Achieving Transparency In Implementing Abortion Laws

Rebecca J Cook, JN Erdman, Bernard M Dickens

International Journal of Gynecology & Obstetrics
International Journal of Gynecology & Obstetrics

Abstract
National and international courts and tribunals are increasingly ruling that although states may aim to deter unlawful abortion by criminal penalties, they bear a parallel duty to inform physicians and patients of when abortion is lawful. The fear is that women are unjustly denied safe medical procedures to which they are legally entitled, because without such information physicians are deterred from involvement. With particular attention to the European Court of Human Rights, the UN Human Rights Committee, the Constitutional Court of Colombia, the Northern Ireland Court of Appeal, and the US Supreme Court, decisions are explained that show the responsibility of states to make rights to legal abortion transparent. Litigants are persuading judges to apply rights to reproductive health and human rights to require states’ explanations of when abortion is lawful, and governments are increasingly inspired to publicize regulations or guidelines on when abortion will attract neither police nor prosecutors’ scrutiny.


Cook RJ, Erdman J, Dickens BM. Achieving Transparency In Implementing Abortion Laws. Int J Gyn Ob. 2007 Nov;99(2):157-161.

Nurses’ involvement in the care of patients requesting euthanasia: a review of the literature

Nele Del Bal, Chris Gastmans, Bernadette Dierckx de Casterlé

Nurses' involvement in the care of patients requesting euthanasia: a review of the literature
International Journal of Nursing Studies

Abstract
OBJECTIVES: The aim of this paper is to thoroughly examine the involvement and experiences of nurses in the care of mentally competent, adult patients requesting euthanasia (i.e. administration of lethal drugs by someone other than the person concerned with the explicit intention of ending a patient’s life, at the latter’s explicit request) by means of a literature review. . .
CONCLUSIONS: Nurses can make a significant contribution to the quality of care by assisting and counseling patients and their families, physicians, and their nursing colleagues in a professional manner, even in countries where euthanasia is not legal. However, research on nurses’ involvement in euthanasia has methodological and terminological problems,leading to our recommendation for more carefully designed qualitative studies that explore in-depth the experiences of nurses in caring for patients requesting euthanasia.


Bal ND, Gastmans C, de Casterlé BD. Nurses’ involvement in the care of patients requesting euthanasia: a review of the literature. Int J Nurs Studies. 2008;45(4):626-644.

Response to Commentators on “Conscientious Objection and Emergency Contraception”: Sex, Drugs and the Rocky Role of Levonorgestrel

Robert F Card

The American Journal of Bioethics
The American Journal of Bioethics

Extract
I thank the thoughtful commentators on my essay. Their contributions have deepened my grasp of the relevant issues. Unfortunately I cannot discuss each selection in turn, but will instead focus on several commentaries that purport to offer the most serious objections to my argument. . . I was inspired to write this article in order to examine some possible moral justifications for conscientious objection with respect to EC, given that objecting providers seemed to be under no obligation to even state their reasons for refusal. To the extent that this paper spurs further elaboration and evaluation of these reasons, I will consider it a success. (Responds to Farr Curlin, Carson Strong).


Card RF. Response to Commentators on “Conscientious Objection and Emergency Contraception”: Sex, Drugs and the Rocky Role of Levonorgestrel. Am J Bioeth. 2007;7(10):W4-W6.

Professionalism and the Medical Association

Jeff Blackmer

World Medical Journal
World Medical Journal

Extract
In many respects, medical professionalism is currently at a crossroads. The nature of the physician-patient relationship continues to evolve, as physicians struggle to redefine their role in an ever-changing society that is in the midst of a technological revolution. Threats to medical self-regulation and evolving physician scopes of practice have caused many practicing doctors to question whether the profession itself will ever be the same. . . . The objective of this paper has been to examine medical professionalism through the lens of the representative medical association rather than the individual clinician. Through providing both general and specific, concrete suggestions and examples of current and future potential activities which might be undertaken, it is hoped that it will add in a positive and constructive way to the preservation of what most doctors consider to be at the core of medicine: the role of the physician as healer and professional.


Blackmer J. Professionalism and the Medical Association. World Med Ass J. 2007;53(3):58-74.

Reconciling principles and prescriptions: Do pharmacist refusal clauses strike the appropriate balance between pharmacists’ and patients’ rights?

Sarah Tomkowiak   

University of Illinois Law Review
University of Illinois Law Review

Extract
Conclusion:
When a woman and her physician decide that a prescription for contraception is in her best health interests, legal, professional, and ethical obligations should prevent a pharmacist from being able to effectively override that determination. The right of a pharmacist to abide by her moral or religious principles when faced with a prescription that goes against those principles is an important right to protect. However, this right should never be allowed to infringe on a patient’s right to access birth control, an equally important right that has significant implications for the majority of American women’s reproductive health. Pharmacist refusal clauses acknowledge pharmacists’ right to refuse at the expense of women’s right to access contraceptives, inappropriately reconciling these rights. Griswold v. Connecticut may be forty years old, but the issues debated before the Supreme Court then have risen anew today, this time behind the pharmacy counter. Following in the footsteps of the Griswold Court, we must now reaffirm that women have the right to make their own family planning decisions, including the decision to use contraception. Legislatures, pharmacy boards, pharmacies, pharmacists, and patients must work together to put the needs of patients back where they belong—as the first priority of the pharmacy profession.


Tomkowiak S. Reconciling principles and prescriptions: Do pharmacist refusal clauses strike the appropriate balance between pharmacists’ and patients’ rights? U Illinois L Rev 2007(4) 1329-1360

“If Your Hand Causes You to Sin. . .”: Florida’s Chemical Castration Statute Misses the Mark

Tanya Simpson

Florida State University Law Review
Florida State University Law Review

Extract
Recomendations & Conclusion

The United States Supreme Court has identified “the two primary goals of probation—rehabilitation and protecting society from future violations.” Florida can and should redraft its chemical castration statute to comport with these policy goals, pass constitutional muster, and overcome implementation hurdles. In order to draft an effective statute, however, the legislature must acknowledge, as it has in the reports of both chambers, that treatment with MPA has only been shown to be an effective therapy for paraphiliacs when those paraphiliacs volunteer for the treatment, when the treatment is administered in conjunction with psychotherapy, and when certain other criteria are met. . .


Simpson T. “If Your Hand Causes You to Sin. . .”: Florida’s Chemical Castration Statute Misses the Mark. Florida State University Law Review. 2007 Summer;34(1221-1246.

Reasons and Healthcare Professionals’ Claims of Conscience (Conscientious Objection and Emergency Contraception)

Mark R Wicclair

The American Journal of Bioethics
The American Journal of Bioethics

Extract
Robert Card (2007) argues against even a limited conscience based right to refuse to dispense emergency contraception (EC) on the grounds that there are no “reasonable or justified” reasons to support such claims of conscience. This line of argument raises an important question: To what extent is it appropriate to assess reasons in relation to healthcare professionals’ claims of conscience?


Wicclair MR. Reasons and Healthcare Professionals’ Claims of Conscience (Conscientious Objection and Emergency Contraception). Am J Bioeth. 2007;7(6):21-22.

Conscience in America: the slippery slope of mixing morality with medicine

Georgia Chudoba

Southwestern University Law Review
Southwestern University Law Review

Extract

Extract
Conscience clauses in this country are becoming dangerously broad and over-inclusive. What was once a protection for physicians who objected to performing abortions is now a tool for religious activists to obstruct a patient’s right to contraceptives, sterilization, and any other medical procedure that they feel is “morally” wrong. The Legislature must place limits on these clauses to protect patients’ rights. At the onset of new medical research on stem cells and infertility treatments, it is crucial that Congress enact legislation that will protect patients’ rights to these treatments. There needs to be a balance between the doctor’s right of conscience and the patient’s right to treatment.


Chudoba G. Conscience in America: the slippery slope of mixing morality with medicine. Southwestern University Law Review. 2007;36(1):85-106.

The Freedom of Religion in Canada: Challenges and Opportunities

Iain T Benson

Emory International Law Review
Emory International Law Review

Abstract
The paper covers a wide scope in an attempt to examine, in the space available, some of the central cultural and constitutional facts that form the background to recent legal decisions that touch on “religious liberty” in Canada. Important, as well, are recent insights from political theorists, particularly those who examine the nature of liberalism. . . This Article will show that in the last decade the Canadian judicial system has heard a series of important cases in which principles were raised that give a truly Canadian perspective to the relationship between church and state, and the person and the community, in ways that are not developed elsewhere. These cases may provide useful grounding to the principles of accommodation of religion in the public sphere and inclusion of religion in the public sphere, and, further, may reduce the bifurcations that obscure issues where they should elucidate.


Benson IT. The Freedom of Religion in Canada: Challenges and Opportunities. Emory International Law Review. 2007;21(111)

Conscientious Objection the Morning After (Conscientious Objection and Emergency Contraception)

Carson Strong

The American Journal of Bioethics
The American Journal of Bioethics

Extract
In summary, Card supports his view with weak arguments, makes an erroneous assumption about the state of scientific inquiry, and misrepresents the argument of his opponents. When these various errors are brought to light, it becomes clear that Card has not successfully defended his extreme view. . . . Everyone accepts that conscientious refusal conflicts with the patient’s interests. The question is whether this particular type of failure to meet the patient’s interests can ever be ethically justifiable. Simply pointing out that there is a conflict does not constitute an argument. If a limited right to conscientious refusal is consistent with being a professional, then professional organizations that acknowledge such a right are not acting contrary to the purposes and roles of such organizations. What is needed to support de Melo-Martin’s position is an argument that conscientious refusals never, or at least hardly ever, override a patient’s interests, and de Melo-Martin does not provide this.


Strong C. Conscientious Objection the Morning After (Conscientious Objection and Emergency Contraception). Am J Bioethcs. 2007;7(6):32-34.