Tag: referral

Supreme Court of the United Kingdom to hear midwives’s case on 11 November

The Greater Glasgow Health Board has appealed to the Supreme Court of the United Kingdom to overturn a ruling that two midwives cannot be compelled to participate in abortions by delegating, supervising and supporting those involved in the procedures.  The case is to be heard 11 November, 2014.

The midwives’ legal costs have been in excess of £250,000 ($396,758 USD) to date.  The appeal is expected to cost them a further £130,000 ($206,314 USD). The Society for the Protection of Unborn Children is assisting with their legal costs and has appealed for donations.

Supreme Court of the United Kingdom

Greater Glasgow Health Board (Appellant) v Doogan and another (Respondents) (Scotland)

Case ID: UKSC 2013/0124

Issue

Judicial Review – Abortion – Conscientious objection – Midwives

Does s.4(1) of the Abortion Act 1967, which provides that “no person shall be under any duty… to participate in any treatment authorised by this Act to which he has a conscientious objection”, entitle a Labour Ward Co-ordinator to refuse to delegate to, supervise and/or support midwives providing care to patients undergoing termination procedures?

Facts

From the outset of their employment with the appellant health board, the respondent senior midwives, both Roman Catholics, objected to and were exempted from directly participating in the treatment of patients undergoing terminations. Following a service reorganisation, the numbers of abortions performed at the hospital where they worked increased. They sought confirmation from the appellant that they would not be required to delegate to, supervise or support other midwives providing care to such patients. The appellant declined to give this assurance, rejecting the respondents’ grievance and subsequent appeal. The respondents challenged the latter decision by way of judicial review, contending that it contravened s.4(1) of the Abortion Act 1967. They were unsuccessful at first instance but succeeded on appeal to the Inner House.

Judgment appealed

[2013] CSIH 36

Appellant

Greater Glasgow Health Board

Respondents

  1. Mary Teresa Doogan
  2. Concepta Wood

Interveners

  1. Royal College of Midwives
  2. British Pregnancy Advisory Service

 

 

The doctor who refused to abort

 Q&A | Bogdan Chazan lost his post heading a Polish government–run maternity hospital after he said his conscience prevented him from killing an unborn child

World Magazine

Daniel James Devine

Polish media outlets have been abuzz this summer with the story of Bogdan Chazan, a prominent Warsaw doctor who refused to provide a woman with an abortion and was subsequently sacked. . .

. . .The Polish doctor’s troubles began in April, when a pregnant woman wrote to his maternity hospital in Warsaw, the Holy Family Hospital, asking for an abortion. She said her personal physician had detected severe developmental defects in the unborn baby. Chazan, a Roman Catholic who has served as director of the hospital for the past 10 years, wrote back, saying he could not provide an abortion due to a “conflict of conscience.” He provided an address to a hospice that could care for the baby after it was born. [Full text]

I was told to approve a lethal injection, but it violates my basic medical ethics

We risk botched executions so long as they are conducted in a scientific vacuum and medical professionals operate devoid of any moral compass

The Guardian

Marc Stern

I peered through the small window of an otherwise solid steel door of the isolation wing of the prison, and saw a small man on his knees in front of his steel framed bed. He had committed many murders and was sentenced to life without the possibility of parole. Perhaps he was praying. Perhaps he was looking for a pencil. But that’s when it struck me: There might be a punishment worse than execution.

Other than a maximum of one hour per day when he could be escorted to a recreational cage outdoors, he would spend the next 10, 20, perhaps 30 years of his life in this very room – eight feet by 10 feet. He would have little contact with other human beings aside from officers and medical professionals. Forging a new friendship or hugging a loved one, if possible at all, would be rare, supervised and not likely spontaneous. His life would be restricted to the same 80 square feet – forever. . . [Full Text]

 

Project Submission to the College of Physicians and Surgeons of Ontario

Protection of Conscience Project

Re: Physicians and the Ontario Human Rights Code

Abstract [Français]

The Ontario Human Rights Commission made a serious error in 2008 when it attempted to suppress freedom of conscience and religion in the medical profession on the grounds that physicians are “providers of secular public services.” In its public perpetuation of this error, the Commission has contributed significantly to anti-religious sentiments and a climate of religious intolerance in Ontario. Both were on display earlier this year when it became front page news and a public scandal that three physicians had told their patients that they would not recommend, facilitate or do what they believed to be immoral, unethical, or harmful.

The physicians had followed the guidelines of the Canadian Medical Association and the College of Physicians and Surgeons of Ontario. Physicians must advise patients about treatments or procedures they are unwilling to recommend or provide for moral or religious reasons, so that patients can seek the services elsewhere. Physicians are not required help patients obtain services or procedures they believe to be wrong.

The arrangement is a compromise that safeguards the legitimate autonomy patients and preserves the integrity of physicians, but it has been continually attacked by activists who want to compel objecting physicians to provide or facilitate abortion and contraception, and, lately, euthanasia. Essentially, the activists assert that physicians have a duty to do what they believe to be wrong because they must not act upon their moral or religious beliefs.

However, it is incoherent to include a duty to do what one believes to be wrong in a code of ethics, the very purpose of which is to encourage physicians to act ethically and avoid wrongdoing. Moreover, one cannot practise medicine without reference to beliefs, whether they reflect a secular ethic or a religious one, and neither a secular ethic nor a religious ethic is morally neutral. Thus, demands that physicians must not act upon their beliefs or must practise medicine in a morally “neutral” fashion are unacceptable because they are impossible.

The demand that physicians must not act upon religious beliefs because medical practice is a secular profession is unacceptable because it is erroneous. The Supreme Court of Canada has acknowledged that a secular society is not faith-free; it includes both religious and non-religious believers, and rational democratic pluralism must make room for them all. The full bench of the Court has warned that to disadvantage or disqualify the exercise of religiously informed conscience in public affairs is an illiberal distortion of liberal principles that offers “only a feeble notion of pluralism.”

If it is legitimate to compel religious believers to do what they believe to be wrong, then it is equally legitimate to compel non-religious believers to do what they think is wrong; everyone would have a duty to do what is believed to be wrong.

Hence, the compromise worked out by the Canadian Medical Association not only safeguards the integrity of physicians and legitimate autonomy of patients, but protects the community against the temptation to give credence to a dangerous idea: that a learned or privileged class, a profession or state institutions can legitimately compel people to participate in what they believe to be wrong – even gravely wrong – even murder – and punish them if they refuse.

Freedom of conscience and freedom of religion are subject to reasonable limitations, but the mantra, “the freedom to hold beliefs is broader than the freedom to act on them”  is inadequate. More refined distinctions are required to address the difficulties that arise in a pluralist democracy. One of them is the distinction between the two ways in which freedom of conscience is exercised: by pursuing good and avoiding evil. There is a significant difference between preventing people from doing the good that they wish to do and forcing them to do the evil that they abhor.

As a general rule, it is fundamentally unjust and offensive to force people to support, facilitate or participate in what they perceive to be wrongful acts; the more serious the wrongdoing, the graver the injustice and offence. It is a policy fundamentally opposed to civic friendship, which grounds and sustains political community and provides the strongest motive for justice. It is inconsistent with the best traditions and aspirations of liberal democracy.  And it is dangerous, since it instills attitudes more suited to totalitarian regimes than to the demands of responsible freedom.

This does not mean that freedom of conscience exercised to preserve personal integrity can never be limited. It does mean, however, that even the strict approach taken to limiting other fundamental rights and freedoms is not sufficiently refined to be safely applied here. Like the use of potentially deadly force, if the restriction of preservative freedom of conscience can be justified at all, it will only be as a last resort and only in the most exceptional circumstances.

When the College of Physicians and Surgeons of Ontario receives complaints from patients who have been unable to obtain services they want, the College should help connect the patients with willing service providers. That would be more helpful than attempting to suppress freedom of conscience and religion in the medical profession. [Full Text]

Demande à l’Ordre des médecins et chirurgiens de l’Ontario

Protection of Conscience Project

Objet : Les médecins et le Code des droits de la personne de l’Ontario

Résumé [En Anglais]

La Commission ontarienne des droits de la personne a commis une grave erreur en 2008 lorsqu’elle a tenté d’éliminer la liberté d’opinion et la liberté de religion de la profession médicale sous prétexte que les médecins sont des « fournisseurs de services publics laïcs ». Dans son interprétation publique de cette erreur, la Commission a largement contribué à la diffusion d’un esprit antireligieux et à la création d’un climat d’intolérance religieuse en Ontario. Ces deux phénomènes ont fait la manchette et ont été l’objet d’un scandale public plus tôt cette année lorsque trois médecins ont dit à leurs patients qu’ils ne recommanderaient, n’offriraient ou ne feraient pas ce qu’ils jugent immoral, contraire à l’éthique ou néfaste.

Ces médecins suivaient ainsi les directives de l’Association médicale canadienne et de l’Ordre des médecins et chirurgiens de l’Ontario. Les médecins doivent aviser leurs patients des traitements ou des procédures qu’ils refusent de leur recommander ou leur offrir pour motif moral ou religieux afin que ces derniers puissent recevoir des soins ailleurs. Les médecins ne sont pas tenus d’aider leurs patients à obtenir un service ou à suivre une procédure qu’ils jugent néfaste.

Ce compromis qui permet de protéger l’autonomie légitime des patients et de préserver l’intégrité des médecins est constamment attaqué par des activistes voulant contraindre les médecins à offrir ou à conseiller un avortement ou des moyens contraceptifs et, récemment, à pratiquer l’euthanasie alors qu’ils s’y objectent. Ces activistes croient essentiellement que les médecins ont le devoir de faire ce qu’ils tiennent comme étant mal, car ils ne doivent par agir en fonction de leurs convictions morales ou religieuses.

Il est toutefois incohérent d’inclure dans un code de déontologie le devoir de faire quelque chose considéré comme mal, puisque la nature même d’un tel code est d’encourager les médecins à agir de façon éthique et de prévenir les méfaits. De plus, il est impossible de pratiquer la médecine sans faire référence à des convictions, que celles-ci relèvent de l’éthique laïque ou religieuse, et ni une éthique laïque ni une éthique religieuse ne sont moralement neutres. Ainsi, demander que les médecins n’agissent pas en fonction de leurs convictions ou qu’ils pratiquent la médecine de manière moralement « neutre » est inacceptable, car cela est impossible.

Demander que les médecins n’agissent pas en fonction de leurs convictions religieuses puisque la médecine est une profession laïque est inacceptable, car cela est erroné. La Cour suprême du Canada a reconnu qu’une société laïque n’est pas sans foi; les personnes qui la composent peuvent avoir des convictions religieuses ou non, et un pluralisme démocratique rationnel doit accepter toutes ces personnes. La Court a mis en garde, en séance plénière, contre la défavorisation ou la suppression de la conscience au courant des aspects religieux des affaires publiques représente une distorsion mesquine des principes libéraux qui n’entraîne « qu’une piètre notion de pluralisme ».

S’il est légitime de contraindre des personnes ayant des convictions religieuses de faire ce qu’ils considèrent comme étant mal, il est donc également légitime de contraindre les personnes n’ayant pas de convictions religieuses à faire ce qu’ils considèrent comme étant mal. Ainsi, le compromis fait par l’Association médicale canadienne ne sert pas uniquement à protéger l’intégrité des médecins et l’autonomie légitime des patients, mais également à faire en sorte que la société ne soit pas tentée de croire en une idée dangereuse, à savoir qu’une classe, une profession ou une institution d’état privilégiée peut, de manière légitime, contraindre des gens à participer à des actes qu’ils jugent comme étant mal (même très mal, comme un meurtre) sous peine de représailles s’ils refusent.

La liberté d’opinion et la liberté de religion sont sujettes à des contraintes raisonnables, mais la maxime voulant que la liberté d’avoir des convictions soit plus large que la liberté d’agir en fonction de ces dernières est inadéquate. Il est nécessaire de faire appel à des distinctions plus précises pour affronter les difficultés d’une démocratie pluraliste. Une d’entre elles est la nuance entre les deux manières dont s’exerce la liberté d’opinion : en faisant le bien et en évitant le mal. Il existe une différence considérable entre le fait d’empêcher les gens à faire le bien qu’ils souhaitent faire et le fait de les contraindre à faire le mal qu’ils abhorrent.

De manière générale, il est fondamentalement injuste et offensant de contraindre des gens à soutenir, offrir ou participer à des actes qu’ils considèrent comme étant mal, et plus le méfait est grave, plus cette injustice ou cette offense est grave. Il s’agit d’une pratique fondamentalement opposée au civisme, lequel permet de maintenir une communauté politique et de favoriser une justice forte. Elle va à l’encontre des meilleures traditions et des aspirations d’une démocratie libérale.  Elle est de plus dangereuse, car elle encourage une attitude plus près de régimes totalitaires que des demandes qui caractérisent une liberté responsable.

Cela ne veut pas dire pour autant qu’il ne faille pas imposer de limites à la liberté d’opinion exercée pour préserver l’intégrité personnelle. Cela veut par contre dire que même l’approche stricte visant à imposer des limites à d’autres libertés et droits fondamentaux n’est pas assez précise pour pouvoir être appliquée sans danger ici. à l’instar de l’utilisation d’une force potentiellement mortelle, la restriction de la liberté d’opinion à des fins de protection ne peut être justifiée qu’en dernier recours et uniquement dans des circonstances exceptionnelles.

Lorsque l’Ordre des médecins et chirurgiens de l’Ontario reçoit des plaintes de patients qui n’ont pas pu obtenir les services qu’ils voulaient, il devrait aider ceux-ci à les mettre en contact avec des fournisseurs prêts à leur offrir ces services. Ceci sera plus constructif que de tenter d’éliminer la liberté d’opinion et la liberté de religion de la profession médicale. [Demande]