Protecting freedom of conscience and religion for physicians

doctor with pills
Our submission to the College of Physicians and Surgeons of Ontario regarding its draft Policy on Professional Obligations and Human Rights follows:
Action Life is a non-denominational  educational pro-life organization promoting respect for human life from conception to natural death. We count approximately 4,000 supporters in Ottawa and the surrounding region.
Action Life is greatly troubled by the sections of the draft policy pertaining to freedom of conscience and religion for doctors. The draft policy requires physicians  who will not provide certain services for reasons of conscience or religious beliefs to refer to another  “non-objecting, available, and accessible physician or other health care provider”. For objecting physicians, the act of referral itself would violate their conscience. Physicians should not be forced to refer for services to which they object on moral or religious grounds.  
Freedom of conscience and religion are fundamental in a free and democratic society. To demand that physicians leave their conscience at the door is an attack on the physician’s integrity and his constitutional rights to freedom of conscience and religion as enshrined in the Canadian Charter of Rights and Freedoms. Physicians have a right to practice in accordance to their conscience. Patients do not have a right to demand services to which the physician objects. Physicians should be able to work without fear of retribution if they decline to provide services which are in opposition to their moral and religious beliefs. The recent Supreme Court of Canada’s decision on euthanasia and assisted suicide will further increase pressure on physicians. If the physician will not kill the patient or write a prescription for a lethal dose of drugs, will he now be forced to refer to someone who will? 
Attacks on the freedom of conscience of physicians continue to mount.  We share the grave concerns of some physicians who wonder if the field of medicine will now only be opened to those who are willing to compromise their moral and religious beliefs. The Ontario Medical Association’s Section on General and Family Practice in its August 6, 2014 letter to the College of Physicians and Surgeons observed: “The Section believes it is important to ensure that the public continues to have access to care from the best and brightest minds and we are concerned that quality could suffer if we only accept medical students who are willing to compromise their personal values.” 
We ask that  the College abandon the sections of its draft policy which would force physicians to act contrary to their conscience and religious beliefs. In its place, the policy should include a protection of conscience clause for physicians to ensure that  freedom of conscience and religion is respected.
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Always a human being, always a person

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Protecting physicians from coercion

male_medical_worker

The Colleges of Physicians and Surgeons in the provinces of Ontario and Saskatchewan have introduced draft policies which if passed would require physicians to refer for services to which they object even if doing so would violate their conscience. We can think of referrals for abortion or euthanasia if euthanasia is legalized in Canada.  Such policies in our view would trample on the  freedom of conscience and religion rights of physicians . Both colleges are seeking submissions from the public regarding the proposed changes. For more information, please read the press release below:

Protection of Conscience Project
  www.consciencelaws.org

News Release

Policy wording supplied by abortion and euthanasia activists

Policy would apply to euthanasia, if legalized.

The College of Physicians and Surgeons of Saskatchewan proposing a draft policy demanding that physicians who object to “legally permissible and publicly-funded health services” must direct patients to colleagues who will provide them.  If another physician is unavailable, the College demands that they provide “legally permissible and publicly-funded” services,  even if doing so “conflicts with physicians’ deeply held and considered moral or religious beliefs.”

Physicians usually refuse to participate in abortion because they believe it is wrong to kill what the criminal law refers to as a child that has not become a human being.1 The proposed policy will require them to find a physician willing to do the killing they won’t do.  Should the Supreme Court of Canada legalize euthanasia, the policy will require objecting physicians who refuse to kill patients to find someone who will.

The seamless fit between referral for abortion and referral for euthanasia is not surprising.  The draft College policy was largely written by abortion and euthanasia activists, notably Professor Jocelyn Downie of Dalhousie University.

In a 2006 guest editorial in the Canadian Medical Association Journal, Professor Downie and another law professor claimed that objecting physicians are obliged to refer patients for abortion.2  Their views were vehemently rejected by physicians and repudiated by the Canadian Medical Association.3  Partly as a result of the negative response, Professor Downie and her colleagues in the “Conscience Research Group” decided to convince Colleges of Physicians and Surgeons to impose it.4

Saskatchewan’s draft policy is taken almost verbatim from their “Model Conscientious Objection Policy.”

The Conscience Research Group is  a tax-funded initiative that includes Professors Downie and Daniel Weinstock.5   Both  were members of an “expert panel” that recommended that health care professionals who object to killing patients should be compelled to refer patients to someone who would,6 because (they claimed) it is agreed that they can be compelled to refer for “reproductive health services.”7

Current efforts by the College of Physicians and Surgeons of Ontario to suppress freedom of conscience in the medical profession may have been influenced by the Conscience Research Group.  However, the College in Saskatchewan is the first to copy and paste its preferred model into a draft policy.

The Project insists that it is incoherent and contrary to sound public policy to include a requirement to do what one believes to be wrong in a professional code of ethics. It is also an affront to the best traditions of liberal democracy, and, ultimately, dangerous.

The College Council has approved the policy in principle, but will accept feedback on it until 6 March, 2015.

Notes:

  1. Criminal Code, Section 238(1). (Accessed 2014-12-02)
  2. Rodgers S. Downie J. “Abortion: Ensuring Access.” CMAJ July 4, 2006 vol. 175 no. 1 doi: 10.1503/cmaj.060548 (Accessed 2014-12-02).
  3. Blackmer J. Clarification of the CMA’s position on induced abortion. CMAJ April 24, 2007 vol. 176 no. 9 doi: 10.1503/cmaj.1070035 (Accessed 2014-02-22)
  4. McLeod C, Downie J. “Let Conscience Be Their Guide? Conscientious Refusals in Health Care.” Bioethics ISSN 0269-9702 (print); 1467-8519 (online) doi:10.1111/bioe.12075 Volume 28 Number 1 2014 pp ii–iv
  5. Let their conscience be their guide? Conscientious refusals in reproductive health care: Meet the team.(Accessed 2014-11-21)
  6. Schuklenk U, van Delden J.J.M, Downie J, McLean S, Upshur R, Weinstock D. Report of the Royal Society of Canada Expert Panel on End-of-Life Decision Making (November, 2011) p. 101 (Accessed 2014-02-23)
  7. Schuklenk U, van Delden J.J.M, Downie J, McLean S, Upshur R, Weinstock D. Report of the Royal Society of Canada Expert Panel on End-of-Life Decision Making (November, 2011) p. 62 (Accessed 2014-02-23)

 

Contact:

 

(Sean Murphy) Administrator

Protection of Conscience Project

 

7120 Tofino St.

Powell River

British Columbia

Canada V8A 1G3

 

Tel: 604-485-9765

E-mail: protection@consciencelaws.org

 

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RU-486, the abortion pill

young woman 4

The push to allow the use of mifepristone better known as the abortion drug RU 486, continues its unrelenting march in Canada. An application was filed with Health Canada in 2012 seeking approval of this drug in our country. Promoters of RU 486 abortion use the term “medical” abortion but chemical abortion is a better descriptor. Mifepristone has been called the “gold standard” for chemical abortions by its promoters.  Gold standard, really? Many would disagree with that description including Professors Renate Klein, Janice G. Raymond and Lynette J. Dumble, all supporters of legal abortion.

Their book RU 486, mifepristone: Misconceptions, myths and morals refutes the claim that an RU 486/prostaglandin (PG) abortion is a safe and effective alternative to surgical abortion. Among the findings of their research listed on the back cover of the 2013 edition of their book,  we read: “Heavy bleeding, transfusions, vomiting, severe pain and infection are among the unpredictable adverse effects. Women have died from sepsis and cardiovascular events.”

On page 47,  Ms. Klein and colleagues write: “Researchers and clinicians minimize  the drug cocktail effect,  as they minimize other complications. As we evaluated the literature on complications, it became clear to us that the medical acceptance, without comment or criticism, of what have now become ‘minimal’, ‘tolerable’, and ‘acceptable’ side effects for women, deserves to be highlighted for what it is – unethical medical practice.”

What has the evidence revealed concerning RU 486 abortions?Consider the data of an Australian study from 2011. It compared  surgical and chemical(RU 486) abortions in South Australia over a two year period from January 1, 2009 to December 31, 2010. The researchers found that serious complications were higher for RU 486 abortions than surgical abortions. For first trimester abortions, the rate of severe haemorrhage was one in 3000 for the surgical patients and one in 200 for the chemical abortion patients.   The patients who used RU 486 had a higher rate of admittance to hospital following their abortions than the patients who underwent surgical abortions. The rate of admissions for surgical patients was 0.4% compared to 5.7% for users of the abortion pill.

As concerns second trimester chemical abortions, the study found that complications occurred in up to 33% of the cases reviewed by the researchers.

The Food and Drug Administration (FDA) in the United States reported in its Mifepristone Post marketing Adverse Event Summary through April 30, 2011 that it received notice of 2,207 cases of adverse events following RU 486 abortions.  The adverse events listed: 612 women required hospitalization, 339 experienced blood loss requiring transfusions, 256 had infections with 48 having severe infections, 58 had ectopic pregnancies and 14 women died. Seven of the women died from sepsis  involving the bacteria Clostridium sordellii. Two other deaths were caused by ruptured ectopic pregnancies.

The FDA allowed the use of Mifepristone in the U.S. in 2000. It notes in its summary concerning blood loss that that”bleeding or spotting can be expected for an average of 9-16 days, and may last up to 30 days.”

An RU-486 chemical abortion is not a simple and easy process. It requires the use of two drugs, first mifepristone than 36 to 48 hours later, it is followed by administration of a prostaglandin. In the U.S., this prostaglandin is misoprostol.

Common side effects of this abortion regimen are  cramping, abdominal pain, bleeding for many days even weeks,  back pain, vomiting, diarrhea, dizziness, nausea, fatigue and chill/fever.

Ru 486 results in an incomplete abortion in some instances requiring the woman to undergo a second abortion, a surgical one to finish the process.

What does an an RU 486 abortion involve? The first drug mifepristone blocks progesterone and sloughs off the nutrient rich lining of the uterus causing the death of the developing child and the second drug misoprostol (Cytotec) stimulates contractions expelling the dead child.

Misoprostol is more commonly known as Cytotec , a drug used to treat and prevent gastric ulcers. Searle, the maufacturer of Cytotec has never approved  its product for abortion. This is considered off label use. In fact, Searle warned in 2000 that “Cytotec is not approved for the induction of labor and abortion.”

The fact that abortion supporters maintain that this abortion pill regimen is safe and effective would bring little comfort to the father of 18 year old Holly Patterson who died after an RU-486 abortion in California.

The pharmaceutical company Exelgen admitted to the Italian government in 2009 that at least 29 women worldwide had died after using the abortion pill.

A 26 year old Canadian woman  died from septic shock following an RU 486 abortion during a clinical trial of the drug in 2001 in Canada. The trial was halted after her death.

An RU 486 abortion is deadly for the unborn child and sometimes for the mother as well.

 

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Discrimination against the unborn child

unbornchild - discriminationSharing photo from Human Life Alliance

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Euthanasia of newborns with disabilities

As mentioned by Andrew Coyne, Canadian professor Udo Schuklenk advances that with parental consent, the euthanasia of newborns with disabilities can be justified in some cases. Sadly, this practice is already occurring in Holland and Belgium. In a seven year span 22 babies with spina bifida were euthanized in Holland. A survey of Dutch neonatologists published in the Lancet of April 2005 found that there were 15 to 20 cases of infant euthanasia a year. There were 17 cases of infant euthanasia by administration of lethal drugs in Flanders, Belgium in a one year period according to another study in the Lancet.

Doctors have at their disposal the means to provide pain relief without resorting to euthanasia. If the condition is not fatal, an infant with proper care will continue to live.

The notion that others can decide if a life is worth living is truly frightening. Killing the child based on an assessment of his quality of life and future prospects is eugenics thinly disguised as compassion.

baby foot

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Sliding down the slippery slope of euthanasia

elderly personA letter writer to the Ottawa Citizen approved of Steven Fletcher’s bills which would legalize assisted suicide and euthanasia. Many persons with disabilities fear and reject these practices. The Council of Canadians with Disabilities has spoken out against Mr. Fletcher’s bills.

Whether euthanasia or assisted suicide, safeguards will not protect the vulnerable. In Belgium and Holland where euthanasia is legal, studies show that patients have been euthanized without consent or explicit request. Oregon law allows assisted suicide where the physician provides a prescription for a lethal dose for the patient. Patients Barbara Wagner and Randy Stroup received letters from the Oregon Health Plan refusing to pay for cancer drugs  and offering palliative care or assisted suicide instead. Both were distressed by the refusal to cover the medications and the offer of assisted suicide.

So when the letter writer mentions the financial costs of delivering health care to the very elderly who would prefer “assisted dying” instead, Canadians should take notice.  Killing the patient by lethal injection or providing a prescription for a lethal dose of drugs is less costly but it is not health care nor is it death with dignity. The fear of being a burden and economic pressures are a dangerous mix.

Euthanasia and assisted suicide provide neither compassion nor mercy.

Photo shared from American Life League

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Beware euthanasia and assisted suicide

Euthanasia is lethalSharing photo from Euthanasia Prevention Coalition

Senate Bill S-225 based on Member of Parliament Steven Fletcher’s bills would legalize both assisted suicide and euthanasia.

It would permit euthanasia by lethal injection and assisted suicide by lethal prescription.

Many persons with disabilities oppose these bills including the Council of Canadians with Disabilities.

Assurances that safeguards will protect the vulnerable can be refuted by data on the euthanasia experience in Holland and Belgium where it is legal.  In these jurisdictions, some patients have been euthanized without consent or explicit request in spite of safeguards. We know from a study published in the Canadian Medical Association Journal in June 2010 that 31% of euthanasia deaths were done without explicit request in Flanders, Belgium between June and November 2007.

As for assisted suicide, consider the experience of Oregon cancer patient Jeanette Hall who voted for assisted suicide in a state ballot initiative.  After the enactment of Oregon’s law, she was diagnosed with cancer and asked for assisted suicide but her physician encouraged her to “think of living instead of dying”.

Said Jeanette: “I am so grateful that Dr. Stevens worked with me and helped me change my mind to fight. If he believed in physician-assisted suicide, I would not be here 13 years later to thank him, I would be dead.”

Killing the patient by lethal injection or providing the patient with the means to end his own life is not medical care.

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Euthanasia

euthanasia- alliance for lifeThe legalization of euthanasia and assisted suicide would fundamentally alter the role of physicians and could adversely affect the doctor patient relationship.

Many physicians oppose euthanasia and assisted suicide. They do not wish to be involved in killing patients by lethal injection or providing a prescription for a lethal dose of drugs.  They are part of a healing profession. They work to heal, to treat and cure when they can.

Some individuals in society have become convinced  that they can achieve a dignified death through lethal injection by a physician or a prescription for a lethal dose of drugs. Dignity however is not found in allowing yourself to be killed.

Valuing each person and providing quality care until life’s natural end is the solution. Physicians and patients need to be protected from euthanasia and assisted suicide.

 

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Council of Canadians with Disabilities rejects assisted suicide bills

Member of Parliament Steven Fletcher introduced two private member’s bills to legalize assisted suicide in March 2014. We would like to share with you this press release issued in response to Mr. Fletcher’s proposal by the Council of Canadians with Disabilities.

Steven Fletcher Is Wrong: Assisted Suicide Not A Form of Love

27 March 2014

For Immediate Release

The Council of Canadians with Disabilities (CCD) is speaking out against MP Steven Fletcher’s Private Member’s Bills on assisted suicide because legalized assisted suicide threatens the lives and dignity of people with disabilities and the elderly.  In a media interview promoting his Bills, Mr. Fletcher questioned, “Where is the love, where is the compassion,” and CCD answers that neither love nor compassion for people with disabilities are to be found in assisted suicide.

In making the case for assisted suicide, Steven Fletcher presented the frightening image of people drowning in their own phlegm.  He neglected to inform the public of existing options, such as palliative sedation, which are available to alleviate extreme forms of suffering.  Ethical options of symptom management seek to kill the pain, not the patient.

Since it intervened in the Sue Rodriguez case at the Supreme Court, CCD has been analyzing the effect of assisted suicide on people with disabilities, by monitoring other jurisdictions where it has been legalized.  As CCD spokesperson Jim Derksen has written, “Most people think the eligibility criteria for assisted suicide is terminal illness and constant pain that cannot be relieved, but these are very slippery and difficult concepts. The concept of pain as expanded under permissive assisted-suicide legislation in European countries such as Belgium and the Netherlands includes existential and emotional pain. Broad definitions of terminality and pain include disabilities that do not necessarily prevent people from living full lives.”

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To arrange a media interview, please contact Mr. Laurie Beachell,  CCD National Coordinator (204-947-0303 or laurie@ccdonline.ca).

 

 

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