Freedom of conscience and nursing in Alberta

Sean Murphy*

Introduction

Nursing has often been described as a “caring profession.” For historical reasons associated with the development of nursing, it appears that most nursing guidance documents use the terms “care” or “nursing care” with respect to all nurse-patient interactions, including interventions or treatments ordered by attending physicians.

This puts objecting nurses at a rhetorical disadvantage. Objections are made to treatments or interventions, not to caring. However, in a nursing context this is more readily perceived or characterized as “refusing to care.”

The failure to distinguish between “care” and “treatment” can introduce uncertainty into guidance about conscientious objection, which, for example, may insist that an objecting nurse continue to provide “care” for a patient until relieved, without specifying that the care does not include the treatment or intervention to which the nurse objects…[Full text]

Physician freedom of conscience in Alberta

Sean Murphy*

Alberta has been identified by freedom of conscience advocates as providing a satisfactory model of accommodation that should be imitated across the country. In late 2019 the head of the Alberta Medical Association and sponsor of a controversial protection of conscience bill in the Alberta legislature agreed that existing protections were “appropriate and effective.” On the other hand, it has been reported that Alberta physicians are obliged to refer for morally contested services, including assisted suicide, which would be unacceptable to many objecting practitioners. The dissonant evaluations reflect differences between actual practice and two College policies that take different approaches to freedom of conscience…[Full text]

Physician freedom of conscience in Manitoba

Sean Murphy*

The MAiD Act

Manitoba is the only Canadian province with a stand-alone statute that protects health care professionals who refuse to provide services: the Medical Assistance in Dying (Protection for Health Professionals and Others) Act (MAiD Act).1

The MAiD Act is a procedure-specific law applying only to euthanasia and assisted suicide (EAS). It protects all regulated professionals who refuse to provide or “aid in the provision” of the procedures from professional disciplinary proceedings and adverse employment consequences because they have refused. They remain liable for other misconduct in relation to the refusal.

The Act protects those who refuse for any reason; refusal need not be based on any specific ground. Hence, it equally protects refusal for reasons of personal discomfort, distaste or fear and refusal based on moral or ethical objections. . . [Full text].

Medicine, morality and humanity

Sean Murphy*

Medicine is a moral enterprise.

Medicine, morality and humanityThe practice of medicine is an inescapably moral enterprise precisely because physicians are always seeking to do some kind of good and avoid some kind of evil for their patients. However, the moral aspect of practice as it relates to the conduct and moral responsibility of a physician is usually implicit, not explicit. It is normally eclipsed by the needs of the patient and exigencies of practice. But it is never absent; every decision concerning treatment is a moral decision, whether or not the physician specifically adverts to that fact.

This point is frequently overlooked when a physician, for reasons of conscience, declines to participate in or provide a service or procedure that is routinely provided by his colleagues. They may be disturbed because they assume that, in making a moral decision about treatment, he has done something unusual, even improper. Seeing nothing wrong with the procedure, they see no moral judgement involved in providing it. In their view, the objector has brought morality into a situation where it doesn’t belong, and, worse, it is his morality. . .  [Full Text]

Christian Medical Association Physicians Gain Support from Congress and States in Court Fight Against Discriminatory Firing

States and Members of Congress file brief supporting conscience rule protections

News Release

For immediate release

Christian Medical and Dental Associations (USA)

Washington, DC—May 26, 2020 – Christian Medical Association physicians (CMA*, www.cmda.org) received support from states, Members of Congress, minority groups, medical affiliate organizations, and legal experts who recently filed legal briefs in a case regarding a federal conscience protection rule for health professionals.

In New York v. HHS, CMA and Dr. Regina Frost are defending against attempts by states that want to discriminate against doctors and nurses who refuse to violate their consciences and medical judgment by performing procedures such as abortions or physician-assisted suicide. This case is now in the U.S. Court of Appeals for the Second Circuit.

CMA CEO Dr. Mike Chupp noted, “As a general surgeon who did patient care for over 30 years, my professional judgment has been based upon available medical evidence, training and experience, and a deep sense of obligation to care for my patients in a way that best benefits their health. The conscientious practice of medicine depends upon the integration of these factors by a healthcare professional. The informed conscience of every healthcare professional serves as an inner compass for the best kind of patient care. The HHS conscience rule affirms that our CMA members must be protected from violating their deeply held beliefs as they seek to serve all patients with excellence and compassion.”

CMA Senior Vice President for Bioethics and Public Policy and Obstetrician-Gynecologist, Dr. Jeffrey Barrows noted, “As an Ob-Gyn physician, I have delivered many babies of mothers and fathers who specifically sought a life-affirming physician for their care. The conscience rule not only upholds and enforces decades of federal law passed on a bipartisan basis; it also helps ensure that patients will have a choice of life-affirming physicians who match their values.

“All health care professionals must have the freedom to practice medicine without being forced to violate their conscience. The updated conscience rule released by HHS in 2019 ensures this freedom, establishing conscience protections for all health care professionals, regardless of faith background.”

Evidence indicates that conscience protections help ensure patient access to healthcare at a time of physician shortages nationally. National polling commissioned by CMA and conducted in 2019 by an independent polling firm found that while faith-based health professional respondents overwhelmingly said that they care for all patients regardless of agreement with patients’ choices, none of ten said that being required to violate their consciences would force them to leave the practice of medicine.

For more information on the court case and access to the amicus briefs, see https://www.becketlaw.org/case/new-york-v-hhs/.

For legal perspectives and attorney interviews, contact Ryan Colby: media@becketlaw.org, 202-349-7219.

*The Christian Medical Association serves approximately 19,000 members and, along with the Christian Dental Association, forms the Christian Medical & Dental Associations.