Journal Articles Archives - Page 63 of 67 - Protection of Conscience Project Library

Artificial Reproduction and Child Custody

Bernard M Dickens

This article considers general principles of child custody law in regard to children born following artificial reproduction that employed donated sperm, ova
or embryos, and the law applicable when women give birth to children conceived in order to be surrendered to others (notably their biological fathers). Claims to parental rights raise the issue of who the legal parents are, and may conflict with the apparent best interests of such children and the state’s view of its responsibility. The article considers interests of the unconceived child, the embryo and fetus in utero, the embryo extra uterum and a child born of donation, and the status of sperm, ovum and embryo donors and of “surrogate” mothers. Particular attention is given to the Ontario Law Reform Commission’s Report on Human Artificial Reproduction and Related Matters (1985), which is the first Canadian report to make wide-ranging recommendations on these issues .

Dickens B. Artificial Reproduction and Child Custody. Can Bar Rev 1987 Mar; 66(1): 49-75.

Prenatal diagnosis and female abortion: a case study in medical law and ethics

Bernard M Dickens

Abstract
Alarm over the prospect that prenatal diagnostic techniques, which permit identification of fetal sex and facilitate abortion of healthy but unwanted female fetuses has led some to urge their outright prohibition. This article argues against that response. Prenatal diagnosis permits timely action to preserve and enhance the life and health of fetuses otherwise endangered, and, by offering assurance of fetal normality, may often encourage continuation of pregnancies otherwise vulnerable to termination. Further, conditions in some societies may sometimes render excusable the inclination to abort certain healthy female fetuses. In places where abortion for fetal sex alone is recognised as unethical, however, medical licensing authorities already possess the power to discipline, for professional misconduct, physicians who prescribe or perform prenatal diagnosis purely to identify fetal sex, or those who disclose fetal sex when that is unrelated to the fetus’s medical condition.

Dickens BM. Prenatal diagnosis and female abortion: a case study in medical law and ethics. J Med Ethics 1986 Sep; 12(3): 143-144.

Will the “Conscience of an Institution” Become Society’s Servant?

Joan Mclver Gibson, Thomasine Kimbrough Kushner

Extract
(Overview of accomplishments and future direction of hospital ethics committees) Overall, there is a modest sense of satisfaction with present mechanisms for dealing with ethical dimensions of patient care decisions, and a cautious optimism about the future. This is tempered by a growing, though as yet unfocused concern that emerging issues of cost, access, and quality of care will press ethics committees, now the “consciences” of institutions, into service on behalf of the community at large. . .

Gibson JM, Kushner TK. Will the “Conscience of an Institution” Become Society’s Servant? Hastings Cent. Rep. 1986 Jun;9-11.

Retention of products of conception after therapeutic abortion

Ellen R Wiebe

Canadian Medical Association Journal, CMAJ — Canadian Medical Association Journal

Extract
Failure to remove all the products of conception during a therapeutic abortion is an acknowledged complication whose incidence increases with increased gestational age. In the following case, symptoms of an incomplete abortion were experienced for 2 1/2 years after the abortion.

Wiebe ER. Retention of products of conception after therapeutic abortion. Can Med Assoc J. 1986 Mar 1;134(5):505.

Professions as the conscience of society

Paul Sieghart

Abstract
Ethics is no less of a science than any other. It has its roots in conflicts of interest between human beings, and in their conflicting urges to behave either selfishly or altruistically. Resolving such conflicts leads to the specification of rules of conduct, often expressed in terms of rights and duties. In the special case of professional ethics, the paramount rule of conduct is altruism in the service of a ‘noble’ cause, and this distinguishes true professions from other trades or occupations. If professional ethics come into conflict with national laws, the professional today can test the legitimacy of such laws by reference to internationally agreed legal standards in the field of human rights, and so help to perform the role of ‘professions as the conscience of society’.

Sieghart P. Professions as the conscience of society. J Med Ethics. 1985 Sep;11(3):117-122.

Conscientious objection: a constitutional right

Frederick L Brown, Stephen M Kohn, Michael D Kohn

Brown FL, Kohn SM, Kohn MD. Conscientious objection: a constitutional right. New England Law Review. 1985;21: 545-569

Conscience, good character, integrity, and to hell with philosophical medical ethics?

Raanan Gillon

British Medical Journal, BMJ — British Medical Journal

Extract
. . .A recurring theme throughout medical discussion of medical ethics, typified by the British Medical Association’s Handbook of Medical Ethics,’ is the importance of recourse to conscience. In addition to this positive attitude to the importance of good conscience, good character, and integrity, doctors often have a distinctly negative attitude to philosophical discussion, argument, and criticism concerning medical ethics. . .

Gillon R. Conscience, good character, integrity, and to hell with philosophical medical ethics? Br Med J. 1985 May 18;290(6480):1497-1498.

Civil disobedience, conscientious objection, and evasive noncompliance: a framework for the analysis and assessment of illegal actions in health care

James F Childress

Abstract
This essay explores some of the conceptual and moral issues raised by illegal actions in health care. The author first identifies several types of illegal action, concentrating on civil disobedience, conscientious objection or refusal, and evasive noncompliance. Then he sketches a framework for the moral justification of these types of illegal action. Finally, he applies the conceptual and normative frameworks to several major cases of illegal action in health care, such as “mercy killing” and some decisions not to treat incompetent patients.

Childress JF. Civil disobedience, conscientious objection, and evasive noncompliance: a framework for the analysis and assessment of illegal actions in health care. J Med Philos. 1985 Feb 01;10(1):63-83.

Beyond Medical Paternalism and Patient Autonomy: A Model of Physician Conscience for the Physician-Patient Relationship

David C Thomasma

Abstract
Medical paternalism lies at the heart of traditional medicine. In an effort to counteract the effects of this paternalism, medical ethicists and physicians have proposed a model of patient autonomy for the physician patient relationship. However, neither paternalism or autonomy are adequate characterizations of the physician patient relationship. Paternalism does not respect the rights of adults to self-determination, and autonomy does not respect the principle of beneficence that leads physicians to argue that acting on behalf of others is essential to their craft. A model of physician conscience is proposed that summarizes the best features of both models-paternalism and autonomy.

Thomasma DC. Beyond Medical Paternalism and Patient Autonomy: A Model of Physician Conscience for the Physician-Patient Relationship. Ann. Intern. Med.. 1983;98(2):243-248.

CMA reviews its position

Normand Da Sylva

Extract
Throughout the 1 970s and early 1 980s the issue of abortion was causing such concern that, at its 1981 meeting in Halifax, General Council directed the association “to review the situation with respect to therapeutic abortions in Canada”. As part of this review, the Board of Directors decided to go to the grassroots or the association and to ask individual physicians what their opinions were, not only on the procedural aspects of the current legislation, but also on the ethical and moral aspects of terminating a pregnancy. . . . With the help of an outside consultant, we then drew the names of 2000 physicians from the associations membership file to get a statistically valid sample, proportionally representative of our membership by province and by specialty.

Sylva ND. CMA reviews its position. Can Med Assoc J. 1983;128(1):57.