Protection of Conscience Project
Protection of Conscience Project
Service, not Servitude

Service, not Servitude

Legal Commentary

The commentaries provided on the website are not a substitute for legal advice provided by a qualified professional.  Commentaries are grouped by national jurisdiction.


Re: General Commentary

Human Rights and Obstetric Practice: Legal Issues

  • Alberto Mazza* | . . . The scientific advances in the field of health today make possible a number of practices and treatments which sometimes place the professionals who have to apply them in a clear dilemma whereby they question the goodness of such practices and not just their legality. . . In an increasingly pluralistic society, there will be more and more practices that a doctor may object to . . .It would imply a severe injury to the doctors' rights if they were left aside for refusing to undertake certain practices for personal convictions. . .
    Full Text


Re: General Commentary

Australia needs to recognise conscience rights, not just religious rights

  • David Van Gend*| . . .  I ask the question: how would a Religious Discrimination Bill protect the free speech, and therefore free conscience, of traditional-minded people like me who make a stand on conscientious, not religious, grounds?
    Full Text

Coalition’s religious discrimination bill goes far, but not far enough

  • Xavier Symons* |  It is no surprise that the Religious Discrimination Bill is being criticised as too strong by aggressive secularists and too weak by people of faith.  .  . It is a religious discrimination bill with a narrow focus on a very specific set of issues. . .  a patchwork, jury-rigged, rickety scaffolding to placate religious critics without laying a firm foundation.
    Full Text

The great divide where religious beliefs and the law meet

  • Michael Quinlan* | . . . freedom of conscience and belief is not treated with the importance our history and international law call for and state and territory laws regularly override religious freedom. . . Religion is not going away. Our laws can do a better job of accommodating people of faith. Our history demands no less.
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Re: Reproductive Health Care Reform Bill 2019 (New South Wales)

The conscience rights of health practitioners must be protected
A NSW bill could deter some of the brightest and best from entering health services

  • Greg Walsh* | One of the main concerns about the Bill recently introduced to amend New South Wales laws on abortion is how health practitioners with a conscientious objection to participating in abortion will be regulated. Under the Bill, health practitioners must disclose that they have a conscientious objection if they are asked to perform, assist with, provide advice about, or make a decision concerning whether an abortion should be performed.  .  .
    Full Text

Abortion bill in New South Wales a global first
Freedom of conscience conditional upon gestational age

Re:  Voluntary Assisted Dying Bill 2017 (Victoria)

New euthanasia/assisted suicide law in Australia
Victoria's Voluntary Assisted Dying Act 2017

  • Sean Murphy* | On 19 April, 2018, the legislature of the State of Victoria, Australia, passed the Voluntary Assisted Dying Act 2017, which will come into force in June, 2019.  It is currently the most restrictive euthanasia/assisted suicide (EAS) legislation in the world, running to 130 pages.  In brief, the law authorizes physician assisted suicide for terminally ill adults, but permits euthanasia by physicians only when patients are physically unable to self-administer a lethal drug.  In both cases a permit must be obtained in advance.  The main elements of the law are set out below, followed by consideration of its protection of conscience provisions.
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Politicians wrestle with doctors' consciences in Victoria: Conscientious objection needs to be protected

  • Paul Russell* | As the Victorian Ministerial Advisory Panel on "assisted dying" makes ready to release its interim report sometime in April, The Age newspaper turned its attention to the matter of conscience whether a doctor may refuse to take part in any action that would bring about the premature and deliberate death of a person.  Conscience - or the ability to draw upon one's own personal belief system in making a decision about an action - plays out at different levels in any debate on euthanasia and assisted suicide. . . .
    Full Text

Re:  Abortion Law Reform Bill 2008
(State of Victoria)

The Abortion Law Reform Bill 2008 legalized abortion in the State of Victoria, Australia.  It demands that physicians who object to abortion for reasons of conscience must refer a woman to a colleague who has no such objections in order to facilitate the procedure, and requires physicians to perform abortions if necessary "to preserve the life of the pregnant woman."  A number of individuals and groups spokeout against the bill and the law, often for a combination of reasons.


  • Doctors in Conscience Against Abortion Bill

    • . . .We believe it to be an attack on the basic human rights of health professionals which undermines their moral integrity and professional autonomy. The state should not coerce its health professionals to participate in the taking of human life. . .
      Position Statement
  • Dr. John Neil

    • . . . It is ludicrous that a "registered medical practitioner" should have to perform an emergency abortion. Firstly it is coercive, and others will speak about this. Secondly, it is based on a false premise that an emergency abortion actually is ever necessary. Coercion to make an "effective referral" is also unnecessary and prejudicial. . .
      Full Text

    • . . .This Bill misrepresents and undervalues the process and responsibilities of professional referral. This Bill implies that referral removes obligation and participation. However, referrals between medical professionals imply a partnership of care. . . There is no way that a practitioner can make or receive such a referral in good conscience if they do not agree with the procedure and care to be undertaken. . .
      Full Text
  • Jacinta Le Page (Medical Student)

    • . . . Firstly, referring personally to another medical practitioner, as this Bill states, seems to be clearly participating in abortion. . . we fear we will be required to research for a colleague who will readily 'help' her have an abortion. Such a personal referral equals participation in the killing. . .
      Full Text
  • Joanne Grainger (Registered Nurse, Bioethicist)

    • . . . I am not here representing all Victorian nurses - that would be a presumptuous assertion. However, there are over 80,000 registered nurses in Victoria - and I speak on behalf of those many nurses who have a conscientious objection to their participation in an abortion on religious, cultural, personal or ethical grounds. . .
      Full text of speech
  • Justine Armstrong (Victorian Division One Theatre Nurse)

    • If passed, this Bill would force me to directly participate in abortions as a theatre nurse. This is totally unacceptable to me and my family. It is immoral. It violates my personal and professional ethical framework. It is an affront to my faith and it strips me of my fundamental rights as a human being and as a professional, to object to an action that contravenes my personal conscience.
      Full Text
  • The Australian Egyptian Doctors and the Coptic Doctors

    • . . .The bill as it stands . . .coerces the health practitioner to behave or act in a manner which comprises his or her ethics, morals, culture and religious beliefs. . .(Egyptian Doctors)
      Full Text
  • George Cardinal Pell

    • The rights of freedom of thought, conscience, religion and belief are fundamental. The ability to exercise conscientious objection is a keystone of democracy. All of us should have the right to hold a belief and not be compelled by the state to act contrary to that conviction. It is the difference between the free society and the one subject to tyranny.
      Full text of news release
  • Greg Craven

    • . . .This centrality of conscience in rights discourse hardly is surprising. Of all the rich and varied freedoms, the freedom to think and believe is fundamental. Without it people not only have fewer human rights, they are less human. . .
      Full text
  •  Michael Cook

    • . . . One of the most objectionable features of this legislation is that it effectively removes doctors' right to conscientious objection. It requires doctors-who-won't to refer women to doctors-who-will. Furthermore, "in an emergency where the abortion is necessary to preserve the life of the pregnant woman", the doctor must perform it. . .
      A question of conscience
    • . . . corrupting the medical profession by forcing doctors and nurses to collude in this is a clear violation of a universally acknowledged human right to freedom of conscience. Nowhere else in the world does such a draconian law exist, not in New Zealand, not in the United Kingdom, not in Canada, not in the United States. . .
      Forcing compliance
  • Liberty of Conscience in Medicine: A Declaration

    • . . . Liberty of conscience is critical for individual doctors as it lies at the very heart of our integrity and self-identity. It is conscience that must compel doctors to refuse to participate in treatments they believe to be un-ethical or that they consider not to be in the best interests of patients. . .
      Full Text of Declaration
  • Conscience Laws and Healthcare Conference

    • Dr. Lachlan Dunjey:  In this video, Dr Lachlan Dunjey speaks on the topic: The Coercion of Doctors: What is happening to modern medicine?
    •  Francis Sullivan:  In this video, Francis Sullivan speaks on the topic: Freedom of Conscience and Good Medical Practice: The Australian Medical Association's position.
    • Martin Laverty:  In this video, Martin Laverty speaks on the topic: The Victorian Abortion Law and the threat to religious affiliated healthcare.
    • Nigel Preston:  In this video, Nigel Preston speaks on the topic: The Victorian Abortion Law and Conscientious Healthworkers: Is there a way out or do we need a test case?
    • Julian McGauran:  In this video, Julian McGauran speaks on the topic: The Coercion of Conscience: A Federal Political Response.

Fundamental freedoms
Why the right to conscientious objection must be restored

  • David van Gend* |  I feel a little out of place coming from Queensland to speak about the wretched situation in Victoria: coming from a State where it is always sunny, where the people are always nice, and where we don't have oppressive laws that try to compel the conscience of free citizens. But we are all in this together: an assault on fundamental freedoms in one State will become a precedent for similar abuses in other States. . .
    Full Text

Forcing compliance
The Australian state of Victoria has a world first: a law which forces doctors to refer women for abortion or to do it themselves -- even if they have a conscientious objection.

  • Michael Cook*  | Set in a huge mosaic in the lobby of Parliament House in Melbourne is a Biblical proverb, "Where no counsel is, the people fall; but in the multitude of counsellors there is safety." A good number of healthcare workers in the state of Victoria must be wondering now whether this is still true. Last week their Victorian legislators passed the only law in the Western world which forces doctors and nurses to participate in abortions against their conscience. . . .
    Full Text

A question of conscience.
Why are pro-choice activists so dismissive of freedom of conscience?

  • Michael Cook*  | The conscience of a moral relativist makes arbitrary, even capricious, choices. It is just a whim. The traditional view of conscience is quite different. Only a malfunctioning conscience is capricious.
    Full Text

Re:  Reproductive Health (Access to Terminations) Bill (2013)
(State of Tasmania)

New frontiers in repressing dissent

  • Mishka Gora* | Tasmania may be small, but it will punch far above its weight on the world stage in shutting down protests against abortion if a new bill is passed. . . the real aim of the Labor-Green coalition which is running Tasmania is to criminalize abortion dissent.
    Full Text

Submission to the Tasmanian Government

  • Australian Medical Association Tasmania Ltd. | AMA Tasmania has grave concerns that the draft legislation has the potential to criminalise members of the profession with conscientious objection to termination of pregnancy.
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General Commentary

Jurisdictional, organizational and regulatory framework for health care delivery in Canada

  • Sean Murphy* | Canadian provinces have constitutional jurisdiction in the regulation of health care and health care professions and over labour and civil rights law within the scope of that jurisdiction. . . .
    Full Text

Conscience Rights Matter

  • Sohail Gandhi* |  . . To those physicians who are opposed to legal protection for Conscience Rights, let me ask you this.  What would you do if a patient asked you for a referral to have only a blue eyed, blonde haired baby?
    Full Text

In defence of conscience rights: Bill C-418 

  • David Anderson* | Bill C-418 seeks to amend the Criminal Code to make it an offence to intimidate a medical practitioner, nurse practitioner, pharmacist or any other health care professional for the purpose of compelling them to take part, directly or indirectly, in the provision of physician-assisted suicide. . .
    [Full text]

Nurse diagnosed with PTSD after interacion with patient seeking euthanasia
Tribunal rules "her own convictions" caused her injury: Denies claim for compensation

  • Administrative Labour Tribunal | The worker is a nurse in the palliative care unit of the Notre-Dame Pavilion at the University Hospital of Montreal. In December 2015, a patient for whom she was in charge decided to avail himself of the new provisions of the Act Concerning End-of-Life Care, commonly known as medical assistance in dying. This was a first: he was the first patient of this hospital to express his desire to plan his death. The worker was informed that one of her patients had requested medical intervention to end his life and developed a psychological reaction following the death of the latter. . .
    Full Text

Conscience Versus the Spirit of the Age

  • Jason Kenney* | . . . This evening I wish to share with you, distinguished members of the bar gathered under the patronage of Saint Thomas More, some thoughts about the importance of conscience in the life of legislators like myself and those who, like yourselves, are charged with the administration and adjudication of those laws. I seek to do so because history in general— and the history of Thomas More in particular —teaches us that the recognition of the rights of conscience is an essential limitation of State power. Put another way, where the rights of conscience are violated, the prospect of a State that unjustly limits liberty becomes all too real throughout history. . .
    Full Text

"Autonomy", "Justice" and the  Legal Requirement to Accommodate 
the Conscience and Religious Beliefs of Professionals in Health Care  

  • Iain T. Benson* | Frank M. Archer's critical review, though it might seem to some people to be a legal and ethical view is, with respect, neither of these things. While it is, in its way, critical, it does not deal with the legal or ethical principles that are necessary in order to make an informed decision regarding law or ethics in relation to the practice of a profession in general or the question of "emergency contraceptives" in particular. . .
    Full Text

Eternal Vigilance is the Price of Conscience Protection:
The Freedom of Conscience in Relation to "Health"

  • Iain T. Benson* | . . .Apparently this medical student has been threatened with loss of graduation if, because of his stated religious reasons, he will not offer abortion as an option to a patient. In terms of the legal requirement, the issue is whether or not a physician is required to refer a patient for an abortion. . . .
    Full Text

"Do Not Resuscitate": Whose Choice?  
Court Gives Course In Medical Ethics To The Public Trustee

  • Iain T. Benson* Brad. B. Miller* | . . .Can a doctor or health care facility legally issue a "do not resuscitate" order if the patient or the patient's guardian refuses to consent to that order? What are the obligations of the Public Trustee's office with respect to consenting or opposing "do not resuscitate orders? . . .
    Full Text

The Courts' Spectacles:
Some Reflections on the Relationship between Law and Religion in Charter Analysis

  • Mr. Justice David M.Brown* | . . .The main point which I wish to make in this paper is that when courts engage in this "managing" exercise they do not operate as philosophically-neutral actors. Instead, the case law reveals that they perform the "managing" exercise through philosophical lenses that are not blank, but reflect philosophical choices which inform their balancing task. . .[
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In Defence of the New Heretics: A Response to Frank Archer
Responding to Archer F. Emergency Contraceptives and Professional Ethics.
Canadian Pharmaceutical Journal, May 2000, Vol. 133, No. 4, p. 22-26

  • Sean Murphy* | Before taking action that they may later regret, those who would coerce or discriminate against conscientious objectors, or drive them from the practice of pharmacy, would do well to revisit Frank Archer's critical review . . . Although many pharmacists have accepted the review as a definitive ethical statement, it is insufficient warrant for repression of freedom of conscience within the profession. . .
    Full Text (Ethical Commentary)

Postscript for the Journal of Obstetrics and Gynaecology Canada:
Morgentaler vs. Professors Cook and Dickens
Responding to Cook RJ, Dickens BM, "In Response". J.Obstet Gyanecol Can 2004; 26(2)112;  Cook RJ, Dickens BM, Access to emergency contraception [letter] J.Obstet Gynaecol Can 2004; 26(8):706.

  • Sean Murphy* | . . . the arguments of Professors Cook and Dickens for mandatory referral are unsupported and even contradicted by their own legal and ethical references. Regulatory officials with the power to enforce the views of Cook and Dickens are unlikely to discover this in the pages of the Journal, since, by editorial fiat, the discussion was terminated with the publication of their 'final word' on the subject. Here, then, is the postscript to the discussion, supplemented by developments in the United Kingdom and Belgium that have a bearing on the issue. . .
    Full Text

Commentary on Cecilia Moore's Case 

  • Sean Murphy* | The following commentary concerns the case of Cecilia Moore, a welfare worker who was fired for refusing to authorize medical coverage for an abortion. . .
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Re: Euthanasia and Assisted Suicide

Legalizing therapeutic homicide and assisted suicide:  
A tour of Carter v. Canada

  • Sean Murphy* | The trajectory of the trial was determined by the unchallenged fundamental premise that suicide can be a rational and moral act, and that the sole purpose of the law against assisted suicide is to prevent suicides by vulnerable people in moments of weakness, who might be tempted to commit suicide that is not rational and moral. The only issue was whether or not safeguards could be designed to permit legitimate access to assisted suicide, while preventing the vulnerable from accessing it in moments of weakness. . .
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Project Backgrounder
Re: Joint intervention in Carter v. Canada
Supreme Court of Canada, 15 October, 2014

  • In June, 2012, a British Columbia Supreme Court Justice ruled in favour of physician assisted suicide and euthanasia. The plaintiffs appealed to the Supreme Court of Canada.
  • The Catholic Civil Rights League, Faith and Freedom Alliance and the Protection of Conscience Project were jointly granted intervener status in Carter by the Supreme Court of Canada.  The joint factum voiced concern that legalization of physician assisted suicide and euthanasia would likely adversely affect physicians and health care workers who object to the procedures for reasons of conscience.  The factum was supplemented by a ten minute oral presentation.
    Factum | Backgrounder

Supreme Court of Canada orders legalization of physician assisted suicide - AND euthanasia
Physicians unwilling to kill already face demands that they find someone who will

  • Sean Murphy* | In a 9-0 ruling released on 6 February, 2015, the Supreme Court of Canada struck down two sections of Canada’s Criminal Code "insofar as they prohibit physician-assisted death" in circumstances outlined by the Court. It appears that most or all of the major media outlets understood this to mean that the Court had legalized physician assisted suicide. . . the ruling not only permits physician assisted suicide, but physician administered euthanasia. . .
    Full Text

Decriminalization of assisted suicide and the violation of our rights

  • Albertos Polizogopoulos* | In October, the Supreme Court of Canada heard the Carter case, where parties are challenging Criminal Code prohibitions on physician assisted suicide in the hopes of decriminalizing it. If they're successful, it will impact more than just physicians. . .
    Full Text

Amir Attaran and the elves
A law professor makes much ado

  • Sean Murphy* |  . . . University of Ottawa law professor Amir Attaran asserts that the "corrosive hostility" of the Canadian Medical Association to "physician-assisted dying" is evident in its "cowardly and stupid" position on the procedure. . . In his telling, ever since the Court ignored the threat and struck down the law, the CMA has been acting like a "sore loser," trying to persuade physicians not to participate. . . And he complains that the CMA won't force physicians unwilling to kill patients or help them commit suicide to find someone who will. . .
    Full Text

A "uniquely Canadian approach" to freedom of conscience
Provincial-Territorial Experts recommend coercion to ensure delivery of euthanasia and assisted suicide
Recommendations designed to broaden and maximize impact of Supreme Court ruling

  • Sean Murphy* |  The Experts' recommendations are intended to extend and maximize the impact of the Carter ruling. They will effectively require all institutions, facilities, associations, organizations and individuals providing either health care or residential living for elderly, handicapped or disabled persons to become enablers of euthanasia and assisted suicide. This will entail suppression or significant restriction of fundamental freedoms. . .
    Full Text

To kill — or not to kill? That is the question.
An answer for a Dying With Dignity clinical advisor

  • Sean Murphy* | . .>the DWD Clinical Advisor was exasperated by the description of euthanasia and assisted suicide as "killing." This, he/she exclaims, is a malicious lie that adds to the world's misery.  Such a cri de cœur calls for a thoughtful discussion of the question it raises. Does providing euthanasia and assisted suicide entail killing — or does it not?
    Full Text

Jewish physicians' freedom of conscience and religion and the Carter Case

  • Charles Wagner*, Adam Hummel* | How does the decision in the Supreme Court of Canada (SCC) in Carter v. Canada (Attorney General)1 ("Carter") impact on the religious Jewish doctor? Will this landmark decision bring into conflict these doctors' freedom of conscience and religion with their professional obligations? The Carter case sets aside federal criminal laws as they relate to physician assisted suicide. It stands for the proposition that individuals who are suffering unbearably have a constitutional right to a physician-assisted suicide.
    Full Text

Conscience, euthanasia and assisted suicide in Manitoba
The Medical Assistance in Dying (Protection for Health Professionals and Others) Act

  • Sean Murphy* | . .The MAiD Act is a procedure-specific law applying only to euthanasia and assisted suicide. It protects all regulated professionals who refuse to provide or "aid in the provision" of the procedures from professional disciplinary proceedings and adverse employment consequences because they have refused. They remain liable for other misconduct in relation to the refusal. 
    Full Text

Quebec’s Act Respecting End of Life Care
Reportable and non-reportable euthanasia

  • Sean Murphy* | . .Quebec's euthanasia law, the Act Regarding End of Life Care (ARELC), permits two kinds of euthanasia, distinguished here as reportable and non-reportable euthanasia. . .
    Full Text

Re: "Abortion: Ensuring Access"

  • In July, 2006, the Canadian Medical Association Journal published a guest editorial by Sanda Rodgers of the Faculty of Law, University of Ottawa, and Jocelyn Downie, of the Health Law Institute, Dalhousie University, Halifax, Nova Scotia.  The editorial appears to have been an attempt to bully objecting physicians who refuse to refer patients for abortion by menacing assertions about legal and ethical obligations.  The CMAJ is a publication of the Canadian Medical Association, which, however, asserts that its contents do not necessarily represent the views of the Association.
    Commentary (Ethics)

Re: Draft Code of Ethics for Pharmacists and Pharmacy Technicians

Yet More Pharmacists Who Don't Understand Ethics:  This Time Ontario

  • Iain T. Benson* | . . . For pharmacists and pharmacy technicians the accommodation of religious belief and conscience guaranteed by Section 2 of the Canadian Charter of Rights and Freedoms will be suspended should this principle go ahead as drafted. This is not the approach taken by doctors and the Canadian Medical Association would not endorse this blunt and unfair kind of principle. . .
    Full Text

Letter to Minister of Health (Ontario)

  • Protection of Conscience Project | . . .I understand that the Ontario College of Pharmacists has made a recommendation to the OHPRAC to the effect that freedom of conscience ought to be denied to pharmacists and pharmacy technicians. I am advised by concerned pharmacists that those who would have objected to this were unaware that the College was contemplating such a recommendation and were not consulted about it. . .
    Full Text

Re:  "Physicians and the Ontario Human Rights Code"

Ontario Human Rights Commission attempts to suppress freedom of conscience

  • Sean Murphy* | The College of Physicians and Surgeons of Ontario is the regulatory and licensing authority for physicians and surgeons practising in Ontario, Canada.  In February, 2008, the Ontario Human Rights Commission recommended that the exercise of freedom of conscience by physicians be restricted.  The College then drafted a policy that demanded that Ontario physicians sacrifice their freedom of conscience to avoid prosecution by Ontario's human rights apparatus.
    Commentary (Ethics)

Freedom of Conscience and Human Rights

  • Michelle Davis* | A series of Bioethics Matters will look at the Ontario Human Rights Commission, the Ontario Human Rights Code, and the Canadian Charter of Rights and Freedoms to explore the issues of religious discrimination, the right to be free from discrimination based on creed (religion), and the freedom of conscience and religion. . .
    Full Text

The New Inquisitors

  • Sean Murphy* | . . . OHRC agents have broad powers to enter private property without warrant, and can, without warrant, search premises, examine, measure, photograph the area and and seize they think relevant to the investigation. . . police can be called upon to assist, using force if need be. . .All of this for the purpose of investigating, not unlawful conduct, but mere "tension or conflict," or conditions that might lead to either. In contrast, Canadian police have far less power to investigate criminal offences - including murder. . .
    Full Text

Re:  College of Physicians and Surgeons of Ontario and "effective referral"

Ontario court affirms right of state to compel participation in euthanasia
Doctors must refer patients for 'medical assistance in dying'

  • Michael Cook* | Back in 2006, Oxford University's Professor Julian Savulescu published a frontal attack on the notion of conscientious objection in medicine in the BMJ, a popular medical journal. At the time it seemed odd rather than dangerous, the dream of an ideologue rather than sober policy.  . . .
    Full text

With Ontario court's ruling on doctors, the revolution continues
There is a growing antipathy among Canadian elites against conscientious individuals who refuse to accept their views

  • Barry W. Bussey* | How is it that such a simple decision could be made so complicated? Given the history of accommodating individual conscience in the medical profession and in Canadian law, the case before the Ontario Court of Appeal to accommodate doctors' consciences was a "no-brainer." The law, history, and basic human decency cried out: "Accommodate the physician!" Instead, the highest court in Ontario followed the worrying legal revolution against accommodation and stomped on conscience. . .
    Full text

Forced Referral and Freedom of Religion vs Freedom of Conscience
Without freedom of conscience our free democracy would not exist

  • Shawn Whatley, MD* | A recent court decision in Ontario missed the mark when it ignored the impact forced referral has on freedom of conscience.  On May 15, the Ontario appeals court ruled that doctors must give patients a referral for euthanasia, abortion, and other contentious issues, regardless of what an individual doctor thinks about them. . .
    Full text

Physicians in Canada should be moral actors, not robotic bureaucrats
Doctors should not be obliged to write referrals for procedures they find morally objectionable

  • Brian Bird* | Earlier this week, Ontario's highest court heard a case that pits access to health care against the moral convictions of doctors. The case essentially tests the extent to which Canadians can follow their own moral compasses while operating in a professional capacity.  In Ontario, doctors can refuse to perform procedures or prescribe drugs that they consider immoral. However, the public body that regulates these doctors – the College of Physicians and Surgeons of Ontario (CPSO) – requires them to refer patients to doctors who are willing and able to provide the requested health care service. . .
    Full text

Understanding Freedom of Conscience

  • Brian Bird* | A court case dealing with freedom of conscience gives rise to questions about what freedom of conscience protects and why we protect it. . . . Balancing physicians' freedom of conscience with patients' access to medical services is a delicate task. But that balance will certainly not be struck if, when it comes to freedom of conscience, we do not know what we are talking about or why it matters.
    Full Text

Physicians, conscience, and assisted dying:
By requiring that physicians make referrals for assisted dying, Ontario is forcing them to leave medicine or abandon their ethical framework.

  • Deina Warren,* Derek Ross* | Of all the jurisdictions worldwide that permit some form of assisted suicide, Ontario stands alone in mandating that physicians participate in it. . . [C]ompelling physicians to participate in MAID results in the state deciding what everyone should believe; and second, it undermines physicians' moral integrity, a foundational component of medical ethics and principled health care. . .
    Full Text

Ontario must amend its assisted dying legislation to recognize conscience rights

  • John Milloy* | Canadians ask a lot of our physicians – years of education, long hours, complex cases and demanding patients (full disclosure – I am married to a doctor).  Since June of last year, we have also been asking them to help some of their patients take their own lives. . . Should we not respect the fact that some doctors and other health-care providers simply don't want to be involved in assisted dying for reasons of conscience?
    Full Text

Re:  Redefining the Practice of Medicine

Euthanasia in Quebec
An Act Respecting End of Life Care (June, 2014)

  • Sean Murphy* | Part 1: Overview - An Act Respecting End-of-Life Care ("ARELC") is intended to legalize euthanasia by physicians in the province of Quebec.  It replaces the original Bill 52, the subject of a previous commentary by the Project.  The original text of the Bill 52 did not define medical aid in dying (MAD), but ARELC now makes it clear that Quebec physicians may provide euthanasia under the MAD protocol.  . .
    Part 1
  • Part 2: ARELC in detail - An Act Respecting End-of-Life Care ("ARELC") is intended to legalize euthanasia by physicians in the province of Quebec.  It replaces the original Bill 52, the subject of a previous commentary by the Project. ARELC purports to establish a right to euthanasia for a certain class of patients by including it under the umbrella of "end-of-life care." . . .
    Part 2
  • Part 3: Evolution or Slippery Slope? - Euthanasia laws frequently include guidelines and safeguards intended to prevent abuse.  Eligibility criteria are the most basic guidelines or safeguards.  In considering their stability, it is important to consider not only the elasticity of existing statutory provisions, but recommendations for expansion that might ultimately result in changes to the law. . .
    Part 3
  • Part 4: The Problem of Killing - The original text of Bill 52 did not define "medical aid dying" (MAD), but it was understood that, whatever the law actually said, it was meant to authorize physicians to kill patients who met MAD guidelines.  The Minister of Health admitted that it qualifed as homicide, while others acknowledged that MAD meant intentionally causing the death of a person, and that its purpose was death. . .
    Part 4
  • Part 5: An Obligation to Kill - Statistics from jurisdictions where euthanasia and/or assisted suicide are legal suggest that the majority of physicians do not participate directly in the procedures.  Statistics in Oregon and Washington state indicate that the proportion of licensed physicians directly involved in assisted suicide is extremely small. . .
    Part 5
  • Part 6: Participation in Killing - It appears that, even where euthanasia or assisted suicide is legal, the majority of physicians do not actually provide the services.  However, by establishing a purported legal "right" to euthanasia, ARELC generates a demand that physicians kill their patients, despite the high probability that a majority of physicians will not do so. . .
    Part 6
  • Part 7: Refusing to Kill - It is important identify problems that the Act poses for those who object to euthanasia for reasons of conscience, and to consider how objecting health care workers might avoid or respond to coercion by the government and the state medical and legal establishments . . .
    Part 7
  • Part 8: Hospitality and Lethal Injection - Under the Act Respecting End of Life Care (ARELC) palliative care hospices may permit euthanasia under the MAD protocol on their premises, but they do not have to do so.  Patients must be advised of their policy before admission.  The government included another section of ARELC to provide the same exemption for La Michel Sarrazin, a private hospital.  The exemptions were provided for purely pragmatic and political reasons. . .
    Part 8
  • Part 9: Codes of Ethics and Killing - Refusing to participate, even indirectly, in conduct believed to involve serious ethical violations or wrongdoing is the response expected of physicians by professional bodies and regulators.  It is not clear that Quebec legislators or professional regulators understand this. . .
    Part 9
  • Quebec Euthanasia Guidelines: Practice guide issued by Quebec health care profession regulators (August, 2015)


Re:  PACE Report:
"The Problem of Unregulated Use of Conscientious Objection"

PACE Resolution on Restricting Conscientious Objection Endangers Freedom of Conscience of Medical Practitioners

  • European Centre for Law and Justice* | . . .The ECLJ must warn the members of PACE that several recommendations of the resolution are direct and serious violations of the freedom of conscience of medical practitioners, as guaranteed by European and International law. . .
    Full Text

Protection of Conscience Project Submission to the Parliamentary Assembly of the Council of Europe

  • . . .Considering the Report from this broader perspective, as we do here, it becomes apparent that its recommendations are offensive to human freedom and dignity and repugnant to fundamental principles of liberal democracy. . .[
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Europe's Choice on Conscience Protection

  • Matthew Schmitz* | This Thursday the Council of Europe . . .will vote on a resolution and series of recommendations on conscience protection. . . .It would create guidelines that encourage member states to force doctors to perform abortions in some circumstances and to make referrals for them in every circumstance. . . .it is an all-out assault on conscience and community. . .
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Medicine, Strasbourg, and conscientious objection
European Court of Human Rights decision

  • Julian Sheather* | . . .Conscientious objection is a live issue in medicine. . . Given the prevailing political pluralism-given the co-existence in our culture of different value systems-to what extent should medicine accommodate such objections? Should those whose consciences differ be treated differently? What forms of conscientious objection should be tolerated and on the basis of what criteria?
    Full Text [Legal Commentary]

UN Special Rapporteur on Freedom of Religion or Belief
Favours of a Right to Conscientious Objection in the Context of Abortion and Euthanasia

  • European Centre for Law and Justice | On the occasion of a conference organized by the ECLJ at UN headquarters in Geneva, Professor Heiner Bielefeldt, the UN Special Rapporteur on Freedom of Religion or Belief, spoke in favor of the right of medical staff to refuse to participate in performing an abortion or euthanasia. He mentioned the case of a midwife who was harshly sentenced in Sweden for having refused to participate in an abortion and was forced into "professional exile." . . .
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Protection of Life During Pregnancy Act 2013

Why abortion bill is a prime example of moral weakness

  • Fr. Vincent Twomey* |  . . . This legal injunction offends against one very specific, universal moral perception which, in the academic discipline of ethics, has been articulated most clearly in the "principle of co-operation". . . one should not knowingly co-operate in what will cause serious harm to another person that is foreseen and unavoidable.
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Health (Regulation of Termination of Pregnancy) Bill 2018

The abortion law is about coercion and manipulation

  • Dr. Noreen O'Carroll*  |  I was very struck by the phrase “the abuse of conscience” used by Pope Francis in his apology for the abuse perpetrated on minors by members of the clergy and hierarchy; he apologised not only for sexual abuse and the abuse of power but also for the abuse of conscience (Letter to the People of God, August 20, 2018). The Catholic Church is not the only institution that has failed to protect people from the abuse of conscience. The Oireachtas has questions to answer in this regard too.
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Philippines "RH Act" of 2012

  • Sean Murphy* |  . . .  the RH Act would have made the exercise of freedom of conscience impossible or ridiculous, requiring objectors to invite public obliquy by false confessions of prejudice, in exchange for which the Act offers only counterfeit accommodation. Given the problems with the wording of other sections of the law, it is not clear whether this provision was deliberately constructed as an obstacle to conscientious objection, or if it was simply the product of appalling legislative draftsmanship. . .
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  • Appendix "A" | The Philippines population grew from about 27 million in 1960 to over 100 million in 2018. However, from 1984 the rate of population growth decreased. By 2017 the Philippines' birth rate had fallen about 15% in 17 years, more than the reduction in the global birthrate. The Philippines fertility rate was halved between 1973 and 2013.
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  • Appendix "B" | The "RH Act" (2012)  in brief |  Annotated Text of the Responsible Parenthood and Reproductive Health Act of 2012
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  • Supreme Court of the Philippines Decision: 2014


Proposed Rwandan law would legalize abortion, make conscientious objection illegal

Law Governing Reproductive Health

  • Sean Murphy* |  . . .  Rwanda's proposed Reproductive Health Bill: text and commentary. With respect to freedom of conscience, the oppressive power of the proposed law is manifestly clear. A particularly draconian feature of the bill is Article 4(14), which would prohibit any expression of opposition to the bill or to anything it advocates.
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When can a doctor conscientiously object?

  • Bernard G. Prusak* | Over the last decade, the culture wars in the United States have broken new ground: They have become battles over the rights of conscience. For example, now that same-sex marriage is a right, the question before the U.S. Supreme Court in the case of Masterpiece Cakeshop is whether its sympathetic, telegenic owner, Jack Phillips, is within his rights to refuse to make a wedding cake for a gay couple. Similarly, under the Obama administration, the court heard arguments more than once over whether employers who object on religious grounds to contraceptives or abortion should be exempted from having to provide employees health insurance that includes such services. . .
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Medics should not be forced to do procedures they object to on ethical grounds

  • David S. Oderberg* | For most people, the term "conscientious objection" evokes images of Quakers and pacifists registering to avoid military service. Many countries have a long and honourable tradition of accommodating such conscientious objectors. It might not be about bombs and bullets, but healthcare professionals often find themselves fighting a conscience battle of their own. . .
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Abortion law reform and conscientious objection in the United Kingdom

  • Jacky Engel* | Jacky Engel reviews the legal history of abortion in the United Kingdom from 'Lord Ellenborough's Act' of 1803, though most of her attention is directed to developments beginning with the Bourne case of 1939. Ms. Engel's discussion of the parliamentary debates in 1967 is reproduced below because of its references to conscientious objection.
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Conscientious Objection to Abortion: Ethics, Polemics and Law

  • Charles Foster* | The pro-abortion lobby has announced the latest phase in its offensive. Marie Stopes International wants to force GP surgeries to display lists indicating which doctors in the practice will refer women for abortion, and the pressure group Doctors for a Woman's Choice on Abortion is encouraging patients to report to the GMC doctors who refuse to play any part in abortion. . .
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Conscientious Objection

  • Robin Haig*  |   The article below, written by one of ALDU's officers, appeared in ALDU's Newsletter in the Winter of 1982 and considered the question of conscientious objection to abortion and how this might affect the position of doctors.
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Conscientious objection and the worrying implications of the Glasgow midwives case

  • Philippa Taylor* | The right for health professionals to exercise their conscientious objection to participating in abortion – or indeed to choose on occasion to limit the areas in which they work in order not to be ethically compromised – has been under assault worldwide for some time now. . . Now the right for health professionals to exercise their conscientious objection has been put under even more pressure in the UK after the Supreme Court today rejected an appeal for conscientious objection for senior midwives who refused to supervise abortions performed on a labour ward. It has also delivered a controversial ruling on referrals for abortion.
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Re: House of Lords Select Committee
on Assisted Dying for the Terminally Ill Bill

Selections from the First Report

In 2003 Lord Joffe introduced a private member's bill into Parliament, the Patient (Assisted Dying) Bill, which progressed only to second reading. In March of the following year he introduced another private member's bill (Assisted Dying for the Terminally Ill). It received Second Reading and was referred to a House of Lords committee for detailed examination.  Extracts concerning conscientious objection and freedom of conscience in witness testimony and written evidence are noted below.

Examination of witnesses

  • All extracts
  • PROFESSOR JOHN HARRIS, University of Manchester, PROFESSOR SHEILA MCLEAN, Glasgow university, DR EVAN HARRIS, a Member of the House of Commons, MISS DEBORAH ANNETTS, Chief Executive, Voluntary Euthanasia Society, and MR TL BARCLAY (Q1-19; Q20-27)
  • LORD JOFFE: Explains amendment to remove requirement for referral by objecting physician. (Q70-79)
  • Witnesses: DR MICHAEL WILKS, Chairman, Medical Ethics Committee, DR VIVIENNE NATHANSON, Director of Professional Activities, British Medical Association, PROFESSOR SIR GRAEME CATTO, President, and MS JANE O'BRIEN, Head of Standards, General Medical Council, examined. (Q281-299; Q300-319) (Q340-353)

Written evidence

The bill included an exemption for conscientious objectors (Clause 7) which required an objecting physician refer a patient to a colleague willing to process a euthanasia request. This elicited protests during the examination of witnesses and inwritten evidence and an adverse judgement from the Joint Committee on Human Rights, as a result of which Lord Joffe agreed to remove the provision for mandatory referral.

Clause 7 (from the Bill)

From Chapter 4 (from the report)

From Chapter 7 (from the report)

Re: House of Lords & Commons Joint Committee On Human Rights