Abortion Archives - Page 19 of 51 - Protection of Conscience Project Library

The Continuing Conflict between
Sanctity of Life and Quality of Life

From Abortion to Medically Assisted Death

Bernard M Dickens

Annals of the New York Academy of Sciences

The purpose of this paper is to address how analysts and commentators approach the relationship between abortion law and law governing medically assisted death, discussion of which is here limited to assisted suicide and voluntary active euthanasia. The issue of involuntary euthanasia or “mercy killing” of non-consenting persons is beyond the present discussion. This paper is further limited to English language literature, and to legal experience and commentary primarily from the United States of America, Britain and Canada, although reactions to developments in the Netherlands are included. Attention will be directed initially to legal and related analysts and commentators who oppose legalization both of abortion and of medically assisted death, and who resist application of the reasoning that supported decriminalization of abortion to medically assisted death. They represent the socalled Pro-Life protagonists in the debate. Language is often employed instrumentally in the conduct of the disagreement, but the practice adopted here is to refer to protagonists by the titles they give themselves.

Second, attention will be given to adherents to the so-called pro-choice position, who favor both liberalized abortion laws and tolerance of medical means by which individuals may end their own lives when they find survival excessively painful, burdensome, or undignified. Consideration is then given to those who oppose liberal abortion laws, perhaps because of fetal vulnerability, but who consider that non-vulnerable, competent persons, such as terminal patients in unrelievable distress, should be legally entitled to assistance in dying. The reverse is then addressed, concerning those who favor women’s choice on abortion, but oppose medically assisted death because, for instance, it may be exploitive of disabled patients or violative of ethical duties that health care professionals owe patients. In conclusion, it will be proposed that reconciliation of opposing views may be approached through promotion of choice, both to continue unplanned pregnancy and burdensome life, through availability of options that individuals may be encouraged and supported, but not coerced, to adopt.

Dickens BM. The Continuing Conflict between Sanctity of Life and Quality of Life: From Abortion to Medically Assisted Death. Annals NY Acad Sciences 2000 Sep;913:88-104

(News) Matters of principle; AMA favors reproductive rights access but says providers can’t be forced to violate conscience

Deanna Bellandi,Elizabeth Thompson

Extract
After Roman Catholic leaders issued strong criticism about its trampling of religious freedom, the American Medical Association approved a watered-down measure supporting continued community access to a full range of reproductive services following hospital consolidations. The AMA’s amended resolution stopped short of saying Catholic hospitals should have to perform all reproductive health procedures. . . The AMA instead upheld its policy that physicians and hospitals not be forced to perform services that violate their moral principles. . .

Bellandi D, Thompson E. Matters of principle; AMA favors reproductive rights access but says providers can’t be forced to violate conscience. Mod Healthcare 2000 Jun 19; 30(25): 6,14.

(News) With teen pregnancies skyrocketing, ob/gyns seek support for nonprescription “morning-after pill”

Barbara Sibbald

Canadian Medical Association Journal, CMAJ — Canadian Medical Association Journal

Extract
Support for a move to make emergency postcoital contraception available without a prescription appears to be mushrooming in Canada. The Society of Obstetricians and Gynaecologists of Canada (SOGC) and 23 other medical and pharmaceutical organizations have joined the groundswell of support since the SOGC launched a campaign to increase awareness and availability of the “morning-after pill” in November 1998. . . some CPhA members feel emergency contraception “may interfere with implantation of the fertilized egg and they consider that more [like] abortion,” said Cooper. Pharmacists for Life, a Canadian group with about 10 members, has already opposed the move, even though the World Health Organization (WHO) says taking the drug is not equivalent to performing an abortion because the woman is not pregnant.

Sibbald B. With teen pregnancies skyrocketing, ob/gyns seek support for nonprescription “morning-after pill”. Can Med Assoc J. 1999 Oct 5;161(7):855.

Conscience clause: moral compromise

Chris Thatcher

Extract
Ask your pharmacist: It’s the ubiquitous slogan of the past decade, underscoring the campaigns of most national and provincial pharmacy organizations as they promote the value of pharmacy services. But what if the question is about RU-486, the abortion drug, or Preven, the morning-after-pill? What if the question is from a physician seeking information on terminal sedation or assisted suicide?

Such questions push, and often breach, an ethical boundary for some pharmacists, who find their desire to help the patient in conflict with their moral convictions. And the ethical quagmire is likely to get deeper as advocacy groups press the federal government to allow physician-assisted suicide and various health organizations promote greater access to emergency postcoital contraception.

If these practices compromise your moral convictions, could you be fired by your employer for refusing to fill a prescription? More specifically, is there a point at which your personal beliefs supersede your obligation to the patient? That’s the difficult question posed by an Alberta-based group called Concerned Pharmacists for Conscience, which has suggested a conscience clause to protect pharmacists in such situations.

Thatcher C. Conscience clause: moral compromise. Can Pharm J. 1999;132(7):10-11

(News) Leak of abortion information creates turmoil at Foothills

Richard Cairney

Extract

The Calgary Regional Health Authority (CRHA)has won a court judgement preserving the private, confidential nature of documents concerning genetic terminations of pregnancy that were leaked to Alberta Report by one or more angry pro-life nurses. . . .The controversy erupted after one or more members of the nursing staff at Foothills leaked confidential documents to the magazine. The resulting articles were filled with loaded language — “genetic terminations unquestionably constitute murder” and “the abortionist might well be guilty of culpable homicide” are 2 examples. . . ..

Cairney R. Leak of abortion information creates turmoil at Foothills. Can. Med. Assoc. J.. 1999;161(4):424-425.

Some ethical and legal issues in assisted reproductive technology

Bernard M Dickens, Rebecca J Cook

International Journal of Gynecology & Obstetrics

Abstract
The potential and actual applications of reproductive technologies have been reviewed by many governmental committees, and laws have been enacted in several countries to accommodate, limit and regulate their use. Regulatory systems have nevertheless left some legal and ethical issues unresolved, and have caused other issues to arise. Issues that regulatory systems leave unresolved, or that systems have created, include disposal of embryos that remain after patients’ treatments are concluded, and multiple implantation and pregnancy. This may result in risks to maternal, embryonic and neonatal life and health, and the contentious relief that may be achieved by selective reduction of multiple pregnancies. A further concern arises when clinics must or choose to publicize their success rates, and they compete for favorable statistics by questionable patient selection criteria and treatment priorities..

Dickens BM, Cook RJ. Some ethical and legal issues in assisted reproductive technology. Int J Gynecol Obstet. 1999;66(1) 55-61.

Crisis of Conscience: Reconciling Religious Health Care Providers’ Beliefs and Patients’ Rights

Katherine A White

Abstract
In this note, Katherine A. White explores the conflict between religious health care providers who provide care in accordance with their religious beliefs and the patients who want access to medical care that these religious providers find objectionable. Specifically, she examines Roman Catholic health care institutions and HMOs that follow the Ethical and Religious Directives for Catholic Health Care Services and considers other religious providers with similar beliefs. In accordance with the Directives, these institutions maintain policies that restrict access to “sensitive” services like abortion, family planning , HIV counseling, infertility treatment, and termination of life-support. White explains how most state laws protecting providers’ right to refuse treatments in conflict with religious principles do not cover this wide range of services. Furthermore, many state and federal laws and some court decisions guarantee patients the right to receive this care. The constitutional complication inherent in this provider-patient conflict emerges in White’s analysis of the interaction of the Free Exercise and Establishment Clauses of the First Amendment and patients’ right to privacy. White concludes her note by exploring the success of both provider-initiated and legislatively mandated compromise strategies. She first describes the strategies adopted by four different religious HMOs which vary in how they increase or restrict access to sensitive services. She then turns her focus to state and federal “bypass” legislation, ultimately concluding that increased state supervision might help these laws become more viable solutions to provider-patient conflicts.

White KA. Crisis of Conscience: Reconciling Religious Health Care Providers’ Beliefs and Patients’ Rights. Stanford Law Rev. 1999 Jul;51(6)1703-1749.

(News) Task force offers $547,000 to solve shootings (of abortion practitioners)

Barbara Sibbald

Extract
In all, 9 police forces on both sides of the border are investigating 5 incidents that are believed to be linked. All took place around Remembrance Day, all the physicians involved performed abortions and all were shot in their homes. The injured include Dr. Garson Romalis of Vancouver (1994), Dr. Hugh Short of An- caster, Ont. (1995), an unnamed Richmond, NY, physician (1996) and Dr. Jack Fainman of Winnipeg (1997). The first fatality occurred last Oct. 23 when Slepian was shot and killed at his home. An American murder warrant has been issued for Vermont antiabortion activist James Kopp, 44. Kopp, whose whereabouts are a mystery, is charged only in the slaying of Slepian. He remains a “person of interest” in connection with the other shootings.

Sibbald B. Task force offers $547,000 to solve shootings (of abortion practitioners). Can Med Assoc J. 1999 Jun 15;160(12).

Human rights and abortion laws

Rebecca J Cook, Bernard M Dickens

Abstract
Human rights protections have developed to resist governmental intrusion in private life and choices. Abortion laws have evolved in legal practice to protect not fetuses as such but state interests, particularly in prenatal life. National and international tribunals are increasingly called upon to resolve conflicts between state enforcement of continuation of pregnancy against women’s wishes and women’s reproductive choices. Legal recognition that human life begins at conception does not resolve conflicts between respect due to women’s reproductive self-determination and due to prenatal life. Human rights protect healthcare providers’ claims to conscientious objection, but not at the cost of women’s lives and enduring health.

Cook RJ, Dickens BM. Human rights and abortion laws. Int J Gynecol Obstet. 1999 Apr 22;65(81-87.

(News) US antiabortion pamphlet stirs anger north of the border

Patrick Sullivan

Extract
An American antiabortion publication that was mailed to Canadian physicians has angered many Ontario doctors and caused Queen’s University to contact police. The 32-page pamphlet, Quack the Ripper , was mailed by Life Dynamics Inc. of Denton, Texas, in March. . . the publication’s goal is to dissuade young physicians from providing abortions by insulting those who do perform them.

Sullivan P. US antiabortion pamphlet stirs anger north of the border. Can Med Assoc J. 1999;160(7):977.