Protection of Conscience Project News
Service, not Servitude
Calgary Herald
They’re the forgotten ones in the heated debate over assisted suicide — the doctors.
Up until now, discussion of the issue has focused exclusively on patients. However, a new Canadian Medical Association survey that shows only about one-quarter of doctors would be willing to participate in an assisted suicide should act as a warning to all. Suddenly, the doctors’ perspective comes into plain view — doctors do not want to help kill people.[Full text]
Calgary Herald
Just 26 per cent of doctors surveyed by the Canadian Medical Association said they would be “very or somewhat likely” to participate in doctor-assisted dying.
Only one quarter of the nation’s doctors would be willing to help terminally ill patients end their lives if the practice of doctor-assisted suicide were legalized in this country, a survey by Canada’s biggest doctors’ group suggests.
Just 26 per cent of doctors surveyed by the Canadian Medical Association said they would be “very or somewhat likely” to participate in doctor-assisted dying, while 54 per cent were “very or somewhat unlikely” to do so, according to a summary of the survey posted on the CMA’s website. [ Full text]
Reproduced with permission
The fight over conscientious objection to abortion has moved from the evening news to the academic journals. In the April issue of the American Journal of Public Health, two defenders of reproductive rights outline strategies to restrict abortion rights. They complain that “unregulated conscientious objection” seems to be growing, especially in countries where opposition to abortion is strong.
In a SSRN paper which is yet to be published, Lachlan De Crespigny, an Australian doctor writing from Oxford, and two academics from Monash University fiercely defend a recent law in the state of Victoria which forces doctors to refer for abortion. “The unregulated use of conscientious objection impedes women’s rights to access safe lawful medical procedures,” they write. “As such, we contend that a physician’s withdrawal from patient care on the basis of conscience must be limited to certain circumstances.”.
They contend that arguments in support of conscientious objection are often a smokescreen for imposing Catholic dogma. But women who conscientiously desire abortions also have rights. “The choice of abortion is in many cases the morally responsible decision that should not be overridden by the imposition of another’s conscience.”
A recent paper in the Journal of Bioethical Inquiry by two Canadians, a doctor and a lawyer, tries to make some philosophical distinctions which make conscientious objection to abortion more plausible. They distinguish between “perfective” and “preservative” freedom of conscience. The former is exercised in the pursuit of a perceived good. This must often be limited. The latter is more fundamental and cannot legitimately be coerced except in the most exceptional circumstances.
“If the state can legitimately limit perfective freedom of conscience by preventing people from doing what they believe to be good, it does not follow that it is equally free to suppress preservative freedom of conscience by forcing them to do what they believe to be wrong. There is a significant difference between preventing someone from doing the good that he/she wishes to do and forcing him/her to do the evil that he/she abhors.”
It could be argued that an ethics committee, or an institution or a government assumes the moral responsibility for a coerced decision. But this does not take into account the well-documented guilt and shame felt by concentration camp survivors who were forced to participate in heinous crimes. “When it is suppressed by coercion, the result is the kind of spiritual rape suffered by those victims of the camps who were forced to do what they believed to be wrong.”
Abstract:
Two recent research papers based on a 2011 survey of physicians providing abortion in British Columbia assert that “rural abortion services are disappearing in Canada.” However, what the papers contribute to an understanding of the “barriers” to abortion services in rural British Columbia is doubtful, for two reasons. First: the analytical structure proposed (the urban-rural dichotomy as defined by the authors) is inadequate. Second: the authors ignore the significance of an important variable: the nature of the facilities or institutions where abortions are performed. Concerns expressed about “access” to abortion are frequently accompanied by demands that freedom of conscience for health care workers should be suppressed. Given the weaknesses noted above, the authors would have been hard-pressed to justify such a suggestion. To their credit, they do not do so.
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Dr. Joseph Lee, a physician in Blenheim, New Zealand, has been criticized by abortion activists because he refused to prescribe contraceptives for a 23 year old patient. Dr. Lee practises at the Wairau Community Clinic. A pamphlet in the reception area advises patients that some of the clinic’s physicians will not prescribe contraceptives, and staff attempt to direct patients accordingly. The clinic leader may consider installing a sign to minimize further conflicts.
Dr. Lee identifies himself as a Catholic, but is reported to have said that he would be willing to prescribe the birth control pill to a woman who was spacing children or had had at least four children. That is not consistent with the teaching of the Catholic Church on the subject, and it is an unusual position among health care workers who object to providing contraception.
The Abortion Law Reform Association NZ (ALRANZ) wants the General Medical Council to force objecting physicians to refer patients or otherwise assist them to obtain morally contested services. The president of ALRANZ, Dr. Morgan Healey, claims that a High Court decision in 2010 has made the question of referral legally ambiguous. [New Zealand Herald]
However, Justice Alan MacKenzie of the High Court in Wellington, New Zealand,unambiguously ruled that New Zealand’s Contraception, Sterilisation and Abortion Act protected objecting physicians, and that the General Medical Council could not force them to refer abortion. All that is required of a physician who objects to abortion is to decline to begin the process and inform his patient that she may obtain the procedure from another practitioner. The protection of conscience provision states that objecting health care workers are not obliged “To fit or assist in the fitting, or supply or administer or assist in the supply or administering, of any contraceptive, or to offer or give any advice relating to contraception.” The ruling was the result of litigation by the New Zealand Health Professionals Alliance, which, earlier this year established a website to support freedom of conscience for health care workers.