Julian Savulescu, an ethicist at the University of Oxford, argues that the current practice of using prenatal screening and abortion to eliminate embryos suspected of having disabilities or diseases is akin to Nazi eugenic policies, which were also directed at eliminating the ‘unfit.’ He supports the use of prenatal testing to identify and destroy embryos with disease or disabilities as long as it is understood that this implies nothing about the moral status of disabled people, but argues that people should also be able to select for desirable characteristics, like intelligence or sex. His position is that “freedom of reproduction” can be restricted “for social purposes,” but only if the purposes are “uncontroversially good,” the restrictions are necessary, and that no less restrictive policies would be workable. [News Limited]
Category: Ethics
UN Human Rights Commission demands suppression of freedom of conscience
The UN Human Rights Commison has issued a document that purports to base the restriction or suppression of freedom of conscience among health care workers on human rights claims. Technical guidance on the application of a human rights based approach to the implementation of policies and programmes to reduce preventable maternal morbidity and mortality. Section 30 of the document calls for changing laws and policies that allow conscientious objection “to hinder women’s access to a full range of services.” Section 61 states that laws, polices and regulations that allow “unregulated conscientious objection” should be changed, and “newly established obligations of providers and rights of individual users should be disseminated.” The resolution was endorsed by New Zealand, Burkina Faso, and Colombia and enumerates access to abortion among “sexual and reproductive health rights.” 20 of the 47 council members opposed the text. The UN General Assembly will consider adopting it later in October. [CFAM]
Spanish physicians urged to disobey law on treating immigrants
According to a law that went into effect on 1 September, Spanish physicians may not provide health care for undocumented migrants except in cases of emergency, pregnancy, or delivery. The Spanish Society of Family and Community Medicine (SEMFyC), supported by the Spanish Medical Colleges, holds that the law is contrary to medical ethics and is advising physicians to become “conscientious objectors” to the law. [Hastings Center Bioethics Forum]
McGill University professor suggests new profession needed if euthanasia legalized
J. Donald Boudreau, Arnold P. Gold Foundation Associate Professor of Medicine at McGill University, has written a column protesting a decision by a B.C. Supreme Court judge to legalize physician assisted suicide and euthanasia. Dr. Boudreau argues that the decision, if upheld, would poison the practice of medicine. He closes with the suggestion that, if Canadians are willing legalize assisted suicide and euthanasia despite the concerns of palliative care physicians, responsibility for providing the services should be assigned to a new profession: euthanatrics. [Globe and Mail]
General Medical Council guideline criticized by Protection of Conscience Project
Unfair to impose “long-discredited policies of forced conversion and exclusion”
NEWS RELEASE
The Protection of Conscience Project has expressed concern that the state physician regulator in the United Kingdom intends to prosecute those who refuse to convert to the religious, moral or ethical systems it approves. If actual conversion is not required, it appears that by forcing physicians to do what they believe to be wrong as a condition of practising medicine, the regulator “may simply be resurrecting the Test Act in modern professional dress.”
The criticisms appear in a Protection of Conscience Project submission to the General Medical Council (GMC) of the United Kingdom in response to the draft GMC guideline Personal Beliefs and Medical Practice. The Project comments that “it would be unfair to impose on physicians long-discredited policies of forced conversion and exclusion that would be plainly unacceptable to other professions and to the people of the United Kingdom as a whole.”
The Project submission points out that it would be hypocritical for the GMC to discipline objecting physicians who refuse to refer for morally contested treatments, since they act on the same principles applied by the GMC in its policies on organ trafficking and assisted suicide. Strong exception is taken to the suggestion that physicians act like bigots if they refuse to facilitate adultery, premarital sex, and morally contested services like the mutilation or amputation of healthy body parts or the killing of human embryos or fetuses.
In other respects, the Project expressed qualified agreement with the provisions of Personal Beliefs and Medical Practice and identified parts of the guideline requiring clarification. Specifically, physicians
- should do their best to notify patients and employers in advance of treatments to which they object for reasons of conscience, though they cannot be expected to anticipate every possible conflict;
- should not refuse to provide treatment or care to a patient on the grounds that she has had a previous morally contested treatment;
- must be prepared to treat “the health consequences of lifestyle choices” with which they disagree or to which they object (though not to provide morally contested treatments);
- should disclose beliefs only when the disclosure is solicited by a patient, or when it is reasonable to believe that it would be welcomed by the patient;
- should limit discussion of beliefs to what is relevant to the patient’s care and treatment, taking into account the importance of dialogue that is responsive to the needs of the patient.
The Project cautioned the GMC that physicians should not be discplined or criticized for a conversation naturally arising from the disclosure of conscientious objection, since disclosure is required by its guidelines. It also warned that an adverse emotional response by a patient is not necessarily evidence of professional misconduct.