Journal Articles Archives - Page 53 of 67 - Protection of Conscience Project Library

Conscientious Objection and the Pharmacist

Henri R Manasse Jr

Abstract
What has been lost in the media coverage of and political dialogue about this issue are the nuances and implications of conscientious objection. Like their physician and nurse colleagues, pharmacists routinely operate within both professional and personal ethical frameworks (3). On a personal level, pharmacists have the same rights as their fellow health-care colleagues. Like a surgeon who refuses to perform abortions because of a personal moral objection or a nurse who believes that turning off a patient’s respirator would contradict her beliefs on the sanctity of life, pharmacists must be allowed to be true to their own belief systems as they practice their profession. This does not mean that pharmacists should be allowed to impose their personal morals on patients under their care. As with physicians and nurses, it simply means that pharmacists must maintain the right to “step away” from the offending activity and should refer the patient in question to another pharmacist who can dispense the prescription.

Manasse Jr HR. Conscientious Objection and the Pharmacist. Science. 2005 Jul 10;308(5728):1558-1559.

Conscience Clauses for Pharmacists: The Struggle to Balance Conscience Rights with the Rights of Patients and Institutions

Matthew White

Abstract
Conclusion
. . .The patchwork of current conscience protection for pharmacists indisputably fails its purpose-in almost all cases the current legislation is severely one-sided and out of date. Although such conscience protection admirably attempts to embody the purposes of the First Amendment, most of the actual and proposed legislation suffers from severe partisan myopia. Statutes purporting to offer absolute protection to patients, to employers, or to health care providers rather than striking a balance tend to prolong and enlarge conflict rather than resolve it. . .

Patients, pharmacists, and employers all have civil rights implicated in the delicate interactions that surround the use of oral contraception, and decisive action should be taken to enact statutes that protect the rights of each, rather than statutes that protect one group exclusively. Legislators should make a painstaking effort to craft new conscience legislation that protects the conscience rights of pharmacists without inserting the pharmacist between the patient and her doctor. Such legislation should also make some provision for employers that would be substantially burdened by an inability to conduct their business in the event of a bona fide conscience claim.

White M. Conscience Clauses for Pharmacists: The Struggle to Balance Conscience Rights with the Rights of Patients and Institutions. Wisc Law Rev. 2005;6(1611-1648.

Of Pills and Needles: Involuntary Medicating the Psychotic Inmate When Execution Looms

Julie Cantor

Extract
The coalescence of involuntarily administered antipsychotic medications and competency for execution created a novel and controversial issue that became the basis of Singleton’s final appeal. The Arkansas Supreme Court stated the question succinctly: May the State ”mandatorily medicate [Singleton] with antipsychotic drugs in order to keep him from being a danger to himself and others when a collateral effect of that medication is to render him competent to understand the nature and reason for his execution[?]” Or, as Singleton put it, “Am I too sane to live, or too insane to die?” The cynical view of that question is that Singleton was clever and manipulative. Like most people, he would do just about anything to forestall his death. The more charitable view is that Singleton found an Achilles heel in the execution process and physicians’ involvement with it, one that created what some physicians consider to be an intolerable dilemma.

Cantor J. Of Pills and Needles: Involuntary Medicating the Psychotic Inmate When Execution Looms. Indiana Health L Rev. 2005;2(1):119-172.

Unspeakably Cruel-Torture, Medical Ethics, and the Law

George J Annas

New England Journal of Medicine, NEJM — New England Journal of Medicine

Extract
The Nazi doctors defended themselves primarily by arguing that they were engaged in necessary wartime medical research and were following the orders of their superiors. These defenses were rejected because they are at odds with the Nuremberg Principles, articulated a year earlier, at the conclusion of the multinational war crimes trial in 1946, that there are crimes against humanity (such as torture), that individuals can be held to be criminally responsible for committing them, and that obeying orders is no defense.

Annas GJ. Unspeakably Cruel-Torture, Medical Ethics, and the Law. N. Engl. J. Med.. 2005;352(20):2127-2132.

Un aspect crucial mais délicat des libertés de conscience et de religion des articles 2 et 3 des Chartes canadienne et québécoise: l’objection de conscience

Henri Brun

Abstract
The Supreme Court of Canada, obiter, in the Big M Drug Mart Case, has spoken of the “Constitutional Exemption”. It is the possibility not to be bound to obey the neutral laws that conflict with one’s conscience or religion. It is what we call in French l’objection de conscience. The institution exists in Canadian and Québec Law as a part of the right to freedom of conscience or religion expressed in 2a) and 3 of the Canadian and Québec Charters of Rights. And it goes well beyond the right not to fight within the armed forces. The Supreme Court of Canada has actually delivered six judgments touching on the subject in 1985 and 1986. The conditions under which l’objection de conscience come into play are not so well known however. Does it cover matters of worship or only rules of morals ? Secular or only religious principles ? Personal or only group beliefs ? Do the existence of the rule, the sincerity of the objector and the reasonableness of the exemption have to be proved? Above all, what is the difference between a creed and an opinion ? The following article tries to formulate answers to these questions, with the help of current case-law.

Brun H. Un aspect crucial mais délicat des libertés de conscience et de religion des articles 2 et 3 des Chartes canadienne et québécoise: l’objection de conscience. Les Cahiers de Droit. 1987;28(1):185-205.

The Concealment of Religious Values in Judicial Decisionmaking

Scott C Idleman

Extract
Religious beliefs and values can play a significant and potentially necessary role in the judicial disposition of cases, particularly those in which the positive law is meaningfully underdeterminate. With some exceptions, however, the permissible role of such beliefs and values in various stages of the judicial process is not often appropriately addressed within public and even academic circles. To the contrary, the issue tends by most commentators to be either largely overlooked, perhaps due to its delicacy or complexity, or categorically disposed of pursuant to a debatable theory of public discourse or a distinctive reading of the Constitution’s religion clauses. The central thesis of this Essay is that the relationship between judging and religious influences, as a result of these and other circumstances, is one defined substantially by concealment, much of it unconscious, rather than by truly principled and effective regulation. The Essay’s purposes, accordingly, are to develop this thesis more fully; to examine its chief consequences, especially for the legitimacy of judicial decisionmaking; and, to the extent that these consequences are unfavorable, to suggest some modest corrective measures.

Idleman SC. The Concealment of Religious Values in Judicial Decisionmaking. Va Law Rev. 2005 Apr;91(2):515-534.

Pre-implantation genetic diagnosis and ‘savior siblings’

Bernard M Dickens

International Journal of Gynecology & Obstetrics

Abstract
From its emergence, preimplantation genetic diagnosis (PGD) has been opposed by religious, feminist, and disability-rights advocates. PGD has developed, however, to extend beyond genetic diagnosis of embryos to diagnose chromosomal abnormalities. Evidence shows that PGD is safe, children born after in vitro fertilization (IVF) and PGD having no higher rate of birth defects than children of normal pregnancies. Laws may accommodate PGD directly or indirectly, but some prohibit PGD totally or except to identify sex-linked genetic disorders. When children suffer severe genetic disorders and require stem-cell transplantation, compatible donors may be unavailable. Then, IVF and PGD of resulting embryos may identify some whose gestation and birth would produce unaffected newborns, and placental and cord blood from which stem-cells compatible for implantation in sick siblings can be derived. Ethical issues concern conscientious objection to direct participation, discarding of healthy but unsuitable embryos, and valuing savior siblings in themselves, not just as means to others’ ends.

Keywords:

Dickens BM. Pre-implantation genetic diagnosis and ‘savior siblings’. Int J Gynaec Obstet. 2005;88(1):91-96.

Ethical analyses of vaccines grown in human cell strains derived from abortion: Arguments and Internet search

Richard Kent Zimmerman

Abstract
The fact that certain vaccines are grown in cell strains derived decades ago from an aborted fetus is a concern for some. To understand such concerns, a standardized search identified internet sites discussing vaccines and abortion. Ethical concerns raised include autonomy, conscience, coherence, and immoral material complicity. Two strategies to analyse moral complicity show that vaccination is ethical: the abortions were past events separated in time, agency, and purpose from vaccine production. Rubella disease during pregnancy results in many miscarriages and malformations. Altruism, the burden of rubella disease, and protection by herd immunity argue for widespread vaccination although autonomous decisions and personal conscience should be respected.

Zimmerman RK. Ethical analyses of vaccines grown in human cell strains derived from abortion: Arguments and Internet search. Vaccine. 2004 Oct 2004;22(31-32):4238-4244.

Speciesism as a precondition to justice

Y Michael Barilan

Abstract
Over and above fairness, the concept of justice presupposes that in any community no one member’s wellbeing or life plan is inexorably dependent on the consumption or exploitation of other members. Renunciation of such use of others constitutes moral sociability, without which moral considerability is useless and possibly meaningless. To know if a creature is morally sociable, we must know it in its community; we must know its ecological profile, its species. Justice can be blind to species no more than to circumstance. Speciesism, the recognition of rights on the basis of group membership rather than solely on the basis of moral considerations at the level of the individual creature, embodies this assertion but is often described as a variant of Nazi racism. I consider this description and find it unwarranted, most obviously because Nazi racism extolled the stronger and the abuser and condemned the weaker and the abused, be they species or individuals, humans or animals. To the contrary, I present an argument for speciesism as a precondition to justice.

Barilan YM. Speciesism as a precondition to justice. Politics and the Life Sciences. 2005;23(1):22-33.

War Crimes and Legal Immunities: The Complicities of Waffen-SS General Karl Wolff in Nazi medical experiments

Michael Salter, Suzanne Ost

Extract
There is a considerable amount of academic and popular literature on Nazi medical experimentation within concentration camps, however, the existing research largely focuses on the doctors and the details of their experiments and has neglected two interesting themes. The first neglected theme is the potential legal liabilities and defense strategies of those among the SS leadership, such as SS General Karl Wolff. Wolff facilitated these experiments in a purely administrative capacity, but without his contribution this type of war crime would not have been possible. Secondly, the research has neglected the extent to which Wolff was able to avoid legal accountability for these and other war crimes, as a result of his wartime cooperation with a U.S. intelligence agency and his post-war assistance to interrogators within the Allied Military Intelligence as well as the Nuremberg prosecutors. [2] The present article, which is the first in a series of related studies, focuses largely on the first theme. This article gives particular attention to Wolff’s attempts to avoid prosecution by insisting that the experiments were of a voluntary nature, based on the consent of the research subject, and were, therefore, not criminal acts. Additionally, the article focuses on Wolff’s claim that he did not possess the requisite mens rea or intent necessary to secure a criminal conviction.

Salter M, Ost S. War Crimes and Legal Immunities: The Complicities of Waffen-SS General Karl Wolff in Nazi medical experiments. Rutgers J Law Rel. 2004(1);1-69.