0 - Protection of Conscience Project Library

The women’s conference: where aspirations and realities met

Jeanette H Johnson, Wendy Turnbull

Abstract
PIP: This article is a reflection on the Fourth World Conference on Women in Beijing in September 1995, including its preparatory meetings. Delegates from 187 nations negotiated and decided on the disputed passages of the draft Platform of Action, which comprised 40% of the 150 page document. The atmosphere prior and during the conference was not peaceful. The UN and China disputed over the location of the nongovernmental organizations’ (NGO) forum that took place at the same time of the conference. The US and Chinese governments squabbled about China’s detention of a Chinese-American human rights activist. The US First Lady attended the conference and the NGO forum, promoting human rights. Most delegates had decided that this conference would not be a retreat from the Cairo conference. In comparison to Cairo, the Vatican delegation had toned down its opposition. US based antiabortion groups and conservative women’s groups arrived in greater numbers in Beijing than in Cairo, in hopes to reverse actions taken in Cairo. They had few victories. A contentious issue was parental rights and responsibilities, specifically adolescents’ access to confidential health services. Compromise wording was worked out in two paragraphs. All other references to parental rights were deleted or there was a reference to the compromise wording. The Beijing platform was the first universal document recognizing the right of a woman to say no to sexual intercourse. The references in the Beijing document recognizing sexual rights as human rights were a major accomplishment. Debates over the issue of abortion took place: the proposed conscience clause and a call for the review of laws containing punitive measures against women who have had an illegal abortion. The vocal delegates from developing countries are silencing the accusation that radical Western women are thrusting women’s rights on the rest of the world.

Johnson JH, Turnbull W. The women’s conference: where aspirations and realities met. Fam Plann Perspect. 1995 Dec;21(4):155-159.

Pharmaceutically assisted death and the pharmacist’s right of conscience

William L Allen, David B Brushwood

Extract
In this article, we describe the pharmacist’s potential involvement in what has been referred to as “physician assisted suicide”. We suggest that when a physician prescribes a medication for the purpose of terminating a patient’s life, and when that prescription is presented to a pharmacist for filling, a moral dilemma may exist. The basis of the dilemma is the choice a pharmacist may be required to make between the duty to fill a legal prescription for a medication that is deemed appropriate by both the prescriber and the patient, and the duty to adhere to one’s own belief that medication should not be used to end life. We contend that in filling a prescription, especially given the recent advances in pharmacy practice, a pharmacist is no mere bystander in drug therapy. Rather, the pharmacist is an active participant whose values, attitudes, and beliefs should be given consideration.

Allen WL, Brushwood DB. Pharmaceutically assisted death and the pharmacist’s right of conscience. J Pharm Law. 1996;5(1):1-18

The Right to Procreate: When Rights Claims Have Gone Wrong

Laura Shauuer

Abstract
Debates regarding the development of new reproductive technologies (NRTs), funding for infertility treatments, and non-medical criteria for access to infertility treatments frequently invoke “rights to reproduce” or “procreative rights”. The claim of this right – literally the right to have children – is not the same thing as many other “reproductive rights” that are invoked in contraception, abortion, and pregnancy management discussions.

The author argues that the claim of a right to bear or beget children, which may in turn support research into NRTs and then funding and access claims, is not justified. Framing procreative decisions in terms of rights claims is a problematic ethical project, which in turn creates difficulties for the establishment of legal procreative rights. There are two critical problems: first, the distinction between positive (entitlement) and negative (liberty) rights claims leaves those requiring reproductive assistance in need of a different justification for their claims than those who need no help; second, a procreative right is generally claimed to be limited by the rights or interests of the future children, but a right of non-conception is an intemally contradictory concept.

The author then discusses variations of procreative rights claims, including claims of rights to enter reproductive contracts or to seek assistance, and other conceptual foundations for reproductive decisions. Thus, while reproductive rights are often helpful in protecting individuals and families from undue governmental intrusion, rights are shown to be a problematic, inadequate, and inappropriate framework to describe both the legal and moral status of claims for assisted procreation.

Shauuer L. The Right to Procreate: When Rights Claims Have Gone Wrong. McGill Law J. 1995 Aug;40(823-874.

(News) Murder-suicide involving BC doctor raises troubling questions about euthanasia

Valerie Wilson

Canadian Medical Association Journal, CMAJ — Canadian Medical Association Journal

Abstract
The deaths last September of a British Columbia physician and his wife have raised troubling questions about euthanasia and Alzheimer’s disease. Police described the deaths of Dr. Tom Powell and his wife Dr. Lorraine Miles, a retired dentist, as a murder-suicide. Friends of the couple wonder if more lenient laws concerning euthanasia and assisted suicide might have saved Miles’ life.

Wilson V. Murder-suicide involving BC doctor raises troubling questions about euthanasia. Can Med Ass J 1995 Jun 1; 152(11) 1855-1856.

In Britain Fewer Conflicts of Conscience

Cicely Saunders

Extract
The ethical principles of care have to balance patient autonomy or control with the justice owed to society as a whole. Our choices do not take place in a purely individual setting and the change in society’s attitude when a hastened death is available is illustrated by the changes that are taking place in the Netherlands.

Saunders C. In Britain Fewer Conflicts of Conscience. Hast Cent Rep. 1995 May-Jun;25(3):44-45.

Conflicts of Conscience: Hospice and Assisted Suicide

Courtney S Campbell, Jan Hare, Pam Matthews

Extract
Proposals to legalize assisted suicide challenge hospice’s identity and integrity. In the wake of Measure 16, Oregon hospice programs must develop practical policies to balance traditional commitments not to hasten death and not to abandon patients with dying patients’ legal right to request lethal prescriptions. . . . . .

Regardless of the path an individual hospice may follow,-it cannot avoid the uncharted and unknown territory of a law that legalizes a lethal prescription and a scheduled death for some terminally ill patients. Whether a hospice forges a path through the middle of this territory through full participation, skirts along its borders by forms of indirect participation, or creates a detour through abstention and nonparticipation, the nature and mission of hospice in Oregon will be irreversibly altered.

Campbell CS, Hare J, Matthews P. Conflicts of Conscience: Hospice and Assisted Suicide. Hastings Cent Rep. 1995 May;36-43.

(Correspondence) Abortion: a violent procedure?

Brian A Shamess

Extract
I too was dismayed and deeply concerned about the attack against Dr. Romalis. None the less, I must comment on Marshall and colleagues’ statement that “we abhor the use of violence in ethical debates.” These students must realize that therapeutic abortion is the only legalized medical procedure in which another human life is taken. . . Certainly the medical community should oppose violence against physicians practising in this area. Even if this perpetrator, or convicted US murderer Paul Hill, was exercising a difficult personal choice in targeting a physician who performs abortion, a violent act against a physician remains as abhorrent as abortion itself.

Shamess BA. (Correspondence) Abortion: a violent procedure? Can Med Assoc J. 1995 May 01;152(9):1376.

Revision of Code of Ethics proving to be complicated procedure

Patrick Sullivan

Abstract
Although the CMA Code of Ethics is only a 10-page booklet, revising it is proving to be complicated and time consuming. It is currently undergoing its first major revision in 25 years in an attempt to bring it up to date with changes within the medical profession and medical practice. The work was to have been completed in time for presentation to General Council during the 1995 annual meeting, but because of its complexity and the need for consensus the revised code will not be presented to council until August 1996.

Sullivan P. Revision of Code of Ethics proving to be complicated procedure. Can Med Assoc J. 1995;152(6):934-934. Available from:

(Editorial) Abortion- a debate

J Smith

Extract
The wave of abortion-on-demand legislation sweeping the world has reached our shores. The first blows to the concept of the sanctity of human life are being dealt at a time when health care in South Africa is undergoing tremendous upheaval. This concept may be irreparably damaged if the present Abortion and Sterilisation Act of 1975 is changed. . . Health professionals should be guided in their decisions and proposals by health values and by scientific evidence. Unfortunately these are not the only prerequisites, since moral and religious considerations are always subconscious realities. Enormous moral and ethical pressures already confront those making decisions about the provision of medical and health care in developing countries. . . The ‘unwanted’ child . . .is therefore victimised, not because of his or her own shortcomings but because society attempts to solve its socio-economic and broader health problems through the sacrifice of its children. . . To avoid abortions, fertility regulation (family planning)should be aggressively propagated in South Africa with specific emphasis on female education and counselling regarding contraceptive information, services and supplies and sterilisation. Contraception saves the lives of thousands of women around the world owing to avoidance of unwanted pregnancies.

Smith J. (Editorial) Abortion- a debate. S Afr Med J. 1995;85(3):137-139.

(Correspondence) Understanding fanatics and followers (The author responds)

Douglas Waugh

Extract
Dr. Hoaken brings his formidable analytic talents to bear on the problem of assaults on abortionists. Certainly the concept of “justifiable homicide” would or should be abhorrent to us all – I say this as a former soldier in World War II, in which a lot of “justifiable homicide” took place. . . .If I read his letter correctly, his plea is for a greater degree of humane tolerance than seems to prevail now. I could not agree more strongly. I believe that Drs. Fireman and Lemoine would endorse this view. Their comments on the genocidal behaviour in Nazi Germany during World War II are well taken; in an earlier draft of my manuscript I did make this comparison. . . . I believe Fireman, Lemoine and I have similar, if not identical, views on this.

Waugh D. (Correspondence) Understanding fanatics and followers (The author responds). Can Med Assoc J. 1995 Mar 15;152(6):808.