Extract Religious initiatives to propose, legislate, and enforce laws that protect denial of care or assistance to patients, (almost invariably women in need), and bar their right of access to lawful health services, are abuses of conscientious objection clauses that aggravate public divisiveness and bring unjustified criticism toward more mainstream religious beliefs. Physicians who abuse the right to conscientious objection and fail to refer patients to nonobjecting colleagues are not fulfilling their profession’s covenant with society.
Extract Savulescu’s account of conscientious objection in medicine is a bold statement that requires all obstetricians to perform abortions, regardless of any moral convictions that they may have to the contrary. Unfortunately, he violates the standards of argument based ethics.
Extract Since visiting Auschwitz, I have grappled with the question of how I would have behaved as a doctor in Nazi Germany or Stalinist Russia. I hope I would have had the moral courage to refuse to participate in the various perversions of medicine that these regimes demanded — for example, respectively, eugenic “research” and psychiatric “treatment” of dissidents. . . . My chances of behaving honourably would have been greatest if I had felt part of an independent medical profession with allegiance to something higher and more enduring than the regime of the day. They would have been least if Savulescu’s opinions had prevailed . . .After 30 years of reading the BMJ, Sava- lescu’s article was the first one to make me feel physically sick.
Gamal I Serour, International Federation of Gynecology and Obstetrics (FIGO)
International Journal of Gynecology & Obstetrics
Abstract The FIGO Committee for the Ethical Aspects of Human Reproduction and Women’s Health held a combined meeting with the Committee of Women’s Sexual and Reproductive rights to discuss ethical aspects of issues that impact the discipline of Obstetrics, Gynecology, and Women’s Health. The following document represents the result of that carefully researched and considered discussion. This material is not intended to reflect an official position of FIGO, but to provide material for consideration and debate about these ethical aspects of our discipline for member organizations and their constituent membership.
Extract There is concern that conscience clauses for pharmacists will lead to pharmacists refusing to fill prescriptions outside the area of contraception. For example, pharmacists who believe AIDS is a punishment from God may not fill a patient’s prescription for AIDS medication. Doctors who think children should only be born to heterosexual, married couples may not provide adequate fertility treatment or may not encourage their patients to explore their options fully. The current trend of pharmacists refusing to fill prescriptions because of personal beliefs violates a woman’s constitutional rights, a pharmacist’s duty of care, and a woman’s right to confidentiality. Forcing pharmacists to fill prescriptions that conflict with their religious beliefs also violates their constitutional right to free exercise of religion. Allowing individual pharmacists to decline to fill prescriptions while mandating that pharmacies have a policy to ensure that customers’ needs are met will help alleviate the concerns of both parties to the conflict. Thus, any legislation that is enacted should balance the needs of both pharmacists and patients.
Oswaldo Castro, Frederic A Lombardo, Victor R Gordeuk
New England Journal of Medicine
Extract Real medical care and services always respect human life. No one should be forced to collaborate in abortion (even when it is achieved through the prevention of implantation), lethal research on embryos, euthanasia, or assisted suicide.
Extract L.L. deVeber and Ian Gentles imply that termination of pregnancy causes psychological problems. However, pre-existing differences between women who seek abortion and those who carry pregnancies to term are considerable and may account for differences in psychological status after abortion or delivery. A relevant comparison would assess psychological distress experienced by women seeking and obtaining an abortion and those seeking but denied pregnancy termination. . . The research cited by deVeber and Gentles, however, fails to meet this standard. . . . There is no causal evidence that abortion alone elevates the risk of psychiatric admission. Observational evidence of such an association may be readily interpreted as resulting from confounding pre-existing factors.
Extract . . . In medical and legal opinion, Terri Schiavo’s cognizance of her self and her life ended in 1990, when she suffered a cardiac arrhythmia and massive cerebral cortical encephalopathy that left her in a persistent vegetative state. Her facial expressions, along with a seemingly “normal” sleep–wake cycle, constituted but one dimension of the cruelty of this condition. . .
. . .More than one commentator has viewed the “right- to-life” fight to prolong Schiavo’s pitiable existence as an anti-abortion campaign “by other means.” . . .
. . . there seems little doubt that, in North America, ideology and religion have begun to seriously distort the type of consensus-building that is the proper business of democratic politics . . .
Where do physicians find themselves in such debates? Medicine is a secular and scientific profession that, for all that, must still contend with the sacred matters of birth, life and death. In practice, physicians must set aside their own beliefs in deference to the moral autonomy of each patient — or else transfer that patient’s care to someone who can meet this secular ethic. . .
. . .The emotionalism and rancour that swirled around the Schiavo case underscores a wider societal duty borne by the medical and scientific community. This is to remain alert to political and legislative tendencies that impose imprecise moral generalizations on the majority, at the expense of reason, scientific understanding and, not infrequently, compassion.
Extract The New Brunswick government is refusing to pay for abortions performed at private clinics, despite renewed warnings from Ottawa. Federal Health Minister Ujjal Dosanjh told the province it is violating the Canada Health Act . . . New Brunswick medicare only pays for abortions up to 12 weeks, performed in hospitals with the approval of 2 physicians. About 600 women a year pay up to 750 for the procedure at the Morgentaler clinic.
Sibbald B. Abortion payment. Can Med Assoc J. 2005 Mar 1;172(5):624.
Extract I cannot understand how Dr. Ursus can claim to have a “middle-of-the- road” position on abortion . . . however, by performing these procedures or referring patients for them, he’s chosen against his smaller, defenceless patients. He is on that side of the road.
