Publications Archives - Page 17 of 28 - Protection of Conscience Project News

Project letter to the New Brunswick Minister of Health

Re: compulsory referral for abortion

3 December, 2014

The Honourable Victor Boudreau,
Minister of Health,
HSBC Place,
P. O. Box 5100
Fredericton, NB
Canada E3B 5G8

Dear Mr. Boudreau:

The Protection of Conscience Project is a non-profit, non-denominational initiative that advocates for freedom of conscience in health care. The Project does not take a position on the acceptability of morally contested procedures.

I am writing about a statement attributed to you in the Fredericton Daily Gleaner:

Health Minister Victor Boudreau: “No physician can be forced to [perform abortions], but at the same time there is a duty to refer to someone who will.”¹

It is instructive to compare this to a demand made by a panel of experts of the Royal Society of Canada:

Royal Society Panel: “. . . health care professionals are not duty bound to accede to [requests for euthanasia and assisted suicide] . . . but . . . they are duty bound to refer their patients to a health care professional who will.”²Since you are new to the position of Minister of Health, you are likely unaware of the fact that arguments used by those who demand that physicians be forced to refer for abortion are also used to demand that they be forced to refer for euthanasia or assisted suicide. It was for this reason that the Protection of Conscience Project joined an intervention in the case of Carter v. Canada in the Supreme Court of Canada.³

Counsel for the Project told the Supreme Court justices that what is demanded by the Royal Society experts (and, perhaps, the New Brunswick government?) is “precisely the sort of thinking that, in our submission, ought to be protected against.”⁴

Any number of physicians may agree to referral for abortion or other controversial procedures because they find that it relieves them of a moral burden or of tasks they find disturbing or distasteful. However, for others, as Holly Fernandez-Lynch has observed, referral imposes “the serious moral burdens of complicity.”⁵ They refuse to refer for abortion because they do not wish to be morally complicit in killing a child, even if (to use the terminology of the criminal law) it is, legally speaking, “a child that has not become a human being.”⁶

Just as these physicians refuse to facilitate killing before birth by referring patients for abortion, they and other physicians would refuse to facilitate killing patients after birth by referring them for euthanasia or assisted suicide. Influential academics and abortion and euthanasia activists want to force objecting physicians to do both.

Professor Jocelyn Downie of Dalhousie University was one of the architects of the Carter case,⁷ a member of the Royal Society panel, and a long-time advocate of compulsory referral for abortion.⁸ She was live- tweeting the hearing from the courtroom. Udo Schuklenk, one of her fellow Royal Society experts, was following the proceedings via a live audio-video link. He described most of the interveners as “Christian activist groups, some more fundamentalist than others.” After questioning the integrity of “the God folks,” he commented on the joint intervention involving the Project:

Then there was a lawyer representing groups called the Faith and Freedom Alliance and the Protection of Conscience Project. He . . . asked that the Court direct parliament to ensure that health care professionals would not be forced to assist in dying if they had conscientious objections. That, of course, is the case already today in matters such as abortion. However, this lawyer wanted to extend conscience based protections. Today health care professionals are legally required to pass the help-seeking patient on to a health care professional willing to provide the requested service. The lawyer wanted to strike out such an obligation. I am not a fan of conscientious objection rights anyway, so I hope the Court will ignore this.⁹ (Emphasis added)You can see clearly from this that Professors Downie, Schuklenk and their supporters hold that because physicians can be forced to refer for abortion, they can and ought to be forced to refer for euthanasia and assisted suicide. The weakness in this claim is the false premise that objecting physicians can or ought to be compelled to refer for abortion. Notwithstanding your assertions and the views of Dr. Haddad and Professors Downie and Schuklenk, this claim is sharply disputed, and for good reason.

Physicians are required to disclose personal moral convictions that might prevent them from recommending abortion, but not to refer the patient or otherwise facilitate the procedure. The arrangement preserves the integrity of physicians, and it safeguards the legitimate autonomy of the patient, who is free to seek an abortion elsewhere.¹⁰ But it also protects the community against the temptation to give credence to a dangerous idea: that a learned or privileged class, a profession or state institutions can legitimately compel people to do what they believe to be wrong.

Just how far this can go is now coming into focus, thanks to the Royal Society’s panel of experts and their supporters. They argue that it is not sufficient to simply encourage and allow willing health care professionals to kill patients. They demand that health care professionals be compelled to participate in and facilitate the killing of patients – even if they believe it to be wrong, even if they believe it to be murder – and that they should be punished if they refuse to do so.

Killing is not surprising; even murder is not surprising. But to hold that the state or a profession can, in justice, compel an unwilling soul to commit or even to facilitate what he sees as murder, and justly punish or penalize him for refusing to do so – to make that claim ought to be beyond the pale. It is profoundly dangerous, for if the state or civil society or professional organizations can legitimately require people to commit or aid in the commission of murder, what can they not require?

Particularly in view of the possibility that the Supreme Court of Canada might legalize physician assisted suicide and euthanasia, it is of grave concern that your comments can be taken to be supportive of the movement to develop and entrench a ‘duty to do what is wrong’ in medical practice. I know of no other profession that has accepted such a duty as a requirement of membership, and I am certain that the Liberal Party of New Brunswick does not and would not impose such a duty upon its members.

I have enclosed an abstract (in English and French) of the Project’s recent submission to the College of Physicians and Surgeons of Ontario about its policy, Physicians and the Ontario Human Rights Code, which is relevant in this case. The full submission, which is on line, is available in English only.

I note that a CBC news reported in July that the President of the New Brunswick Medical Association, Dr. Camille Haddad, included refusal to refer for abortion among alleged “barriers to access” to the procedure. The CBC report added, “The society says it wants the New Brunswick government to come up with a plan to address those barriers.”¹¹

If Dr. Haddad or others have urged you to adopt policies to promote access to abortion, that is outside the scope of Project concerns. However, I respectfully suggest that a plan to address alleged “barriers” must not include the suppression of freedom of conscience among physicians by compelling them to refer for abortion. The state has other means at its disposal to deliver the service.

Sincerely,

Sean Murphy, Administrator
Protection of Conscience Project

Notes
1. Huras A. “Abortions won’t be available in all hospitals.” Fredericton Daily Gleaner, 28 November, 2014

2. Schuklenk U, van Delden J.J.M, Downie J, McLean S, Upshur R, Weinstock D. Report of the Royal Society of Canada Expert Panel on End-of-Life Decision Making (November, 2011) p. 70 (Accessed 2014-12-02)

3. Murphy S. “Re: Joint intervention in Carter v. Canada– Project Backgrounder.” Supreme Court of Canada, 15 October, 2014. Protection of Conscience Project

4. Murphy S. “Re: Joint intervention in Carter v. Canada- Selections from oral submissions.” Supreme Court of Canada, 15 October, 2014. Protection of Conscience Project

5. Fernandez-Lynch, Holly, Conflicts of Conscience in Health Care: An Institutional Compromise. Cambridge, Mass.: The MIT Press, 2008, p. 229.

6. Criminal Code, Section 238(1). (Accessed 2014-12-02)

7. In a 2007 symposium at Carleton University in Ottawa, Professor Downie asserted that the Supreme Court of Canada might be willing to reverse its 1993 ruling in Rodriguez. She outlined the strategy for a legal challenge under Canada’s Charter of Rights and Freedoms and said that she was looking for an ideal test case to use to strike down the law. She published a paper and essay in 2008 that appear to have drawn from her Carleton presentation. The 2007 presentation and subsequent publication set out the strategy for the plaintiffs’ successful argument in Carter. Professor Downie assisted the plaintiffs in the Carter case in preparing their expert witnesses. “Rodriguez Revisited: Canadian Assisted Suicide Law and Policy in 2007.” Dalhousie University, ListServ Home Page, FABLIST Archives, Message from Rebecca Kukla, 6 February, 2007. “Symposium on physician assisted suicide.” (Accessed 2012-06-27); Schadenberg, Alex, “Dalhousie law professor seeks to re-visit Rodriguez court decision.” Euthanasia Prevention Coalition. Downie J, Bern S. “Rodriguez Redux.” Health Law Journal 2008 16:27-64. (Accessed 2012-06-27.) Carter v. Canada (Attorney General) 2012 BCSC 886, Supreme Court of British Columbia, 15 June, 2012. para. 124. (Accessed 2014-12-02)

8. Rodgers S. Downie J. “Abortion: Ensuring Access.” CMAJ July 4, 2006 vol. 175 no. 1 doi: 10.1503/cmaj.060548 (Accessed 2014-12-02). McLeod C, Downie J. “Let Conscience Be Their Guide? Conscientious Refusals in Health Care.” Bioethics ISSN 0269-9702 (print); 1467-8519 (online) doi:10.1111/bioe.12075 Volume 28 Number 1 2014 pp ii–iv

9. Schuklenk, U. “Supreme Court of Canada heard arguments in Charter challenge to assisted dying criminalisation.” Udo Schuklenk’s Ethx Blog Thursday, October 16, 2014 (Accessed 2014-12-02)

10. Murphy S. “‘NO MORE CHRISTIAN DOCTORS.’ Appendix ‘F’- The Difficult Compromise: Canadian Medical Association, Abortion and Freedom of Conscience.” Protection of Conscience Project

11. “New Brunswick Medical Society calls for abortion access plan: Doctors’ group says 2 doctor rule no different than any other procedure.” CBC News, 26 July, 2014 (Accessed 2014-12-02)

Ontario physicians to be forced to do what they believe to be wrong

Draft policy demands that objectors provide or refer.

Policy would apply to euthanasia, if legalized.

Protection of Conscience Project News Release

A draft policy of the College of Physicians and Surgeons of Ontario demands that physicians must provide services to prevent imminent “harm, suffering and/or deterioration,” even if doing so is contrary to their moral beliefs.

Should the Supreme Court of Canada legalize euthanasia, the policy will require objecting physicians to lethally inject patients themselves if a delay would result in “harm” or “suffering.” In less urgent circumstances, the policy will require physicians unwilling to kill patients to promptly refer them to “a non-objecting, available physician or other health-care provider.”

However, many physicians who object to killing patients for reasons of conscience would also object to referral. Dr. Charles Bernard, President of Quebec’s Collège des médecins, has explained that mandatory referral effectively nullifies freedom of conscience: “It is as if you did it anyway.”¹

Dr. Bernard was talking about Quebec’s euthanasia law, but the same principle holds with respect to abortion – another procedure that involves killing.

Prominent academics and activists want to force objecting physicians to provide or refer for abortion and contraception. They and others have led increasingly strident campaigns to suppress freedom of conscience among physicians to achieve that goal. The College’s draft policy clearly reflects their influence.

However, crusades against physicians who refuse to provide or refer for abortion are dress rehearsals for eventual campaigns against physicians who refuse to kill patients. It is not a coincidence that activists who would force objecting physicians to facilitate abortion and contraception also intend to force objectors to refer for euthanasia – and for the same reasons.²

The Project insists that it is incoherent and contrary to sound public policy to include a requirement to do what one believes to be wrong in a professional code of ethics. It is also an affront to the best traditions of liberal democracy, and, ultimately, dangerous.

The College Council has tentatively approved the policy, but will accept further public input until 20 February, 2015 before imposing it on Ontario physicians.

Project Submission to the College of Physicians and Surgeons (2014)

Notes:

1. Consultations, Tuesday 17 September 2013 – Vol. 43 no. 34: Collège des médecins du Québec, (Dr. Charles Bernard, Dr. Yves Robert, Dr. Michelle Marchand) T#154

2. For example: Schuklenk U, van Delden J.J.M, Downie J, McLean S, Upshur R, Weinstock D. Report of the Royal Society of Canada Expert Panel on End-of-Life Decision Making (November, 2011) p. 62, 69, 101 (Accessed 2014-02-23)

New Brunswick health minister unaware of abortion-euthanasia connection

Project Letter to the Editor,
Fredericton Daily Gleaner

Sean Murphy*

Re: “Abortions won’t be available in all hospitals. “The Fredericton Daily Gleaner, 28 November, 2014

New Brunswick’s Minister of Health and the President of the province’s Medical Society both claim that physicians who refuse to provide abortion for reasons of conscience have an obligation to refer patients to colleagues who will. These assertions contradict the positions of the Canadian Medical Association and the College of Physicians and Surgeons of New Brunswick. Mr. Boudreau and Dr. Haddad also fail to recognize how such a policy would play out should assisted suicide and euthanasia be legalized. The Protection of Conscience Project intervened at the Supreme Court of Canada in the Carter case on precisely this point.¹

Some influential academics have been attempting to force physicians to refer for abortion for years. They now claim that “because” physicians can be forced to refer for abortion, they should be forced to refer for euthanasia.² If they have succeeded in converting Mr. Boudreau and Dr. Haddad to their point of view, it is not shared by physicians who refuse to be parties to killing, before or after birth.

The Canadian Medical Association expects physicians who decline to provide abortions for reasons of conscience to notify a patient seeking abortion “so that she may consult another physician.” There is no requirement for referral.³ The College of Physicians of New Brunswick suggests referral as a “preferred practice,” but acknowledges that referral may not be acceptable. Physicians may, instead, provide information about resources available to patients that they can use to obtain the service they want.⁴

Notes:

1. Murphy, S. “Project Backgrounder Re: Joint intervention in Carter v. Canada.” Supreme Court of Canada, 15 October, 2014

3. Murphy S. “‘NO MORE CHRISTIAN DOCTORS.’ Appendix ‘F’- The Difficult Compromise: Canadian Medical Association, Abortion and Freedom of Conscience.” Protection of Conscience Project

4. Comment by College of Physicians and Surgeons of New Brunswick (November, 2002) Re: Declining to provide service on moral/religious grounds.

Looking back on 15 years: an anniversary

December, 1999 to December, 2014

Sean Murphy*

The Protection of Conscience Project celebrates its 15th anniversary in December, 2014. The formation of the Project was one of the eventual results of a meeting in Vancouver with British Columbian Senator Ray Perrault1 in the spring of 1999.

Senator Perrault wished to continue the work of retiring Liberal Senator, Stanley Haidasz, whose protection of conscience bill was stalled in the upper chamber.2 Among the experiences that spurred Senator Perrault to continue Senator Haidasz’s work was an encounter while going door to door during an election campaign. A nurse, in tears, told him that she had quit work after 15 years because she was required to participate in abortions, and could no longer do so in good conscience.

The meeting was sponsored by the Catholic Physicians Guild of Vancouver. Most participants were physicians or pharmacists. They spoke of their growing concern that they would be penalized or forced out of their professions if they continued to practise in accordance with their religious or moral beliefs. It became clear that these health care professionals had come to recognize the growing threat to their freedom to serve their patients without violating their personal and professional integrity. This was a key factor in the establishment of the Protection of Conscience Project nine months later.

While the meeting in 1999 was called by a Catholic organization, the Protection of Conscience Project is a non-profit, non-denominational initiative that does not take a position on the acceptability of morally contested procedures like abortion, contraception or euthanasia: not even on torture. The focus is exclusively on freedom of conscience and religion.

The Project is supported by an Advisory Board drawn from different disciplines and religious traditions, a Human Rights Specialist and an Administrator, all of whom serve without remuneration.3 It was conceived as an initiative rather than an organization, association or society; it has no ‘members’ or structures of an incorporated entity. This ensures that the time and energy that would otherwise be needed to maintain corporate structures is spent on more immediately practical work. The name originated in a comment made by Iain Benson, then Senior Research Fellow of Canada’s Centre for Cultural Renewal, now Senior Resident Scholar, Massey College, University of Toronto.4

“We don’t need another organization,” he said. “We need a project.” [Full text]

Good News and Bad News

Presentation to the Catholic Physicians’ Guild of Vancouver

North Vancouver B.C.

Sean Murphy *

Introduction

Thank you for inviting me to speak this evening. I have never been asked to give a three hour presentation to a group of physicians. You will be relieved to know that I have not been asked to do that tonight.

Those of you who saw the BC Catholic headline may have been expecting a “lecture on medical ethics,” but, thanks to Dr. Bright’s introduction, you now know that I am an administrator, not an ethicist, and that my topic is freedom of conscience in health care.

Protection of Conscience Project

The Protection of Conscience Project will be 15 years old this December. Although a meeting sponsored by the Catholic Physicians Guild provided the impetus for its formation, the Project is a non-denominational initiative, not a Catholic enterprise. Thus, if I mention the Catholic Church or Catholic teaching tonight, it will be as an outsider, as it were, though an outsider with inside information.

One more thing: the Project does not take a position on the acceptability of morally contested procedures like abortion, contraception or euthanasia: not even on torture. The focus is exclusively on freedom of conscience.

Context

The context for my presentation is provided by the passage of the Quebec euthanasia law1 and the pending decision in Carter v. Canada in the Supreme Court.2 Physicians are now confronted by the prospect that laws against euthanasia and physician assisted suicide will be struck down or changed. If that happens, what does the future hold for Catholic physicians and others who share your beliefs?

Will you be forced to participate in suicide or euthanasia?

If you refuse, will you be disadvantaged, discriminated against, disciplined, sued or fired?

Will you be forced out of your specialty or profession, or forced to emigrate if you wish to continue in it?

What about those who come after you? If you avoid all of these difficulties, will they?

In sum, will freedom of conscience and religion for health care workers be protected if assisted suicide and euthanasia are legalized? [Full Text]