In the True North Strong and Free

Project Letter to the Calgary Herald

Sean Murphy*

Twelve years ago, an editorial in the Calgary Herald1 expressed hope that a bill proposed by MLA Julius Yankowsky2 would ensure that health care professionals would not be forced to participate in procedures or services to which they objected for reasons of conscience.

The editorial cited the example of coerced participation of nurses in late term abortions at Foothills Hospital3 and the case of Maria Bizecki, a pharmacist facing discipline for refusing to dispense the morning after pill.4 The bill, said the editorial, was “a common sense compromise” that would respect freedom of conscience without preventing access to abortion or drugs. Yankowsky’s bill did not pass, but a common sense compromise was eventually worked out between Ms. Bizecki and her employer, the Calgary Cooperative Association.5

While Ms. Bizecki’s case was grinding slowly forward, she and Professor Donald De Marco met the Herald editorial board. Danielle Smith, then a member of the board, was at the meeting. So was Herald columnist Naomi Lakritz, who, at one point, personally congratulated Ms. Bizecki for her stand.6

Danielle Smith, now leader of the Wildrose Party, appears to be advocating the kind of compromise supported by the Herald when it expressed support for freedom of conscience for health care professionals. Ms. Lakritz, however, seems to have changed her mind.

“The word ‘conscience,’” she writes, “is now being used to advocate doing the wrong thing” – like refusing to dispense the morning after pill. (“Conscience rights is another way of allowing discrimination.”Calgary Herald, 10 April, 2012)

Ms. Lakritz is not alone in this belief. She reports that Alison Redford, the Premier of the province, is actually frightened by suggestions that at least some people in Alberta might refuse to do what they believe to be wrong. We are told that Liberal and NDP leaders also oppose freedom of conscience, and that the Alberta Party leader condemns protection of conscience legislation as “an exercise in exclusion,” a point apparently overlooked by those who drafted Section 2(a) of the Canadian Charter of Rights and Freedoms.

According to Ms. Lakritz, the Premier believes that suppression of freedom of conscience demonstrates respect for diversity, that people are treated with “dignity and respect” when they are forced to do what they believe to be wrong, and that threatening conscientious objectors with dismissal makes people feel “safe and included.”

We are not told if the Premier and other leaders opposed to freedom of conscience insist that their candidates sacrifice their personal integrity in order to run for office. Nor does Ms. Lakritz tell us if employees at the Calgary Herald must do what they believe to be wrong as a condition of employment or promotion.

She does, however, claim that those who, for reasons of conscience, refuse to provide a legal drug or service act wrongly and dishonourably because they thus treat some people “as though they were much less equal to others.” This is like saying that refusing to sell tobacco is wrong because it treats smokers “as though they were much less equal” to non-smokers, or that refusing to facilitate prostitution is dishonourable because it denies equality to ‘sex trade workers.’ Even if one accepts such a peculiar notion of equality, however, equality is not the only principle relevant to the moral evaluation of an act. Moreover, the mere legality of a product or service imposes no duty to provide it or to affirm its moral acceptability. Ms. Lakritz made this clear when she excoriated Henry Morgentaler and abortion rights groups for suggesting that Catholic bishops should ask people to stop protesting abortions – a legal, tax-paid service.

“[The bishops] are not exactly known for indulging in moral relativism,” she observed.

“What this society needs is more people like them who take a firm stand on issues and do not apologize for refusing to be swayed by whatever current compromise passes for morality.”7

It is a pity that Ms. Lakritz no longer believes this: that she now holds that such people are “truly disgusting,” and that personal integrity and courage are grounds for dismissal in the true north strong and free.

O, Canada.

Notes

1. “Editorial, The Calgary Herald, April 11, 2000. (Accessed 2012-04-11)

2. Bill 212, Human Rights, Citizenship and Multiculturalism Amendment Act, 2000.

3. Ko, Marnie, “Personal Qualms Don’t Count: Foothills Hospital Now Forces Nurses To Participate In Genetic Terminations.” Alberta Report Newsmagazine, April 12, 1999

4. Mastromatteo, Mike, “Alberta Pharmacist Vindicated for Pro-Life Stand.” The BC Catholic, 3 November, 2003

5. Gerald D. Chipeur to the Calgary Co-operative Association Re: Maria Bizecki, 19 December, 2001

6. E-mails from Maria Bizecki to the Administrator, Protection of Conscience Project, 10 and April, 2012.

7. Lakritz, Naomi, “Hypocrite Henry: Morgentaler exercises his own brand of violence.” Winnipeg Sun, 17 January, 1995 (Accessed 2012-04-13)

A correction and qualifications

Letter to the Editor
The BC Catholic
Vancouver, B.C. Canada

20 February, 2012

Sean Murphy, Administrator
Protection of Conscience Project

A correction and some qualifications are in order with respect to the article by Deborah Gyapong about the contraception insurance controversy in the United States (“A Canadian debate over contraception is unlikely,” BC Catholic, 20 February, 2012).

In the first place, Mr. Roche of the Catholic Health Association of Canada is mistaken in his assertion that Catholic hospitals in Canada cannot be compelled to do things contrary to Catholic teaching. In 2006, St. Elizabeth’s Hospital in Humboldt, Saskatchewan, operated by the Saskatchewan Catholic Health Association, decided to stop doing contraceptive sterilizations. Public protests resulted, and a woman denied a tubal ligation filed a human rights complaint. In June, 2007, St. Elizabeth’s was transferred to the Saskatoon Health Region and re-named the Humboldt District Hospital. Three months later, the Saskatchewan Catholic Health Corporation agreed to pay almost $8,000.00 to the complainant in the human rights action to settle the case.1 It would be most unwise to think that this kind of thing could not happen again.

Concerning the situation in the United States, it is true that the Catholic bishops, in a remarkable display of unanimity, have been vocal in protesting the demand to provide insurance coverage for surgical sterilization, contraceptives and potentially embryocidal or abortifacient drugs or devices. Many of them have said that they will refuse to comply with the law. It does not appear that they share Mr. Roche’s view that an emphasis on Catholic identity may be counterproductive with respect to the mission of Catholic health care. Nor do they seem to think that Catholic identity and Catholic mission are in conflict with each other, though they may well be in conflict with dominant social norms – as the example of what used to be St. Elizabeth’s Hospital demonstrates.

The prominence of the Catholic response notwithstanding, this is not a ‘Catholic’ issue. Strong protests have also been made by Jewish groups, Southern Baptists, Lutherans and Evangelical Christians. Colorado Christian University, a non-Catholic institution, filed suit months ago against the U.S. federal government because of this mandate.2 Two more lawsuits have just been filed by Southern Baptist and Reformed Presbyterian colleges.3 And former governor of Arkansas, Mike Huckabee. recently declared that the response to the Obama administration’s mandate reminded him of President John F. Kennedy’s statement to the people of Berlin after the erection of the Berlin Wall: “Ich bin ein Berliner” (I am a Berliner). Huckabee, a Baptist , said, “In many ways, thanks to President Obama, we’re all Catholics now.”4

Testifying before a committee of the U.S. House of Representatives, Rabbi Meir Soloveichik warned that “not only does the new regulation threaten religious liberty in the narrow sense, in requiring Catholic communities to violate their religious tenets, but also the administration impedes religious liberty by unilaterally redefining what it means to be religious.”5

So this is not a ‘Catholic’ issue. Nor is it about women, or health, or birth control or contraception, as Dr. Laura Champion told the same committee. As the Director of Health Services at Calvin College in Michigan, she explained that the College has no objections to contraception, but she was emphatic that the morning after pill is not the same as cancer screening or vaccinations. “Pregnancy is not a disease,” she said. “This is a premise that I reject both religiously and medically.”6

Finally, the BC Catholic story states that the Catholic Health Association of the United States “decided on ‘a cautious acceptance’ of the compromise.” However, the actual wording of the newly published regulation is exactly the same as the wording that launched the firestorm of protest in late January.7 The administration’s promises have no legal significance, and, in any case, will not be fulfilled before the November presidential election. The description of the scheme as a ‘compromise’ thus seems premature.

Notes:

1. CBC News, 13 September, 2007, “Woman given settlement after being denied tubal ligation.”(Accessed 2012-02-20)

2. To see a graphic illustration of the resistance to the HHS mandate, see the interactive map.

3. Alliance Defence Fund news releases, 20 February, 2012 : “ADF, Louisianna College challenge Obama Mandate“; “ADF, Geneva College to reveal lawsuit against Obama mandate Tuesday” (Accessed 2012-02-20)

4 “Mike Huckabee’s Full Speech at CPAC 2012.” ABC News, 10 February, 2012 (Accessed 2012-02-20)

5. Lines Crossed: Separation of Church and State. Has the Obama Administration Trampled on Freedom of Religion and Freedom of Conscience? US House of Representatives Committee on Oversight and Government Reform,16 February, 2012: Testimony of Rabbi Meir Soloveichik

6. Lines Crossed: Separation of Church and State. Has the Obama Administration Trampled on Freedom of Religion and Freedom of Conscience? US House of Representatives Committee on Oversight and Government Reform,16 February, 2012: Testimony of Laura Champion, MD.

7. PART 147—Health Insurance Reform Requirements for the Group and Individual Health Insurance Markets § 147.130 Coverage of preventive health services.

Bedrock values?

Project letter to The Canadian Pharmaceutical Journal

Sean Murphy*

Polly Thompson asserts that religious tolerance is “a bedrock value of our democracy, and it goes both ways,” but then claims that “the onus is on the health professional to respect the religious beliefs of the patient, not the other way around,” a most peculiar form of tolerant reciprocity. The balance of the editorial demonstrates a troubling ignorance of the legal requirements to accommodate conscientious objectors[1] and de facto contempt of the “bedrock value” she purports to respect in theory. (The Public Trust and Access to Medication, Canadian Pharmaceutical Journal, October, 2004, Vol. 137, No. 8).

Patients and pharmacists have equal claims to freedom of conscience and expression, but one looks in vain in the editorial for a thoughtful analysis of how to deal fairly with conflicts of conscience in health care. A principled approach to conscientious objection would, among other things, distinguish between life-threatening injuries or conditions, and non-emergent situations. To equate the provision of blood transfusions for accident victims with dispensing contraceptives or post-coital interceptives suggests a disappointing editorial interest in polemics, not principle.

Thompson is mistaken when she claims that some pharmacists raise religious objections to her access to medication. Their concerns are not with her access, but with their own moral culpability should they facilitate harmful conduct or other wrongdoing by someone else.

The fact that a drug is legal does not determine this issue. By way of comparison, mouthwash is a legal product commonly sold in pharmacies. It can also be an intoxicant when consumed as a beverage. A conscientious pharmacist might well refuse to sell mouthwash to an alcoholic known to consume it for that purpose, whether or not the product could be accessed elsewhere.

Similarly, the practice of law is a self-regulated profession, and, like pharmacists, lawyers are expected to serve the interests of their clients. But a client cannot force a lawyer to facilitate what the lawyer considers to be a wrongful act – even if the act is legal.

Ms. Thompson’s fierce determination to adhere to her own moral views is not surprising, but she has failed to demonstrate that her morality is so superior that it should be imposed upon those who disagree with her. Indeed, she did not even attempt such a demonstration before calling for the elimination of “troubling holes” and “wiggle room” that make grudging allowance for freedom of conscience in pharmacy. Her message to those unwilling to go along with her is uncompromising; get out of the profession. Given this totalitarian mindset, Ms. Thompson’s complaint that ‘fundamentalist extremists’ dictate policy in the United States invites the waggish response that in Canada they write editorials for professional journals.

Pharmacy regulatory authorities can, with some imagination and good will, find ways to ensure “timely access to legal medication” without suppressing of freedom of conscience in the profession. The Canadian Pharmaceutical Journal can contribute to this kind of fruitful accommodation. But the profession and the public are not well served by the kind of incoherence, intolerance, polemics and ignorance of human rights jurisprudence displayed in its October editorial.

Sean Murphy, Administrator
Protection of Conscience Project

Notes

1. Benson I. “Autonomy”, “Justice” and the Legal Requirement to Accommodate the Conscience and Religious Beliefs of Professionals in Health Care [Internet]. Powell River (BC): Protection of Conscience Project; 2001 Mar. The Canadian Pharmaceutical Journal declined to publish the essay, which was a response to an article by Frank Archer that had appeared in an earlier number of the Journal. See also Murphy S. In Defence of the New Heretics: A Response to Frank Archer [Internet]. Powell River (BC): Protection of Conscience Project; 2000 Jul – also declined by the CPJ.

Project Letter to the Western Standard

14 May, 2004

Sean Murphy, Administrator
Protection of Conscience Project

Should doctors be forced to abandon their faith? by Terry O’Neill draws attention to the problem of freedom of conscience in health care.

A bit of history is instructive. The first protection of conscience clause debated in the House of Commons was introduced by M.P. Robert McCleave as an amendment to the Omnibus Bill that legalized abortion in Canada in 1969. Mr. McCleave believed that abortion should be legalized, but also believed that ‘freedom of choice’ should be extended to health care workers.

Compare Mr. McCleave’s notion of ‘choice’ with that espoused by Joyce Arthur. Speaking for the “Pro-choice Action Network,” she refuses to respect the choices of health care professionals who do not wish to participate morally controversial procedures. She seems to believe that freedom of conscience is a problem to be solved by abolishing it, at least in the case of those who don’t agree with her. Arthur’s position is doubly ironic, since Henry Morgantaler justified his defiance of Canadian abortion law in a 1970 article titled, A Physician and His Moral Conscience.¹

Referral is not a satisfactory solution for many physicians who have grave moral objections to a procedure. Objecting physicians hold themselves morally culpable if they facilitate an abortion by referring a patient for that purpose. Nor is this an unusual view. Consider the controversy in Canada over the deportation and torture of Maher Arar. This suggests that few believe that one can avoid moral responsibility for a wrongful act by arranging for it to be done by someone else.

Certainly, Joyce Arthur does not consider abortion to be a wrongful act. However, she has not explained why others should be forced to abide by her moral views.

Unfortunately, between the writer’s desk and publication, a couple of factual errors were introduced into the story.

In the first place, the Project followed the case from the outset, and the student was provided with the same kind of service extended to others in similar situations. His relationship with the Project has been cordial, but it is incorrect to describe me as “a friend of the would-be doctor.” We have never met.

More important, the final paragraph attributes to me statements that I did not make. While I am, nonetheless, in agreement with a number of the points made, I did not suggest that a devout Muslim doctor might refuse to treat women, nor make any statement to a similar effect.

It would be most unfortunate if this falsely attributed statement were to contribute to the already adverse social pressures experienced by Muslims in North America. Muslim health care workers and students are welcome to contact the Protection of Conscience Project. One of the Project advisors is Dr. Shahid Athar, a regent and former vice-president of the Islamic Medical Association of North America and the Chair of its Medical Ethics Committee

Notes

1. The article appeared anonymously in The Humanist. Quoted in Pelrine, Eleanor wright, Morgantaler: The Doctor Who Couldn’t Turn Away. Canada: Gage Publishing, 1975, P. 79

Some corrections and clarifications

Project letter to the Calgary Herald

Sean Murphy*

While I am pleased to see that Laura Wershler is willing to accommodate freedom of conscience among health care workers, I must correct some misleading statements included in her article (“The morning after: Pro-life agenda misrepresents the emergency contraceptive pill, or ECP”,Calgary Herald, 13 February, 2004).

In the first place, http://www.consciencelaws.org is the URL of the Protection of Conscience Project, not “Repression of Conscience”. Contrary to Ms. Wershler’s assertion, this is a non-denominational human rights project, not a not a pro-life initiative. Pro-lifers are interested in the Project and sometimes link to our website, but the Project does not take a position on the morality of controversial procedures. It is enough to recognize the controversy, and advocate the accommodation of conscientious objectors. At least one pro-life pharmacist does not use the Project pamphlet about the morning-after pill precisely because the pamphlet does not argue against its use.

Second, Ms. Wershler’s article incorrectly attributes to the Project the use of the terms “abortion drug” and “emergency contraceptive (ECP)”. The Project does not use either term, except when quoting other sources. They are confusing, and complicate articulation of freedom of conscience issues.

“Abortion drug” is an appropriate description of mifepristone (RU486), which is designed specifically to cause the abortion of an embryo that has implanted in the uterus. The morning-after pill has not been designed for that purpose, and does not act in that way.

“Emergency contraception” is a fabulously successful marketing term. However, 94% of the women who take the morning-after pill do not require it to prevent childbirth. This statistic, provided by the drug’s advocates,[1] belies the notion of ’emergency’ that is often used to browbeat conscientious objectors. As to “contraceptive”, Ms.Wershler herself acknowledges that these drugs have three mechanisms of action, one of which may prevent implantation of the early embryo, thus causing its death. This is considered by many conscientious objectors to be the moral equivalent of abortion, a term acknowledged as appropriate by some authorities,[2] though the usage is not uncontested. The Project refers to these drugs generically as the ‘morning-after pill’ because this term is widely understood. We describe the morning-after pill as “potentially abortifacient”, in the sense that it may cause the death of the early embryo, but does not necessarily do so.

A final note to prevent further confusion: the meaning of “abortifacient” in a medical or scientific context is not the same as its meaning in a moral context. In a medical context, a drug that prevents fertilization (acts contraceptively) 95 to 99 times out of a hundred would be called a contraceptive rather than a abortifacient. But in a moral context, when the outcome may be death, a drug may be treated as an abortifacient if there is even a 1% chance of it killing the embryo by preventing implantation. A number of disputes that arise about the morning-after pill are a regrettable consequence of failing to recognize these distinctions.

Notes

1. Apply a calculator to the following statement: “In 16 months of ECP services, pharmacists provided almost 12,000 ECP prescriptions, which is estimated to have prevented about 700 unintended pregnancies.” Cooper, Janet, Brenda Osmond and Melanie Rantucci, “Emergency Contraceptive Pills- Questions and Answers”. Canadian Pharmaceutical Journal, June 2000, Vol. 133, No. 5, at p. 28.

2. Keith L. Moore and T.V.N. Persaud, The Developing Human: Clinically Oriented Embryology (6th ed.) (Philadelphia: W.B. Saunders Company, 1998), p. 532. Quoted in Irving, Diane N., A “One-Act Drama:The Early Human Embryo:’Scientific’ Myths and Scientific Facts:Implications for Ethics and Public Policy, Medicine and Human Dignity.” International Bioethics Conference, ‘Conceiving the Embryo’, Centre Culturel, Woluwe-St. Pierre, Brussels, Belgium: October 20, 2002 (9:30 A.M.)(Revised 23 October, 2002) Note 23.