Personal Opinions and Ideology, Not “Science”

From Conscience and its Enemies: Confronting the Dogmas of Liberal Secularism

Robert P. George*

On September 11, 2008, the President’s Council on Bioethics heard testimony by Anne Lyerly, MD, chair of ACOG ‘s Committee on Ethics. Dr. Lyerly appeared in connection with the council’s review of her committee ‘s opinion (No. 385) entitled “Limits of Conscientious Refusal in Reproductive Medicine.” That opinion proposes that physicians in the field of women’s health be required as a matter of ethical duty to refer patients for abortions and sometimes even to perform abortions themselves .

I found the ACOG Ethics Committee ‘s opinion shocking and,  indeed, frightening. One problem was its lack of regard – bordering on contempt , really – for the sincere claims of conscience of Catholic, Evangelical Protestant , Orthodox Jewish , and other pro-life physicians and health-care workers. . .[Full text]

What role does Conscience play in Medical Ethics?

  • D. Vincent Twomey, SVD* | . . . conscience is assumed to be a purely subjective thing, a personal preference . . .that is fundamentally irrational. . . The sincerity of those who hold a subjective view of conscience is not in doubt. But is it enough? More importantly, what is wrong about that all-pervasive contemporary understanding of conscience? For the rest of this paper, I will concentrate on such a misunderstanding in the hope of clarifying what conscience in fact is. . . Full Text

Most Flemish physicians avoid euthanasia

Only 400 of 20,000 Flemish physicians are trained to provide euthanasia.  It appears that most physicians do not want to be directly involved with it.  In consequence, the 400 are called upon frequently to provide the required second opinion and sometimes the lethal injection.  There have been complaints that they are not paid for the second opinion. [Bioedge]  Confirming the reluctance of physicians to participate in the procedure, Dr. Sarah Van Laer complains that “there are too few doctors ready to perform euthanasia” and that this is a “badly underestimated problem.” [Bioedge]

Letter to General Medical Council (UK) re: conscientious objection to abortion

 Peter Saunders

When two Glasgow midwives won the right to opt out of supervising abortions last April I suggested that the General Medical Council (GMC) needed to revise its professional guidance on the matter which now seemed to be at odds with the law.

At the time Niall Dickson (pictured), the GMC’s chief executive, actually told the Guardian that the GMC would need to consider the implications of the judges’ decision on its guidance. He is quoted as saying:

We will study the outcome of this ruling, which has just come out, to see if there are any implications for our guidance. We already have clear guidance which says that doctors should be open with employers and colleagues so they can practise in accordance with their beliefs without compromising patient care.

As I have heard nothing further from the GMC about the matter, and almost two months have passed, I have today written to Mr Dickson to ask what is happening. [Full text]

 

Redefining the practice of medicine – Part 3

Winks and nods and euthanasia in Quebec

Re:  Bill 52: An Act respecting end-of-life care (June, 2013)

Sean Murphy*

Part 3: Working in the MAD matrix

Abstract

“Medical aid in dying” in Bill 52 (An Act respecting end-of-life care) will be transformed into euthanasia using the structures and powers established by other Quebec statutes governing the delivery of health care. These laws have established a multi-layered and overlapping bureaucracy. If Bill 52 passes, health care providers and others who want no part of euthanasia will find their working environments increasingly controlled by a MAD matrix functioning within this system.

The Minister for Social Services and Youth Protection may issue “policy directions” about euthanasia. Health care in every region in Quebec is delivered under the direction of a regional health and social service agency. In addition, local health and social services networks have been established. These will be expected to provide or facilitate euthanasia.

Almost all local community service centres, hospital centres or residential and long-term care centres will be required to offer euthanasia, as will rehabilitation centres, which serve developmentally disabled patients. Palliative care hospices and hospitals are not required to do so. Physicians associated with private health care facilities must not provide euthanasia unless authorized by a local health authority.

Policies, standards, codes of ethics, protocols, guidelines, directives, etc. can be used to normalize euthanasia, and disciplinary and complaints procedures can be used to force participation in it. Local complaints commissioners, the Health and Social Services Ombudsman and syndics (investigators) for professional orders could create considerable difficulty for objecting physicians.

Under Quebec’s Professional Code, the Physicians’ Alliance for Total Refusal of Euthanasia, the Euthanasia Prevention Coalition and other groups that oppose euthanasia might face substantial fines if they persist in encouraging or advising physicians not to participate in the procedure.

Physicians may refuse to provide euthanasia if the patient is legally ineligible, and for other reasons, including conscientious objection. Section 30 of the bill should be amended to avoid unnecessary conflict with objecting physicians. Section 44, the provision specific to conscientious objection, is inadequate. Further, patients may lodge complaints against physicians who refuse to provide or facilitate euthanasia with institutions and the regulatory authority, regardless of the reasons for refusal.

Despite the promise of immunity, some Quebec physicians may be unwilling to provide euthanasia while the criminal law stands, even if they do not object to the procedure. Similar reluctance might arise in regional health agencies, councils of physicians or other entities responsible for issuing MAD guidelines. Some might deliberately and obstinately interpret “medical aid in dying” to exclude killing patients, on the ground that the Act does not explicitly require or permit euthanasia, and the criminal law precludes such an interpretation.

Finally, objecting physicians might be able to appeal to the Public Protector, who is empowered to intervene “whenever he has reasonable cause to believe that a person or group of persons has suffered or may very likely suffer prejudice as the result of an act or omission of a public body.” [Full commentary]