Broad support to protect doctors, nurses from discriminatory firing

Medical groups, minorities, legal experts line up against New York’s attempt to block healthcare anti-discrimination law

News Release

For immediate release

Becket Law

WASHINGTON – A diverse group of states, Members of Congress, minority groups, medical affiliate organizations, and legal experts recently filed half-a-dozen briefs supporting the U.S. Department of Health and Human Service’s (HHS) Conscience Rule, which provides federal conscience protections for medical professionals. In New York v. HHS, the Becket Fund for Religious Liberty is defending Dr. Regina Frost and the Christian Medical & Dental Associations (CMDA) from attempts by states to discriminate against doctors and nurses who refuse to violate their consciences and medical judgment by performing procedures such as abortions or physician-assisted suicide.  This case is now in the U.S. Court of Appeals for the Second Circuit.

Highlights from the friend-of-the-court filings in New York v. HHS:

  • A congressional brief filed by dozens of Members of Congress explained why the new rule’s provisions flowed directly from unchallenged—and bipartisan—statutory protections for medical conscience that have been on the books for decades.
  • Former Senator Coats and former Representative Weldon (the named sponsors of two key statutory conscience protections for healthcare providers) filed their own brief in support, explaining why conscience protections are important for health care providers and how the government’s new regulation supports key bipartisan statutory protections that have long been on the books.
  • The Jewish Coalition for Religious Liberty and the Coalition for Jewish Values also highlighted the disproportionate impact that New York’s lawsuit would have on medical professionals of minority faiths.
  • The Center for Constitutional Jurisprudence explained why this new rule helps the government better enforce existing federal conscience protections.
  • A coalition of medical professional organizations—including the American College Of Pediatricians, the Catholic Medical Association, and the National Catholic Bioethics Center—filed a brief highlighting ongoing threats to medical professionals of faith and explaining why this rule will help ensure medical providers cannot be coerced by employers to either violate their conscience or lose their job.

“Healthcare is one area where protecting conscience is particularly vital,” said Ohio Attorney General Dave Yost, in a brief on behalf of sixteen states. “That is why Congress has routinely enacted laws to ensure that these professionals can provide care without violating their beliefs.”

Polling from last year shows that religious healthcare professionals are committed to serving all patients, but face increasing pressures to engage in procedures such as abortions that violate their faith, which could force over ninety percent of religious doctors out of the medical field.  The U.S. Department of Health and Human Services (HHS) issued a Conscience Rule last year to better enforce bipartisan laws that, for decades, have promised to allow religious doctors, nurses and healthcare professionals to serve patients without facing employment discrimination directed against their consciences. The Rule simply clarifies and enforces existing federal statutes designed to ensure religious health professionals won’t be forced out of the practice of medicine by entities that voluntarily choose to accept federal tax money. But, led by the State of New York, several states and abortion providers are suing to keep the federal funds while preventing the government from enforcing the conscience protections that they agreed to when they accepted the funds.

“It is encouraging to see this broad coalition stand up in support of conscience rights,” said Dr. Regina Frost. “I hope the Court will recognize that the Rule simply enforces common-sense, bipartisan protections that protect both medical professionals from unjust discrimination and patients from losing their doctors.”

Dr. Frost is an OB-GYN and one of nearly 19,000 medical professionals in CMDA serving the sick and vulnerable in the United States and abroad. CMDA members serve the homeless, prisoners living with HIV, and victims of opioid addiction, sex trafficking, and gang violence. Overseas, CMDA members serve in war zones, refugee clinics, and remote areas without quality healthcare. New York’s lawsuit needlessly threatens the health and well-being of at-risk, underserved populations across the globe.

Dr. Frost and CMDA are also represented by Allyson Ho and Daniel Nowicki of Gibson, Dunn & Crutcher LLP.

For more information or to arrange an interview with a Becket attorney, contact Ryan Colby at media@becketlaw.org or 202-349-7219.Interviews can be arranged in English, Chinese, French, German, Portuguese, Russian, or Spanish.


Additional Information

Case Page: New York v. HHS

Link: Friend-of-the-Court Briefs in New York v. HHS

Legal Doc: Order in New York v. HHS 11/06/2019

Link: Media Kit

“We are being bullied to participate in medical assistance in dying”

Alert from a growing number of Canadian physicians

News Release

Physicians’ Alliance Against Euthanasia

Montréal, March 9, 2020 – The Physicians’ Alliance against Euthanasia has received reports that unwilling physicians are being pressured and bullied to participate in Medical Assistance in Dying (MAiD): euphemism for euthanasia and assisted suicide.  Fearing reprisals, physicians have asked that no information that could identify them be disclosed.

The pressure has been intense for many physicians, especially amongst palliative specialists, some leaving even before this latest development. Descriptions were made of toxic practice environments and fear of discipline by medical regulators.

“The anxiety, fear, and sadness surrounding my work bled into my family life, and I ultimately felt that I could not manage practicing palliative care at this stage of my life.”  (Former palliative care physician, March 2020)

In different locations across Canada over the last months to weeks there has been a change in certain hospital MAiD policies. The change seems intended to provoke crisis or confrontation: to force objecting physicians to facilitate MAiD, or to have to refuse — and face contrived allegations of “obstructing access.” 

Reports consistently focus on the MAiD providers refusing to accept full responsibility for the death of the patient and forcing other physicians to share responsibility for the death. If the physician asks to withdraw from care and allow the MAiD provider to take over as before, the MAiD provider resists assuming the natural pattern of care.

The reports we are hearing from distressed physicians describe deliberate disruption of arrangements that were previously working satisfactorily and that had permitted patients to have access to MAiD while still allowing for conscience objectors to not be involved in facilitating the patient’s death. This bullying and betrayal of collegial relationships can poison practice environments and compromise patient care. Such behavior should not be tolerated by health care administrators in Canada.

Canadian physicians having similar stories of bullying are encouraged to contact the by email: info@collectifmedecins.org.

Contact: Charmine Francis,Coordinator
438-938-9410
info@collectifmedecins.org

Resources:

Canadian Medical Protective Association: Most Responsible Physician: A key link in the coordination of care.

Lauren Vogel. Culture of bullying in medicine starts at the top.
Canadian Medical Association Journal (December, 2018

Camille Bains. Systemic change needed to address suicide among physicians in Canada, doctors say. CBC News/Canadian Press (May, 2019)

Gabrielle Horne. Physician, heal thyself: the potential crisis of conscience in Canadian medicine. What if your faith in doctors having conscience was shaken? Globe and Mail (May, 2019)

BC Hospice challenges closure over government’s proeuthanasia policy

Government refuses compromise

Easier and cheaper to kill than to care

News Release

Delta Hospice Society

Vancouver — Delta Hospice officials were shocked and outraged this week by the Fraser Health Authority’s blatant move to cut off all discussions and close the facility because it wants the hospice to provide MAiD (Medical Assistance in Dying) at every facility. The Irene Thomas Hospice is dedicated to allowing patients access to expert symptom management for physical, emotional and spiritual distress. It provides comfort, meaning dignity and hope as one dies a natural death.

Angelina Ireland, President of the Delta Hospice, said the Fraser Health Authority and the British Columbia Minister of Health abruptly cancelled the Hospice’s contract on Tuesday without even acknowledging or responding to the hospice’s offer to a reduced level of government financing of the facility by $750,000 per year in order to meet the 50% funding level for exemption from providing MAiD.

“The actions of the Ministry reveal that the issue of MAiD vs. palliative care is an agenda-driven policy rather than one that ensures access to skilled and compassionate palliative care for eligible patients in distress, and their families,” she said. “And it’s all about dollars. It is easier and cheaper for the government to provide euthanasia rather than continue with palliative care. Basically, they are saying that no palliative care facility in BC has a right to exist unless it also provides euthanasia.”

Faced with the government’s decision and refusal to consider other options such as decreased provincial funding, Ms. Ireland said the hospice will look at all of its legal and other options to continue to exist and serve patients and families in their final days, as they have always done.

The decision is particularly baffling, she said, since access to MAiD for those who request it is available at many locations in the lower mainland, including Delta Hospital right next door to the hospice. That, in her mind, reinforces the view that this is not about patients or families, but rather about a social policy agenda.

BC Hospice challenges closure over government’s proeuthanasia  policy

“MAiD is a separate public health care stream, distinct and apart from palliative care. If the government wants to open MAiD facilities that’s their option, but they must not be allowed to download it onto the backs of private palliative care facilities.”

“Palliative care physicians and nurses believe in the philosophy of specialty palliative care and practice as defined by the World Health Organization (WHO), which maintains that palliative care provides relief from pain and other distressing symptoms and which affirms life and regards death as a normal process. At no point does WHO include euthanasia as an aspect of palliative care!”

Forced closure of the facility ignores the fact that this is a privately owned hospice built on land leased from the government, employs more than fifty people and has contributed significantly to BC’s public health care system.

“This is an invasion of the historic medical discipline of palliative care. The Canadian model is respected around the world. The government and the health authority are running roughshod over that principle and reputation.”

Ms. Ireland expressed hope that “even at this late date” Fraser Health Authority and the BC Ministry of Health will come to the table and discuss the issues, including the financial offer. “Our deepest concern is with those patients and families who have entrusted their final days to us. We want to make sure those days are filled with comfort and peace. That is still our goal.”

The Ministry and the Authority have both publicly stated they plan to take control of the premises currently occupied by the Hospice. The Delta Hospice Society built the Irene Thomas Hospice without taxpayer funds, at the cost of approximately $9,000,000. The Society has operated the Irene Thomas Hospice for 10 years, providing more than 700,000 hours of volunteer labour and $30 million to the public health care system. For the government to step in and seize this private property is “a scandalous appropriation of private assets,” said Ireland.

On Saturday April 4, a Rally for Delta Hospice will be held in front of the
Legislative Buildings at noon. Speakers include Dr. Margaret Cottle (palliative care physician) and Dr. Will Johnston (family physician and obstetrician) along with MP Tamara Jansen and Alex Schadenberg of the Euthanasia Prevention Coalition.

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For further information, contact:
Angelina Ireland. President Delta Hospice
irelandangelina@gmail.com

Canadian hospice struggles against state demand to allow euthanasia

Hospice begs permission to refuse $750,000 in state funding

Euthanasia and assisted suicide available in state hospital next door

News Release

Delta Hospice Society

Vancouver area hospice is asking the government to reconsider their proposal to give up $750,000 a year in funding so that it not be required to violate its mandate of care and compassion for patients by providing Medical Assistance in Dying (MAiD) at its facility.

The health authority’s demand is unnecessary, the hospice contends, noting that the MAiD option is widely available at many other facilities, including one next door.

Canadian hospice struggles against state demand to allow euthanasia

By forfeiting the government funding, the hospice would be under the 50% threshold set by the government and therefore exempt from providing MAiD.

Angelina Ireland, President of the Delta Hospice Society, said that the Society’s Charter specifically mandates it to provide compassionate care and support for persons in the last stages of living, so that they may live as fully and comfortably as possible.

“Helping and supporting patients to live fully and comfortably in their last days and giving support to them and their families is what our patients and families come to us for and expect and it is certainly what our staff are dedicated to providing. Taking steps to end a patient’s life is not providing care and support so that ‘they may live fully.’”

Fraser Health Authority ordered the Delta Hospice Society late last year to provide Medical Assistance in Dying (MAiD) claiming that failure to do so would be a breach of the Society’s agreement with the authority.

Ireland said in order to comply with the Authority’s instruction it would have to violate its legal commitments under the province’s Societies’ Act which requires them to follow their Charter. Further, DHS is not in breach of the Agreement. There is nothing in the Agreement which requires DHS to provide MAiD or allow it to be provided on its premises. The FHA is attempting to amend the Agreement by making a unilateral decision to impose an obligation, which in itself would be a contravention of the Agreement. The Fraser Health Authority’s new directive puts the Hospice Society in a difficult position of either honouring their Charter and legal obligations or acceding to what she called “an agenda-driven demand which ignores ourprimary function and pays no heed to the needs or wants of those patients and families we are caring for.”

The Delta Hospice Society has tried to work with the health authority, explaining the dilemma the order places upon them, outlining their function to assist patients live fully in their final days before natural death, and offering options to help settle the dispute but the Fraser Health Authority has refused to budge.

On January 15, 2020, Delta Hospice Society wrote the Fraser Health Authority to ask that they reconsider the proposal to give up the $750,000 a year in funding so that they may benefit from the exemption set out in a Ministry of Health policy.

Ireland said that giving up the funding would cause the Society to focus exclusively on their Hospice operations. The other services the Society provides to the community would be put on the back burner until alternative funding partnerships can be established. The Society is committed to continuing to provide the quality care it has provided since its founding in 1991, and protecting the Society’s mandate and organizational integrity.

Ireland noted further that there are many locations where MAiD is already available to those wishing to avail themselves of that option, including a facility next door.

“Nobody wanting such a service would be prevented access. The issue is not accessibility. It seems to be a purely agenda-driven demand that runs rough shod over both Delta Hospice Society’s desire to live up to its legal requirements under our Charter, as well as ignoring the reality that we are dealing with patients and families in a very vulnerable and delicate position.”

“Our goal,” she added, “is to fulfill our mission. And that is to help patients and their loved ones live quietly, comfortably, and as fully as possible in their final days of life.”

She reiterated the hospice’s desire to negotiate an equitable arrangement with the Fraser Health Authority to maintain Delta Hospice’s role of serving its patients well.

Contact: Angelina Ireland 778-512-8088; irelandangelina@gmail.com

Christian doctors continue the fight for conscience protections

Christian Medical & Dental Associations will appeal decision blocking Trump admin Conscience Rule

News Release

Becket

WASHINGTON – Religious medical professionals in New York have announced that they appealed a district court’s decision to block vital conscience protections for doctors and nurses. In New York v. HHS, the Becket Fund for Religious Liberty is defending Dr. Regina Frost and the Christian Medical & Dental Associations (CMDA) from attempts by Planned Parenthood and New York officials to force religious doctors to perform life-ending procedures that violate their consciences. The Trump administration has until Jan. 6 to join the appeal from the district court’s decision, which struck down one of the administration’s signature regulations.

In May 2019, the U.S. Department of Health and Human Services (HHS) issued a Conscience Rule to better enforce longstanding, bipartisan laws that, for decades, have promised to allow religious doctors, nurses and healthcare professionals to serve patients without being required to violate their consciences. Medical professionals of all faith backgrounds and with moral objections rely on these well established protections. The Rule holds HHS funding recipients to agreements that they made under existing federal statutes to accommodate religious health professionals. But several states and abortion provider and advocacy organizations—including the State of New York and Planned Parenthood, which have long accepted HHS funds—immediately sued to avoid enforcement of their existing agreements under the Rule and to push religious healthcare professionals like Dr. Frost out of the medical profession.

“My faith is at the heart of who I am. It is what drives me to put the needs of women and their children first every day, and to serve everyone in my care with dignity and respect,” said Dr. Regina Frost. “If the government forces me to violate my faith and my medical judgment to perform abortions, I’ll have no choice but to leave the profession.”

Dr. Frost is an OB-GYN and one of nearly 19,000 medical professionals in CMDA serving vulnerable populations in the United States and abroad. Across the country, CMDA members serve the homeless, prisoners living with HIV, and victims of opioid addiction, sex trafficking, and gang violence. Overseas, CMDA members serve in war zones, refugee clinics, and remote areas without quality healthcare. The lawsuit by Planned Parenthood and New York needlessly threatens the health and well-being of at-risk, underserved populations across the globe. New polling shows that healthcare professionals are committed to serving all patients but are facing increasing pressures to perform in certain procedures, which they believe end life and violate their faith—and these pressures could force 91 percent of religious doctors out of the medical field.

In Nov. 2019, a New York district court ruled against the Conscience Rule. Yesterday, Dr. Frost and CMDA appealed this ruling to the U.S. Court of Appeals for the Second Circuit. The deadline for the Trump administration to appeal the district court’s decision is Jan. 6, 2020.

“Like an ideological Grinch stealing conscience rights, Planned Parenthood is robbing not only religious doctors and nurses but also the patients that they serve,” said Daniel Blomberg, senior counsel at Becket. “To hear Planned Parenthood tell it, one pro-life OB-GYN is one too many. That’s wrong and it’s bad for healthcare. In a big, diverse country like ours, we can ensure that everyone will receive the care they need while still respecting the consciences of religious doctors and nurses.”

For more information or to arrange an interview with a Becket attorney, contact Ryan Colby at media@becketlaw.org or 202-349-7219. Interviews can be arranged in English, Chinese, French, German, Portuguese, Russian, or Spanish.