Tag: referral

World Medical Association and unethical “participation”

Those who, for reasons of conscience, refuse to facilitate morally contested procedures by referral or other indirect means should take note of the World Medical Association’s reaffirmation of its position against physician “participation” in executions, which now includes a statement that physicians must not facilitate executions by importing drugs for executions.  Similarly, the British group, Reprieve, has embarked upon a campaign to have drug companies sign a Pharmaceutical Hippocratic Oath against the use of their products in executions.  [Bioedge]

 

Irish panel of appointees recommends compulsory referral for abortion

In a long-awaited report, a panel appointed by the Irish government to study the operation of the abortion law in Ireland has stated the government is obliged to provide guidelines that establish how women in Ireland can obtain abortions consistent with Irish law.  It recommends that a physician who objects to abortion for reasons of conscience should be forced to facilitate the procedure by referring a patient to a willing colleague, and to provide an abortion “when the risk of death is imminent and inevitable.”  The report is not clear on the extent to which conscientious objection might be allowed to other health care workers.  [Report, p. 42, 6.9]

World Health Organization demands referral for abortion

Safe Abortion: Technical and Policy Guidance for Health Systems, a newly revised publication of the World Health Organization, claims that objecting health care workers have an ethical responsibility to refer patients for abortion, or to provide abortions if referral is not possible.  (Sec. 3.3.6, p. 69, Box 3.2,p. 73).  It also claims that conscientious objection without referral is a barrier to health care and that referral is a legal obligation under human rights law.  Chapter 4 of the text, which is the basis for these demands, was revised under the guidance of the Programme on International Reproductive and Sexual Health Law in the Faculty of Law at the University of Toronto, Toronto, Canada (p. 11).  Two professors from this faculty, Rebecca Cook and Bernard Dickens, have been making such claims for years.  They have, in the past, seriously misrepresented the law on this point in an effort to make referral for abortion mandatory.  (See Postscript for the Journal of Obstetrics and Gynaecology Canada: Morgentaler vs. Professors Cook and Dickens, and Conscientious Objection as a Crime Against Humanity.)   The WHO document has been reviewed and criticized by Susan Yoshihara of the Catholic Family and Human Rights Institute, but awaits a critique by medical and legal professionals.

Polish law and conduct of Polish physicians, clergy, activists and authorities leads to adverse judgement

Sean Murphy*

The European Court of Human Rights has issued a judgement adverse to freedom of conscience and ordered Poland to pay two complainants, a mother and daughter, a total of 61,000 Euros in damages and costs.  Subject to the possibility that the English translation of the judgement is faulty, the use of the term “anti-choice activist” by the judges brings their impartiality into question.  However, the facts of the case outlined in the judgement suggest that the conduct of Polish health care personnel, anti-abortion activists, clergy and state authorities effectively guaranteed an adverse outcome.

A 14 year old girl, P. supported by her mother, S.,  sought an abortion for a pregnancy alleged to have been the result of a rape.  While she obtained the necessary prosecutor’s certificate for the procedure, mother and daughter received contradictory information from two public hospitals in Lublin.  Further, health care personnel clearly violated principles of patient confidentiality and informed consent in an effort to dissuade the girl from having an abortion.  These violations included clearly coercive and manipulative tactics.  P and S experienced

  • the intervention of a priest and anti-abortion activists, unsolicited and unwanted,
  • importuning by anti-abortion activists that included confrontations in public,
  • national media attention, including a press release issued by a hospital concerning P,
  • detention and six hours of questioning by the police,
  • apprehension of the girl by state authorities, apparently for the express purpose of preventing the abortion,
  • posting on internet by the Catholic News Agency of the girl’s travel to Gdansk for an abortion,
  • the filing of criminal charges against the girl for having had unlawful sexual intercourse with a minor (i.e., the rape that resulted in pregnancy)

While the court found that objecting physicians had a legal obligation to refer patients for abortion, the source of that legal obligation was Polish law.  Article 39 of Poland’s Doctor and Dentist Professions Act imposes a legal obligation of referral.  The imposition is objectionable in principle, but the European Court of Human Rights can hardly be criticized for applying Polish law to Polish citizens.

American Academy of Family Physicians supports freedom of conscience

The American Academy of Family Physicians (AAFP) passed a resolution at a meeting in Philadelphia supporting freedom of conscience for physicians.  Resolution 507 (Physician Conscience Protection Rights) was proposed by the Florida chapter as a result of concerns about freedom of conscience generated by federal health care reforms.  The Congress of Delegates agreed that hysicians should be able to practise in accordance with their conscientious convictions, “without resulting in loss of licensure or significant financial penalty.”  Current policy of the organization is that physicians who are “uncomfortable” providing contraception should refer patients to colleagues willing to provide “the education and/or service.”  [MedPage Today]