Category: Commentary

Ethics Profiling in the Health Care Profession

Conscience Legislation  Needed to Stop Abuse of Authority

Ottawa
12 May, 2004

Will Johnston, MD President
Canadian Physicians for Life

The recent near-failing of a medical student at a Canadian university, solely because the student has pro-life convictions, shows how intolerant some people have become about choices they dislike. For years, Canadian     Physicians for Life has received anecdotal complaints from students who suspect that their medical school admission interview went badly after they truthfully answered questions which probed for pro-life beliefs. This recent case was blatant and completely documented, created undue anxiety for the student, and only ended after many months of unsuccessful appeals of the teachers’ intolerant actions. A modern democracy should have a keen interest in protecting vulnerable students from coercion by preceptors and professors who are unaware of, or insensitive to, the concept of freedom of conscience.

We don’t screen immigrants to Canada on the basis of race or religion. Why should such litmus tests be applied to citizens applying to enter key professions? Ethics profiling is no less objectionable than racial profiling.

Freedom of conscience, it seems, is now granted freely only to those whose views are acceptable to an authoritarian, secularist establishment. Others must endure the enormous costs and stress of legal challenges or implore sympathetic fellow citizens to petition those in power on their behalf. Until this situation is corrected, the Canadian experiment in pluralism will remain in a delayed adolescence.

Sincere proponents of multiculturalism and pluralism understand the importance of protection of conscience. But they must come to recognize that too many in positions of power need statutory reminders to treat fairly     those who disagree with them about the damage abortion does to women and children.

Basic conscience protection such as that provided in Bill C-276 begins to address the problems of abuse of authority and ethics profiling which lead to the kind of injustice seen in the recent case of the medical student. Such abuses must be explicitly treated in law, not left to an ad-hoc scramble by the victim and his or her friends.

The time is long overdue for the Parliament of Canada to follow the lead of countries like the United Kingdom, Australia, and New Zealand, and 46 American states to protect and clarify freedom of conscience for Canadian health care workers. In addition to necessary employment protection, the proposed Canadian legislation corrects deficiencies found in many such laws by explicitly protecting persons of conscience from exclusion from health sciences education and from discrimination by professional licensing bodies.

Canadian Physicians for Life 29 Moore Street, R.R. # 2 Richmond ON K0A 2Z0 ph/fax: 613-728-LIFE (5433) info@physiciansforlife.ca

When rights collide

© Copyright 2004 Calgary Herald
Reproduced with permission

Nigel Hannaford

A few years ago, a customer asked Co-op pharmacist Maria Bizecki to fill a prescription for an abortion drug. For Bizecki, a Roman Catholic and active pro-lifer, this was akin to being invited to become an accessory to murder. She declined.

It was a risky stand against the prevailing view of pharmaceutical professional associations, and employers retailing drugs. Yet, ultimately it led to a small step forward for Albertans’ religious freedom.

The Alberta College of Pharmacists (ACP), for instance, her profession’s ethics watchdog, emphasizes a client’s right to have pharmaceutical needs met. It grants conscience leeway to its members, though this did not save Bizecki from facing complaints about her stand.

More particularly, the conscience clause is little help to pharmacists dealing with unsympathetic employers.

The letter one Pro-Life Ontario pharmacist got from his boss (quoted in the Pro-Life paper, Interim) eloquently expresses the all-business perspective: “You are not employed by the company to make moral or philosophical decisions about whether birth control is appropriate for the customer . . . we are engaged in a retail activity.”

The letter concluded with a threat of termination, noting that if the pharmacist couldn’t separate his beliefs from his job, he should “think long and hard about whether you could continue in your capacity.”

Co-op was comparatively gentle. Bizecki had been straightforward with them about her views, and was known in the community as a pro-life activist. She was suspended with pay.

She doesn’t talk about the complaints which led to her being investigated by the ACP; the details are subject to her duty of confidentiality. Still, when in 2000, a pro-choice website challenged the conscience rights of pharmacists, the prompt arrival of the first complaint was no surprise.

The situation was a pickle of contending rights and obligations.

Obviously, if a prescribed drug is legal, a client has a right to buy it, and a druggist to sell it. But, only the wilfully blind wouldn’t admit honest people can sincerely disagree over abortion. As employees are not mere instruments of an employer’s will, but have a right of conscience, even an obligation, how does one loosen the tangle?

One way is to choose. When human rights commissions do so, religious freedoms sometimes lose. The case of a Catholic school board
compelled to allow a gay student to bring his boyfriend to a prom, is illustrative.

The other way is negotiation. It took nearly three years for Bizecki’s lawyer, Gerry Chipeur, the college and Co-op to work it out, but there was a happy ending. That is, something which worked for everybody, and it serves as a useful template.

The reasonable accommodation of Bizecki’s principles was a written agreement in which she recognized the public’s right to have a prescription filled by a pharmacist, and that she could not and should not obstruct it. But, employers have a duty to reasonably accommodate employee scruples, and Co-op agreed not to demand she fill prescriptions for drugs which effect abortions. Thus, with the college’s blessing, she would always be part of a two-person dispensary.

Chipeur adds this might not be a reasonable accommodation for a one- person pharmacy: “However, in Canada employers have always had a duty to be reasonable, so long as there’s no undue burden. This is the first time that I’m aware, that there has been such an accommodation. If there’s a similar breakdown in Alberta in the future, it would be unwise for any health employer to not accommodate a pro-life position. I’d just say this to pro-lifers: Don’t take a job in an abortion clinic and then say you don’t want to do abortions.”

What distinguishes this case from some of the head-on rights collisions we’ve seen in Canada, is that the parties would accept a solution, not hold out for a victory. Canada aspires to be a tolerant country.

This is what tolerance looks like.

Related Links:

Project Letter to The Daily News

Nova Scotia, Canada
27 December, 2002

Sean Murphy, Administrator
Protection of Conscience Project

This response to your article Bacon, eggs and peace of mind: Pharmacists, Planned Parenthood push for prescription-free morning-after pill (17 November, 2002) has been delayed by the need to consult the Nova Scotia College of Pharmacists.

With respect to the ‘morning-after-pill’, your article attributed the following quote to Kelly Grover of Planned Parenthood: “Nobody is forcing pharmacists to prescribe this. There is a code of ethics that requires them to refer patients.”

In fact, the College’s Code of Ethics does not require referral. A pharmacist who objects to providing a drug for reasons of conscience is to advise an employer of that fact when being hired. It then becomes the obligation of the employer, not the pharmacist, to find an alternative means to deliver the drug.

The disclosure requirement in the Code of Ethics is intended to ensure that the freedom of conscience of pharmacists is fully respected, without preventing patients from getting drugs or services that they want.  Unscrupulous employers could misuse the disclosure requirement by using it to identify conscientious objectors and deny them employment. One hopes that the College will defend pharmacists against this form of discrimination, as it would be a pity to see Nova Scotians forced to leave home to seek employment in more tolerant environments.

Project Letter to the Telegraph Journal

New Brunswick, Canada
12 November, 2002

Sean Murphy, Administrator
Protection of Conscience Project

Doctors at the hospital in Moncton have decided to perform only abortions they believe necessary for maternal health, so that scarce health care resources can be dedicated to reducing waiting lists for surgery. Dr. Henry Morgentaler calls this “disgusting”. He also accuses his colleagues of unethical conduct because they appear to be imposing their religious or moral views on patients. (Morgentaler calls decision to halt abortions ‘disgusting’ 9 November, 2002)

It is remarkable that Dr. Morgentaler should be disgusted by physicians who perform abortions for ‘health’ reasons, but not abortions for which there is no medical justification. When he decided to break the law against abortion, it was because he decided to follow something he called his “medical conscience”.1 His Moncton colleagues, while they will break no law, are doing the same thing. Baseless diatribes about ‘imposing moral beliefs’ are unfair and do nothing to improve health care in New Brunswick.

Dr. Morgentaler has also misrepresented the Code of Ethics of the Canadian Medical Association by implying that it obliges doctors to provide abortions. It does not, nor does it require physicians to referfor abortions or other morally controversial procedures.

Finally, Dr. Morgentaler clearly applies his own moral views in his own medical practice. Upon what basis would he deny his colleagues the same freedom?

Notes: 1.  Pelrine, Eleanor Wright, Morgentaler: The Doctor Who Couldn’t Turn Away. Canada: Gage Publishing, 1975, p. 29

No More Pro-Choice Movement

US Conference of Catholic Bishops
11 October, 2002

Reproduced with permission

Richard M.  Doerflinger*

Once there were basically two sides to the abortion debate.

One side said that, whatever the moral status of unborn life may be, a woman and her physician must be free to make a choice about abortion. The other side said that, whatever value the struggle for greater freedom may have in other contexts, responsible freedom for women and physicians must stop short     of destroying the life of an innocent child. Not surprisingly, these sides called themselves “pro-choice” and “pro-life” respectively.

Those were simpler times. For however useful these labels once were, it’s becoming ridiculous to refer to abortion advocacy groups as “pro-choice.”

This was already clear to anyone following the debate on U.S. funding of the U.N. Population Fund (UNFPA) a few months ago. President Bush ultimately decided not to give this group any funds this year, because it helps the Chinese government implement a population program that uses coerced abortion and involuntary sterilization. His decision was greeted by howls of protest from pro-abortion groups, who ditched their commitment to women’s “reproductive freedom” to defend their allies in the population control movement.

More recently the coerced-abortion agenda has come home to guide domestic policy. When the House of Representatives debated a modest measure called the Abortion Non-Discrimination Act (ANDA) last month, the idea that each individual should have “freedom to choose” whether to be involved in abortion was denounced as heresy by “pro-choice” groups.

ANDA builds on a law that Congress passed in 1996 to protect medical residency programs from being forced by government bodies to provide abortions or abortion training. It clarifies and extends that law to make sure that this protection covers the full range of health care providers, so everyone can make his or her own conscientious decision whether to  participate in abortions. But to hear pro-abortion spokespersons talk, you would have thought that abortion was about to be declared a capital crime.     If  women can only get abortions from those actually willing to provide them,  they seemed to say, there will be almost no abortions  – an interesting comment on how widely accepted abortion is in the medical profession!

Pro-abortion groups opposed every aspect of this bill — including its effort to extend the conscience protection now enjoyed by doctors to cover other health professionals, such as nurses, who are mostly female. In opposing this modest step toward equal treatment, abortion advocates managed  to promote an agenda that was anti-life, “anti-choice,” and anti-woman all at the same time. Fortunately most House members ignored their tirades and approved the bill, which now goes to the Senate.

One bumper sticker produced by pro-abortion groups says: “Against abortion?     Don’t have one.” That slogan always ignored the unborn child, who has no opportunity to choose not to “have one.” But now women and doctors may join  the child in having their choice disregarded, unless pro-life legislators are vigilant.

Against abortion? If you’re in China, have one anyway. If you’re a health professional in the U.S., perform one anyway. Oddly, that is now what being  “pro-choice” is all about.