregnant wants an abortion or advice about an abortion [i.e., under 9(1)a(i) or (ii)], an objecting practitioner is required to disclose his objection [9(2)] explain how she can contact a non-objecting practitioner [9(3)a], or transfer the care of the patient to a practitioner willing to provide an abortion, or to an agency (health service provider) where an abortion can be provided [9(3)b]. 

However, if the woman is over 22 weeks pregnant, a practitioner is obliged to disclose objections to abortion but, if not convinced that the abortion should be performed, is not obliged to facilitate the abortion by explaining how she can contact a non-objecting practitioner or by a transfer of care to a willing colleague. That is because  section 9(3) makes no reference to 9(1)a(iii).

Practitioners who object to abortion in principle and those who object in particular cases are often unwilling to facilitate the procedure by referral, arranging transfers of care or other means because they believe that this makes them parties to or complicit in an immoral act.  Thus, the provision for conscientious objection in the bill actually suppresses the exercise of freedom of conscience by these practitioners with respect to abortions up to 22 weeks gestation.

On this point Queensland’s Termination of Pregnancy Act, while it also suppresses the exercise of freedom of conscience by physicians who object to referral for abortion, at least does so consistently from conception to birth.

It is possible that the wording of this provision has been been muddled in New South Wales either in an attempt to put an end to the idea that only women can become pregnant, or to avoid the possibility that abortion might not be available to a woman who believes that she is a man, or who believes that she is neither a woman nor a man, but who becomes pregnant.

In any case, New South Wales is the first jurisdiction to make the exercise of freedom of conscience in relation to abortion conditional upon the gestational age of an embryo or foetus.  A physician will be free to fully exercise freedom of conscience at 22 weeks plus one day, but not at 22 weeks minus one day.  The inexact calculation of gestational age contributes further to the arbitrariness of this restriction of fundamental human freedom.