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

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. “‘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

Supreme Court of Canada, OttawaThe 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]

When is a problem not a problem?

Refusing to dispense drugs to kill patients with psychiatric illness

Levenseinde Kliniek complains about uncooperative Dutch pharmacists

Sean Murphy*

When is a problem not a problem?In April, 2014, a complaint was made in the Netherlands that some Dutch pharmacists were refusing to provide euthanasia drugs.  The complaint led members of the Dutch Parliament from the green party, GroenLinks, to ask for a debate with health minister, and members of other Dutch political parties let it be known that they were also concerned.

 According to the news reports, over half the physicians at “the independent euthanasia clinic” had been refused lethal drugs, and 23 percent of 53 pharmacists surveyed reported that they sometimes refused to fill euthanasia prescriptions.  It was argued that pharmacists should not be able to refuse drugs needed to kill patients if two physicians had approved the euthanasia request.  However, while the law in the Netherlands permits physicians to provide euthanasia, it does not mention pharmacists. [Full Text]

Judgementalism and moralising in response to Brittany Maynard suicide

Sean Murphy*

On 1 November, Brittany Maynard,  a 29 year old woman with terminal brain cancer, committed suicide in Oregon State with the assistance of a physician (and, presumably, a pharmacist), who provided the lethal medication she consumed.  Assisted suicide is legal in Oregon; that is why Maynard moved to the state.  In the weeks leading up to her death she had become a celebrity because of her public advocacy of assisted suicide, augmented by a kind of “countdown” to the date she had chosen to die. [NBC News]

It is not surprising that the announcement that she had killed herself as planned was followed by an outburst of judgementalism and moralising.

Prominent bioethicist Arthur Caplan stated, “did nothing immoral when she took a lethal dose of pills.”  He dismisses the view that “only God should decide when we die” because he finds that inconsistent with the existence of free choice, adding, “To see God as having to work through respirators, kidney dialysis and heart-lung machines to decide when you will die is to trivialize the divine.” [Brittany Maynard’s Death Was an Ethical Choice]

Chuck Currie, a minister of the United Church of Christ in Oregon, also insisted that Maynard had “made a moral choice.”  He described committing suicide under the terms of the Oregon law as taking “medically appropriate steps to make that death as painless and dignified as possible” – an appropriate exercise of “moral agency.”  Like Caplan, his theological views about the nature of God inform his approach to the issue. [Brittany Maynard Made A Moral Choice]

Writing in the New York Post, Andrea Peyser did not explicitly address either moral or theological questions, but implicit in her headline and awestruck praise for Maynard’s suicide was the premise that the young woman had done a “brave” and good thing. [We should applaud terminally ill woman’s choice to die]

In contrast, the head of the Catholic Church’s Pontifical Academy for Life in Rome, Monsignor Ignacio Carrasco de Paula, said that Maynard’s killing herself was a  “reprehensible” act that “in and of itself should be condemned,” though he stressed that he was speaking of the act of suicide itself, not Maynard’s moral culpability. [Daily News]

Those who condemn “judgementalism” and “moralising” ought to be offended by all of these commentators, because all of them –  Caplan, Currie, Peyser and de Paula – have expressed moral or ethical judgements.  To condemn suicide as “reprehensible” is surely to make a moral or ethical judgement, but moral judgement is equally involved in a declaration that suicide is a “moral” or “ethical” choice that should be applauded.

Health care workers who refuse to participate in some procedures for reasons of conscience or religion are often accused of being “judgemental” or of “moralising.”  In fact, as the preceding examples illustrate, their accusers are not infrequently just as “judgemental” and “moralistic.”   Such differences of opinion are not between moral or religious believers and unbelievers, but between people who believe in different moral absolutes.

This was one of the points made by Father Raymond De Souza during an interview about assisted suicide on CBC Radio’s Cross Country Checkup.  Interviewer Rex Murphy asked him if he thought that  “the idea of any absolute . . . even on the most difficult of questions of life and death . . . are no longer sufficient . . . for the modern world.”  Fr. De Souza’s response:

It’s a shift, Rex, I would say from one set of absolutes to the other.  And the absolute would be the absolute goodness of life, in one case, to assertion of personal autonomy, which is becoming an absolute assertion. And in fact in some of the arguments that have gone before the court, while acknowledging potential difficulties and philosophical objections, the right to personal autonomy trumps everything else.  So, in a certain sense, I wouldn’t say we are moving away from absolutes, but shifting from one set of absolutes to the other . . . [34:21- 35:24]