Amid a flurry of activity and controversy with the incoming Biden administration, there was still a major victory for religious freedom and conscience protection last week.
On Jan. 19, a federal court, citing the Religious Freedom Restoration Act, upheld conscience protections for physicians and struck down the transgender mandate that ordered doctors to perform transgender interventions when doing so violated the provider’s sincerely held religious beliefs.
The case, Sisters of Mercy v. Azar, is hardly well-known, but no less newsworthy. The plaintiffs are an order of Catholic nuns, a Catholic university, and Catholic health care organizations. They sued the government, challenging Section 1557 of the Affordable Care Act, which forced doctors to perform transgender interventions against their sincerely held religious beliefs or even sound, medical advice. . . [Full text]
Bill C-7, passed by the House of Commons and now in front of a Senate committee, raises even more ethical challenges than the original legislation. Doctors who object should not be compelled to support it.
Ottawa Citizen
Thomas Bouchard, Ramona Coelho, Leonie Herx
Bill C-7 is changing the landscape of Canadian medicine. With this legislation, the federal government is expanding medically administered death (MAiD) to individuals not at end of life and with no requirement for MAiD to be a last resort in patient care. Under Bill C-7, a patient with a chronic illness or disability could receive MAiD when therapeutic options for care that could alleviate suffering have not been provided.
While some physicians may decide to aid in ending the life of their patient who is not dying, what will become of physicians who do not believe that administering death is good medicine?
Professional medical opinions are rooted in extensive medical knowledge, years of training and practice, and an individual practitioner’s conscience. It is our conscience that navigates us through the ethics necessary for providing each patient with the best medical advice for a given situation.
Medicine is not a department store. Our role is not to check the storeroom to see if we have the display item you like in the size and colour you desire. . . [Full text]
BIID is a rare psychiatric condition in which people know that their leg (for instance) is normal and healthy, but still feel that it is not part of their identity; they want it cut off, even though they realise that they will become disabled. Oddly enough, however, they often do not seem to mind wearing a prosthesis to recover some of the limb’s functionality.
In a provocative article in The New Bioethics, Richard Gibson, of the University of Manchester Law School, in the UK, asks whether ultimately there would be anything wrong with BIID if a prosthesis provided equal or better functionality. . . [Full text]
The illustration for the editorial of the January issue of the AMA Journal of Ethics comes from the “doctor’s trials” at Nuremburg in 1947. A young and sullen-looking young woman wearing earphones stands between two helmeted soldier in the dock. She is Dr. Herta Oberhauser, the only woman in the trials, and she was being sentenced to 20 years imprisonment (of which she served only five) for crimes against humanity. She experimented on women at the Ravensbruck concentration camp – deliberately creating gangrenous wounds to test the efficacy of sulpha drugs. She also gave lethal injections to several of her patients.
Oberhauser was one of the small fry amongst the Nazi doctors and nurses who committed medical atrocities before and during World War II.
The journal’s special issue is intended to help doctors not to forget what can happen if healthcare workers misuse their special skills and status. Surprisingly, the editors say that many American doctors are unaware that bioethics arose from the experience of the Nuremburg trials.
the historical impact or resonance of the Holocaust in bioethics has generally been at a low frequency in the United States. This painful history has largely been overlooked in American medical education, perhaps because to examine it closely one must first disturb the comfortable view of our nation and our profession as entirely heroic actors in the Second World War.
They argue that the year 2020, with the Covid pandemic and the Black Lives Matter demonstrations, has shown American doctors that they, too, need to be aware of dark corners of medicine in their own country.
it became widely recognized as problematic—and not just in the United States—to view medical professionals as purely altruistic, color-blind healers, blameless in creating and sustaining health care systems that predictably and consistently generate racial and ethnic health disparities.
The medical history of the Holocaust remains relevant – and essential – in a sound medical education.
[P]erhaps the year 2021 will become the year in which every health professional training program awakens to the fact that health sciences students (and practitioners) must learn about and reflect upon the historical roles of health professionals in creating both the atrocities of the Second World War and the different but related atrocities of racial injustice that we witness today. After all, these legacies are deeply entwined. Our profession’s involvement in providing the pseudoscientific foundations that supported ethnic and racial violence during the Second World War cannot be disentangled from the history of scientific racism and its ongoing, powerful, and pervasive influence on the world today.
This article is published by Michael Cook and BioEdge under a Creative Commons licence. You may republish it or translate it free of charge with attribution for non-commercial purposes following these guidelines. If you teach at a university we ask that your department make a donation to BioEdge. Commercial media must contact BioEdge for permission and fees. Some articles on this site are published under different terms
It is a truth universally acknowledged that defending an opinion on abortion will make at least half of one’s readers unhappy. But Joona Räsänen, a Finnish bioethicist at the University of Oslo, defends an opinion on abortion in the Journal of Medical Ethics which is bound to make all of them unhappy.
He tackles the controversial question of foetal reduction: killing one or more foetuses in a multiple pregnancy. This may happen when one of them is diseased or has a birth defect or when the mother feels incapable of caring for more than one child. It often happens after IVF when a woman ends up with triplets or quadruplets – or even octuplets. Some doctors have refused to “reduce” the pregnancies because they regard it as immoral. . . [Full Text]
