Australia launches inquiry into safety and ethics of transgender medicine

BioEdge

Michael Cook

A national inquiry into the safety and ethics of transgender medicine will be conducted by the Royal Australasian College of Physicians with the backing of Federal Health Minister Greg Hunt.

At the moment there are no nationally agreed standards, although guidelines issued by Melbourne’s Royal Children’s Hospital gender clinic have been referred to as the “Australian standards”. However, this document, which has been described as the “most progressive” in the world by Victoria’s Minister for Health, has not been approved by the National Health and Medical Research Council.

The RCH model commits doctors to the controversial policy of reducing“mental illness in trans and gender diverse children by affirming and protecting their identity in a world where many judge and hurt them”.

According to an exclusive article in The Australian about the inquiry, “Critics say the 2018 standards encourage risky medical treatment without properly considering safer therapies such as counselling for problems such as depression, anxiety, autism spectrum disorder, bullying and family conflict. The RCH standards overplay evidence for medical treatment and downplay risks, say ‘dissident’ clinicians.”

The opposing sides of the debate over transgender Australian youth differ on fundamental issues.

Michelle Telfer, director of the Royal Children’s Hospital Gender Service in Melbourne, told The Australian that commencing medical intervention as young as 13 or 14 was “not at all controversial within those with expertise because we all know that we have been doing this for years”.

Critics question whether gender dysphoria is really understood.

“Far be it from anybody to say that there are absolutely no people in the world who are genuinely gender dysphoric and who find it impossible to live in their biological sex,” said Dr Dianna Kenny, a psychologist. “What I’m saying is it’s been massively and irresponsibly over-diagnosed … (these children and teens) are going to be irrevocably damaged by the treatment they received.”

And the ethics of irreversible medical treatment have not been settled. “Who gave ethics approval for this treatment (at children’s hospitals) when it lacks any scientific basis and therefore is an experiment?” asks Prof John Whitehall, of Western Sydney University. “We should give the psychiatry and psychology a full run before we start castrating children.”


Australia launches inquiry into safety and ethics of transgender medicineThis 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.

David Seymour hits back at National MP seeking ‘protections’ for institutions over euthanasia

News Hub

Zane Small

David Seymour, whose proposed assisted dying law is going through Parliament, has hit back at a National MP asking for institutions like hospices to have the right to conscientiously object. 

Seymour, leader of the ACT Party, responded by saying his End of Life Choice Bill “doesn’t require any organisation to do anything other than the Ministry of Health”. 

“You can’t really be exempted from something you’re not required to do in the first place, but that seems to be what they’re asking for,” he told Newshub. . . [Full text]

Drafting error in abortion bill

Eternity

John Sandeman

The “Reproductive Health Care Reform Bill 2019 – which decriminalises abortion in NSW – has a drafting error in it, according to Freedom For Faith‘s Michael Kellahan.

The drafting error makes the “conscientious objection” provision in the bill much less effective, despite being designed to protect medical practitioners who do not wish to be involved in abortion.

The effect is that the protection is not operative where the pregnant woman herself asks for a termination of the pregnancy. . . [Full text]

Defending freedom of conscience on emergency contraception

CMF Blogs
Reproduced with permission

Philippa Taylor*

The UK’s biggest abortion provider, British Pregnancy Advisory Service (BPAS), has attacked pharmacists who do not sell the ‘morning-after pill’ for conscience reasons. 

After one incident when a pharmacist would not dispense emergency contraception to a woman for ‘personal’ reasons, BPAS condemned both the pharmacist and the conscience protections provided to pharmacists. A petition was set up to prevent pharmacists from claiming freedom of conscience rights. 

Under the current law, covered by guidance from the General Pharmaceutical Council (GPhC), pharmacists with a genuine conscientious objection to selling the pill may refer the customer to another pharmacist.

However, BPAS complained that it is ‘impossible to overstate the significance of even one pharmacist conscientiously objecting to selling the morning-after pill’. 

Fortunately, the General Pharmaceutical Council, in this case, upheld its guidelines and the consequent media coverage has now died down, temporarily at least.

This may seem like a one-off minor incident, but it is an illustration of increasing pressures on freedom of conscience protections. It is often assumed that the role of the conscience in medicine is relevant only to a few specialised and limited areas such as contraception or abortion, but in fact, the concept of the conscience goes right to the heart of what it means to act in a moral way, to act with integrity.

If we do not stand by those who are under pressure, the problems will only get worse and will spread. A well-known quote, often attibuted to Burke though it may have come originally from J S Mill, warns: ‘He should not be lulled to repose by the delusion that he does no harm who takes no part in public affairs. He should know that bad men need no better opportunity than when good men look on and do nothing.’

The Christian Medical Fellowship (CMF) has therefore written to the General Pharmaceutical Council to ensure they are aware of our concerns and to thank them for holding to their guidance. The text of our letter is as follows, with their response after it:

‘I am writing to you following the recent news coverage of a Lloyds pharmacy worker who, according to news reports, conscientiously objected to selling the morning-after pill and directed a customer to another pharmacy instead. I note that a petition has since been set up to prevent pharmacists from claiming conscientious objection rights.

‘The Christian Medical Fellowship is the UK’s largest faith-based group of health professionals and we contributed with both written and oral evidence to your review of your Guidance on Religion, Personal Values and Beliefs. We publicly welcomed the new Guidance and the statement accompanying it, in which the Chief Executive of the General Pharmaceutical Council highlighted the positive contribution that pharmacists’ faith can make in their provision of care. We also welcomed the clear statement that: “Pharmacy professionals have the right to practise in line with their religion, personal values or beliefs”.

‘We all aspire to person-centred care. In any care scenario, there are (at least) two parties – the carer and the one receiving care – each of whom has rights. The General Pharmaceutical Council guidance helpfully achieves a balance between the patient’s right to service access and the pharmacist’s right to freedom of conscience.

Respect for the sincerely held religious and moral beliefs of employees is essential and we are concerned that some of the demands being made, based on this one recent case, would marginalise the beliefs, values and religion of pharmacists disproportionately and unnecessarily, and trivialise their right to freedom of conscience under the law. Despite widespread coverage of this case, we have yet to see evidence of recurring complaints under the present provisions.

‘While we strongly support the right to freedom of conscience for pharmacists, we do also emphasise the importance of openness and sensitive communication with colleagues and employers; any refusal to supply should be made courteously and sensitively.

‘On behalf of CMF, I want to thank the Council for protecting the right of pharmacists to refuse to engage in certain procedures that violate their most profound moral convictions.

‘I also encourage the Council to continue to make it clear, publicly, that all pharmacy professionals have the right to practise in line with their religion, personal values or beliefs.

Yours faithfully

Dr Mark Pickering
Chief Executive, CMF

The General Pharmaceutical Council replied with the following two sentences:

‘Our existing guidance In practice: Guidance on religion, personal values and beliefs (to which you refer) remains in place. We have no current plans to review it. As you are aware, the guidance sits under our standards for pharmacy professionals and relates to standard 1, Pharmacy professionals must provide person-centred care.’

The point here is simple but vital: if we care about liberty and personal integrity, we must make a reasoned defence of it in the public square, from the smallest incident to the biggest.

WA’s take on assisted dying has many similarities with the Victorian law – and some important differences

The  Conversation

Ben White, Katrine  Del Villar, Lindy  Wilmott, Rebecca Meehan

Western Australia may soon become the second Australian state to permit voluntary assisted dying, with the release on Tuesday of its Voluntary Assisted Dying Bill 2019.

As in Victoria, whose law is now just under two months old, the bill was the product of reviews by a parliamentary committee and ministerial expert panel. It’s expected to be debated in the Western Australian parliament in three weeks.

So how does what’s being proposed compare to the law in Victoria? . . . [Full text]