(Correspondence) Readers Advocate Pro-conscience, Not Pro-Choice (Invited response)

Susan Wysocki

The Nurse Practitioner
The Nurse Practitioner

Extract
A nurse practitioner’s personal position on this issue is irrelevant in tem1s of the provision of patient care. Our responsibility as nurse practitioners is to provide our patients with information that helps them to make their own decisions based on the constructs of their own beliefs and needs. This does not mean that nurse practitioners who find a patient’s reproductive-health decisions to be in conflict with their own morals and beliefs should be forced to counsel on those choices. Instead, they have a responsibility to ensure that the patient has her needs met with another provider.


Wysocki S. (Correspondence) Readers Advocate Pro-conscience, Not Pro-Choice (Invited response). Nurse Pract. 1992 Oct;17(10):8-9

(Correspondence) Responsibility and abortion

Glenn Jones

Canadian Medical Association Journal, CMAJ
Canadian Medical Association Journal

Extract
Termination of pregnancy is the act of a powerful person (the pregnant woman) against a voiceless, innocent and powerless person. How does the misuse of power by women in this situation prove that their androgynous and gynocentric approaches to the use of power are different or better? . . . I agree with McEvoy that we must determine what abortion means over time to those most affected by it – women. However, she has failed to do that analysis.


Jones G. (Correspondence) Responsibility and abortion. Can Med Assoc J. 1992 Sep 15;147(6):840-842.

Religious Ethics and Active Euthanasia in a Pluralistic Society

Courtney S Campbell

Kennedy Institute of Ethics Journal
Kennedy Institute of Ethics Journal

Abstract
This article sets out a descriptive typology of religious perspectives on legalized euthanasia — political advocacy, individual conscience, silence, embedded opposition, and formal public opposition — and then examines the normative basis for these perspectives through the themes of sovereignty, stewardship, and the self. It also explores the public relevance of these religious perspectives for debates over legalized euthanasia, particularly in the realm of public policy. Ironically, the moral discourse of religious traditions on euthanasia may gain public relevance at the expense of its religious content. Nonetheless, religious traditions can provide a context of ultimacy and meaning to this debate, which is a condition for genuine pluralism.


Campbell CS. Religious Ethics and Active Euthanasia in a Pluralistic Society. Kennedy Inst Ethics J. 1992;2(3):253-277.

The Hospital Ethics Committee: Health Care’s Moral Conscience or White Elephant?

David C Blake

The Hastings Center Report
The Hastings Center Report

Abstract
In a morally fragmented society there is no good reason for ethics committees to assume any particular point of view, yet failure to do so compromises their ability to function in either a case-review or an educational capacity. A casuist methodology might enable committees to fulfill both roles.


Blake DC. The Hospital Ethics Committee: Health Care’s Moral Conscience or White Elephant?. Hastings Cent Rep. 1992;22(1):6-11.

Abusing human rights in the health care service under a soft dictatorship in Hungary

Gábor Ternák

Journal of Medical Ethics
Journal of Medical Ethics

Extract
Torture probably ended a long time ago in my country, but now we have more sophisticated ways of abusing human rights – in the way we deliver health care. The falsification of morbidity and mortality figures; not paying attention to the so-called ‘Capitalist’ diseases like drug abuse and even AIDS; not talking about the hazards of environmental pollution – all this has prevented us from taking ameliorating and protective measures.


Ternák G. Abusing human rights in the health care service under a soft dictatorship in Hungary. J Med Ethics. 1991;17(Supplement):40.

The position of the Chilean Medical Association with respect to torture as an instrument of political repression

Gunther Seelman

Journal of Medical Ethics
Journal of Medical Ethics

Extract
We reaffirm . . . our most categorical rejection of torture. Likewise, we reiterate our resolute support of the diverse initiatives aimed at investigating the participation of doctors in these unacceptable and condemnable practices, and the sanctioning of these activities within the medical profession and scientific organisations. . . There exists irrefutable proof that, during the 16 years of dictatorship, doctors and other members of the health care professions caused brutal suffering to their peers. Doctors involved in acts of torture are, for the most part, members of the armed forces. The conduct of these professionals is the result of the displacement of their medical vocation by the doctrine of ‘national security’, which conceives of the masses and their social and political organisations as the ‘internal enemy’.


Seelman G. The position of the Chilean Medical Association with respect to torture as an instrument of political repression. J Med Ethics. 1991 Dec; 17(Supplement):33-34.

Torture and the participation of doctors

Ugur Cilasun

Journal of Medical Ethics
Journal of Medical Ethics

(Notes that no doctors in private practice were known to have been involved in torture in Turkey. Those involved were working part-time or full-time for the government, or in the military.)
Extract
. . . Government pressure, on full or part-time employees, emerges in various forms. Doctors who refuse to participate in the act of torture can be accused of not obeying the orders of their immediate superiors and can be either dismissed from government service, or relocated to other posts with highly unfavourable working/living conditions. Material considerations, fear of being removed from family, and the obvious threat of coming under suspicion of ‘secretly collaborating with public enemies’, etc, exerts such emotional pressure that doctors are forced to participate, directly or indirectly, in the act of torture.


Cilasun U. Torture and the participation of doctors. J Med Ethics. 1991 Dec;17(1):S21-S22.

Remarks on medical ethics

Martin Bojar

Journal of Medical Ethics
Journal of Medical Ethics

Extract
Fulfilling the universal code of medical ethics is the ‘conditio sine qua non’ and we should prevent all attempts to change the basic document of European and world medicine, the Hippocratic Oath. Pross’s paper about the total failure of the German Medical Association to acknowledge and deal with war crimes perpetrated by doctors reinforces the need to adhere to the Hippocratic Oath.


Bojar M. Remarks on medical ethics. J Med Ethics. 1991;17(Supplement):39.

Coercive Population Control Policies: An Illustration of the Need for a Conscientious Objector Provision for Asylum Seekers

E Tobin Shiers

Virginia Journal of International Law
Virginia Journal of International Law

Extract
Conclusion

When President Bush successfully thwarted passage of the Emergency Chinese Immigration Relief Act of 1989 and implemented his own order insisting upon “careful consideration” of victims who plead for political asylum because of coercive population control measures in their homelands, he unwittingly illustrated the need for a change in the statutory language. The Executive Order unwisely forces the issue of coercive population control policies into statutory language designed to protect victims of discrimination. Such manipulations would not be necessary if the Refugee Act of 1980 were amended to encompass the Handbook’s interpretation of the U.N. Protocol.

The interpretative guidelines to the U.N. Protocol, and derivatively
to the Convention, call for a “conscientious objector” exception to
military service. The grant of refugee status to individuals who prove
“valid reasons of conscience,” even reasons distinct from religious
claims, recognizes that fitting an individual within the protections of
the refugee definition requires a judgment on the means other nations
use to implement their policy ends, not just the ends themselves.
Rather than relying solely on the five narrow grounds for granting
asylum that were developed in response to the atrocities of World
War II, the U.N. Protocol, as interpreted by the Handbook, also
advocates protection for the individual persecuted by virtue of
mandatory participation in a military service with which he morally
disagrees. Because the debate regarding coercive population control
considers the legitimacy of means employed in achieving governmental
policy objectives, the logic of the conscientious objector exception
also applies to claims such as that of Chang.


Shiers ET. Coercive Population Control Policies: An Illustration of the Need for a Conscientious Objector Provision for Asylum Seekers. Va J Int Law. 1990;30(4):1007-1037.

Fetal rights: Supreme Court tosses ball back in Parliament’s court

Eike-Henner Kluge

Canadian Medical Association Journal, CMAJ
Canadian Medical Association Journal

Extract
The case is of interest to doctors, but not because it deals with midwifery and its legality in Canada – the Supreme Court decision is silent on that point. At issue was the status of the human fetus: Is a full-term human fetus that is partially born a person in the eyes of the criminal law? The court decided it is not. . . . The Supreme Court has decided this case on very narrow legal grounds and it has carefully avoided coming to grips with the issue of whether a fetus is a person in the eyes of the law. This is not surprising. On several occasions, such as cases involving Morgentaler5 and Daigle,6 the Supreme Court has made clear that the status of the fetus should not be resolved in court – the court is not prepared to do Parliament’s work.


Kluge E-H. Fetal rights: Supreme Court tosses ball back in Parliament’s court. Can Med Assoc J. 1991 May 01;144(9):1154-1155.