Tag: participation

Physician warns of threat to freedom of conscience in Ireland

The Irish Times

Andrew O’Regan

Sir, – I have a number of concerns relating to conscientious objection and abortion.

The recently published heads of Bill define termination of pregnancy as “a medical procedure which is intended to end the life of the foetus”.

If the referendum is passed, this is the procedure that will be available on demand for any reason up to 12 weeks and after 12 weeks on vague health grounds.

First, it is of great worry to Irish practitioners that doctors, nurses and midwives cannot avoid participation in abortion in an increasing number of jurisdictions, including Sweden, Iceland, Finland and Bulgaria.

Second, in the UK supreme court, two midwives lost their battle to be treated as “conscientious objectors”, and to be excused from participating in abortions.

The midwives were told that while they could refuse to carry out the procedures themselves, they were obliged to delegate these duties to other staff and to supervise the staff during the abortions.

Many doctors and nurses consider that if their conscience prevents them from intentionally ending the life of the foetus, they should not be required to supervise and organise this same act.

The legislation proposed if the Eighth Amendment is repealed will oblige GPs and other healthcare professionals who conscientiously object to transfer care to another doctor and to inform the patient in writing that they may seek review of the objecting doctor’s decision.

Third, in 2013 a resolution to restrict the right of doctors and nurses to conscientious objection was narrowly defeated in the European Parliament. Some Irish MEPs voted for this. In the recent Dáil debates some politicians argued against a doctor’s right to avoid participation in abortion.

We have seen how one political party expelled a number of members for voting with their consciences in 2013 and how another party suspended one of the youngest female TDs in Dáil Éireann for exercising her conscience in a vote last month.

Fourth, some academic campaigners have been arguing for the removal of conscientious objection across Europe, claiming that it can be used as a “subtle method for limiting access to abortion”.

Finally, under Minister for Health Simon Harris’s plans for abortion, GPs and others will not be entitled to conscientiously object to participating in the intentional destruction (not delivery) of the foetus where there is a risk to the life or health of the patient in an emergency.

No evidence has been produced to show that intentional destruction of the foetus is necessary to avoid risks to the life or health of a pregnant patient.

I would urge GPs and our colleagues from other disciplines who are also in the front line of patient care to inform themselves fully of the implications for the practice of medicine should this referendum be passed. – Is mise,

Dr ANDREW O’REGAN,

(General Practitioner and Senior Lecturer),
Killarney,
Co Kerry.

No legal “duty to refer” for euthanasia or assisted suicide anywhere in the world

 

Maurice Vellacott, MP
Saskatoon-Wanuskewin

For Immediate Release

OTTAWA – In anticipation of the possible striking down of Canada’s laws against euthanasia and assisted suicide (pending the Supreme Court’s decision in the Carter case), and given the College of Physicians and Surgeons of Ontario’s (CPSO’s) draft policy “Professional Obligations and Human Rights” [i] which, if passed, would require Ontario physicians to make referrals for controversial medical procedures regardless of their conscientious/religious convictions, Member of Parliament Maurice Vellacott today issued the following statement:

I am deeply concerned about the assault on the fundamental freedoms of Ontario’s doctors should CPSO’s policy forcing doctors to make referrals for morally objectionable “treatments” pass. If the Supreme Court of Canada strikes down Canada’s current laws on euthanasia or assisted suicide, then CPSO’s policy would mean Ontario’s physicians would have a “duty to refer” patients for treatments intended to kill the patient.

From the research I have conducted, with the help of the Library of Parliament, I have learned there is not a single jurisdiction in the world that forces doctors to violate their consciences through mandatory referrals for these life-ending “treatments.” (See attached list of laws in jurisdictions which have legalized euthanasia or assisted suicide.)

We all recognize it is criminally wrong to aid or abet the commission of a criminal act.[ii] In the same way, it would be morally wrong for a doctor to aid or abet (i.e. through referral) the commission of what that doctor deems to be an immoral act – in this case, intentionally killing, or assisting in the killing of, their patient. Following one’s conscience in the provision of euthanasia or assisted suicide, then, entails making a conscientious decision not only about performing euthanasia or assisted suicide, but also about making referrals for them.

The Canadian Medical Association has long been a defender of a physician’s freedom to abstain from being involved in morally objectionable procedures. Last August, the CMA clearly expressed its support for physicians’ freedom of conscience in the provision of euthanasia and assisted suicide should those acts ever be legalized.[iii]

In spite of no jurisdiction in the world imposing on physicians a legal duty to refer for euthanasia or assisted suicide, and in spite of the support for freedom of conscience by the national medical organization representing Canada’s physicians, we have the regulatory body in Ontario poised to punish physicians who act upon their moral guidance system that tells them that killing their patients is wrong.

Over the years, there have been repeated attempts by activists and special interest groups to impose their version of morality on all health care workers (almost succeeding in 2008 to convince CPSO to impose mandatory referral, until a loud public outcry from right across the country compelled CPSO to reverse course.) Such was the threatening climate that compelled me to introduce several private members bills, in successive Parliaments, that would protect health care workers who had conscientious objections to being involved in practices that deliberately take human life.

If the Supreme Court strikes down our laws against assisted suicide/euthanasia, then it will be up to Parliament to come up with a new law. It is clear from CPSO’s actions that we can’t leave it to the regulatory bodies to protect freedom of conscience. Any new law to regulate these life-ending medical procedures will need to include explicit protection for those health care workers who won’t take part in any action that aids or abets the killing of their patients.

– 30 –

For further information and comment, call (613) 992-1966 or (613) 297-2249; email: maurice.vellacott.a1@parl.gc.ca

Notes

[i] http://policyconsult.cpso.on.ca/wp-content/uploads/2014/12/Draft-Professional-Obligations-and-Human-Rights.pdf

[ii]http://laws-lois.justice.gc.ca/eng/acts/C-46/FullText.html

  1. (1) Every one is a party to an offence who
  • (a) actually commits it;
  • (b) does or omits to do anything for the purpose of aiding any person to commit it; or
  • (c) abets any person in committing it.

[iii] “Medical Association vows to protect conscience rights,” by Michael Swain, The Catholic Register, August 27, 2014, http://www.catholicregister.org/item/18703-medical-association-vows-to-protect-conscience-rights;  and Resolution adopted by General Council at 2014 AGM: “The Canadian Medical Association (CMA) supports the right of all physicians, within the bounds of existing legislation, to follow their conscience when deciding whether to provide medical aid in dying as defined in CMA’s policy on euthanasia and assisted suicide.” (https://www.cma.ca/Assets/assets-library/document/en/GC/Final-Resolutions-GC-2014-Confirmed-Nov-2014.pdf )

Conscientious objection to abortion: Catholic midwives lose in Supreme Court

UK Human Rights Blog

The Supreme Court recently handed down its judgment in an interesting and potentially controversial case concerning the interpretation of the conscientious objection clause in the Abortion Act 1967. Overturning the Inner House of the Court of Session’s ruling, the Court held that two Catholic midwives could be required by their employer to delegate to, supervise and support other staff who were involved in carrying out abortion procedures, as part of their roles as Labour Ward Co-ordinators at the Southern General Hospital in Glasgow.

We set out the background to the case and explained the earlier rulings and their ramifications on this blog here and here. The key question the Supreme Court had to grapple with the meaning of the words “to participate in any treatment authorised by this Act to which he has a conscientious objection” in section 4 of the 1967 Act.

The disappearing Article 9 argument

Somewhat frustratingly (at least from the perspective of the writers of a human rights blog!) an argument based around Article 9 of the European Convention – the right to freedom of thought, conscience and religion – was not really dealt with by the Supreme Court, despite having been trailed in the earlier court proceedings. Lady Hale JSC, who wrote the judgment with which the other Supreme Court Justices agreed, described the point as a “distraction” . . . [Full text]

 

Canadian doctors preparing for ‘all eventualities’ in case top court strikes down ban on assisted suicide

National Post

Sharon Kirkey

The nation’s largest doctors’ group is quietly preparing for possible changes in federal laws governing physician-assisted death, as support among its own members for medical aid in dying grows.

The Canadian Medical Association has consulted medical associations in jurisdictions around the world where euthanasia or assisted suicide is legal to devise possible protocols for Canada if the federal law is changed.

The powerful doctors’ lobby says it would be naïve not to prepare for “all eventualities” as the country awaits a Supreme Court of Canada ruling over whether the federal prohibition outlawing assisted suicide is unconstitutional.

“I think we’re looking at the possibility that the court will refer this back to the lawmakers,” said Dr. Jeff Blackmer, the CMA’s director of ethics.

The Supreme Court could strike down Canada’s ban on assisted suicide and give Parliament one year to craft new legislation, as it did with prostitution.

“They could suggest some framework from the bench that we might want to be in a position to comment on fairly quickly. Or there could be a long period for reflection and committee hearings that we would want to be prepared for,” Blackmer said. “We’re preparing for all eventualities, and that [a lifting of the ban] is absolutely one of them.”

If there is a change in law, Blackmer said doctors opposed to physician-assisted death “will be looking to us for protection of their conscience and their right not to participate.” . . . [Full text]

 

Proposed policy of Ontario College of Physicians “appalling”

Medscape

Reproduced with permission of the author

Dr. Terence McQuiston, M.D.

Dr. Gabel is not alone in this opinion, but I find it nevertheless appalling. Ever since Hippocrates medical ethics were determined by our profession independently of government legislation (including human rights tribunals). We Canadians stood in judgement at Nuremberg over the German physicians of the Nazi period.

Their defense was that they had done nothing outside of the law (true). However, we took the view that ethics transcend and should inform legislation, not the other way around, and therefore we could hold them to account for their deeds.

Such transcendence of ethics is only possible by the exercise of conscience by all physicians. Granted there may be differences arising from this exercise, but we should do our best to accommodate these differences.

That’s why we permit conscientious objection in wartime. Individual conscience is too precious a part of our social fabric to be casually overridden. The policy defended by Dr. Gabel in effect puts conscience on ice. If euthanasia becomes legal, I for one still won’t do it.

This comment responds to the Medscape article “Doctors opposing draft abortion policy may need to rethink whether family practice is right for them, says CPSO official: Direct referrals a sticking point in Ontario’s human rights policy (17 December, 2014)  Dr. Marc Gabel was quoted to the effect that physicians unwilling to provide or facilitate abortion and contraception should not practice family medicine. Administrator