The abortion Bill presented by Minister Simon Harris contains a provision for conscientious objection that is too limited. It should be expanded so to include all medical professionals. It should take into account the profound changes that this Bill will introduce, which require more rigorous safeguards for healthcare workers who value the lives of both pregnant women and their unborn children.
The Act says that it does not oblige “any medical practitioner, nurse or midwife to carry out, or to participate in carrying out, a termination of pregnancy to which he or she has a conscientious objection.” (Part 3, section 23)
This is a “cut and paste” from the Protection of Health in Pregnancy Act, 2013, which allows abortion in emergencies, when there is a risk for the life of the mother, or when there’s a risk of suicide.
The proposed Bill, instead, requires no reason until 12 weeks and, after that period, it is so liberal very few abortions will be denied in practice.
These significant changes should be reflected in the conscientious objection clause. Here are some possible improvements.
– Pharmacists are not included in the Bill, as it refers only to doctors, nurses or midwives. This is already obsolete because nowadays, the majority of abortions are carried out not through a surgical procedure but using pills. Pharmacists working in a hospital will be forced by Minister Harris to actively participate in something that goes against their will and professional conscience.
– The Bill does not include medical students and researchers. They have a conscience too and it should be protected.
– The Bill covers only individuals but no institutions. Hospital and clinics with a pro-life ethos are not exempted from offering abortion services. (Read more here)
The same section 23 also requires the conscientious objector to “make such arrangements for the transfer of care of the pregnant woman concerned as may be necessary to enable the woman to avail of the termination of pregnancy concerned”.
Minister Harris yesterday (Thursday 18th) said that this part of section 23 is in line with the Medical Council guidelines and also with the Nurses and Midwifery Board of Ireland conduct of ethics, with regard to conscientious objection. But he ignored the fact that those codes were not written in the context of the liberal regime that he is proposing. A new scenario requires new and more rigorous safeguards.
The scope of the conscience clause should be expanded, so to include providing information and referrals. These are also forms of participation.
Many health professionals don’t want to be involved in abortions in any form and conscientious objection encompasses more than simply not performing the intervention. Moreover, it is not clear what transfer of care implies.
In order to protect conscientious objectors, the Bill should include antidiscrimination provisions that apply in the context of employment, promotion, or termination of employment. This means that being an objector should never be a reason for discrimination in the recruiting process or any other aspect of work.
These antidiscrimination provisions should not be limited to workers but include the admission to training programmes such as residencies and internship or, in the case of students, the eligibility for scholarships, prizes, etc.
The offices of pro-life groups have been vandalised in the past. Conscientious objector GPs are exposed to the same risk. The government has promised a separate companion piece of legislation to provide for “safe access” to abortion services. How is it going do to protect conscientious objectors from the intimidation and harassment of pro-choice protestors?
The law should also protect objectors from others possible adverse consequences of following their conscience by seeking to protect both lives. These consequences are not limited to the context of employment, or formation, but could include restrictions or disciplinary actions from professional bodies that, led by pro-choice activists, that want to limit conscience rights.
We often hear that Christianity, or religion in general, is unappealing for women because religions tend to be ‘patriarchal’. However, in practice women are more religious than men, and this is particularly the case among Christians. It turns out that the bigger problem Christianity faces is in attracting more men to services.
Pew Research Center in the US conducts major polling on a continuous basis. Several of its surveys have looked at religious participation by sex. For example, one survey found that American women are more likely than men to say religion is “very important” in their lives (60% vs. 47%).
They are more likely than men to pray (64% vs 47%) and to attend a religious service at least once a week (40% vs 32%).
But the gender gap in religion changes among different faiths and among cultures. According to aworld-wide study by Pew, Christian women are more religious than Christian men, but “Muslim women and Muslim men show similar levels of religiousness on all measures of religious commitment except frequency of attendance at worship services. Because of religious norms, Muslim men attend services at a mosque much more often than Muslim women do.”
Scholars agree that the religious gender gap is due to a confluence of multiple factors: psychology, family environment, social status, workforce participation, etc., but there is no consensus on exactly which factors are more responsible for gender differences.
The teachings of a particular creed might make it more appealing to women, rather than men, but local traditions and habits also play a role. This means that even within the same tradition, Christianity for instance, there are significant differences in different parts of the world.
An estimated 83.4% of women around the globe identify with a faith group, compared with 79.9% of men. There is no significant difference in weekly attendance in countries where Buddhism is the major religion.
Christian women have higher rates of church attendance in all countries where Christians are a majority. Interestingly, where they are a minority, the differences among men and women in terms of church attendance are smaller. The prevailing religion plays an obvious influence on the rest of the population in those countries, and culture rather than beliefs explains the gender gap there.
Israel is the only country in the world where a higher percentage of men than women reports engaging in daily prayers. Overall, “the average share of women who say they pray daily is 8 percentage points higher than the average share of men”, the Pew Research Center found. And this is the case also for unaffiliated women, who pray more than men.
Among Hindus in the U.S., daily prayer is significantly more common among women than men (+29%), but the gender differences among Hindus in India are not statistically relevant.
Among Buddhists, women also report a higher rate of daily prayer than men, but the difference is statistically significant only in Japan (+10%).
Only in Israel and Mozambique are men more likely than women to consider religion very important for them personally. Everywhere else, women are more religious. Even the unaffiliated women report higher levels of engagement with religion than unaffiliated men across several indicators, including weekly attendance at religious services, daily prayer and saying religion is very important to them.
After a long and costly battle, Ashers Bakery from Belfast, which is owned and operated by a Christian couple, has been vindicated. Ashers had refused to bake a cake that was to be iced with the words “Support Gay Marriage.” The ruling is a very important one for freedom of conscience.
The case refers to Mr Gareth Lee, an activist from a group called Queerspace, who in 2014 placed an order for a cake to be iced with a cartoon design and above wording. The McArthurs, the Christian family that runs Ashers, decided that they could not in conscience produce a cake with that slogan and so should not fulfil the order. The fact that Mr Lee was gay was not known to the McArthurs, who served him in the past. They objected to this request, but they had no problem with offering him other services.
Mr Lee complained to the Equality Commission for Northern Ireland (ECNI) about the cancellation of his order and the ECNI supported him in bringing this claim for direct and indirect discrimination on grounds of sexual orientation, religious belief or political opinion.
In 2015, the Presiding District Judge held that refusing to complete the order was direct discrimination on all three grounds and awarded Mr Lee damages. The Court of Appeal confirmed this rule, and so the Ashers appealed to the Supreme Court in a bid to overturn the judgement.
The Supreme Court had to decide whether it is discrimination for a bakery to refuse to supply a cake with the message “Support Gay Marriage”, because of their belief that gay “marriage” is inconsistent with their faith.
The Court ruled that the Ashers objected to the message, not the messenger. Mr Lee was treated less favourably than other would-be customers not because of his sexual orientation, as he claimed, but because of the message he wanted to be iced on the cake. In fact, a person with a similar request and a different orientation would have been treated in the same way and this is not discrimination, according to the Supreme judges.
“There was no less favourable treatment on this ground because anyone else would have been treated in the same way. The objection was not to Mr Lee because he, or anyone with whom he associated, held a political opinion supporting gay marriage. The objection was to being required to promote the message on the cake. The less favourable treatment was afforded to the message not to the man. … The evidence was that they were quite prepared to serve him in other ways. The situation is not comparable to people being refused jobs, accommodation or business simply because of their religious faith. It is more akin to a Christian printing business being required to print leaflets promoting an atheist message. “, Lady Hale, president of the Supreme Court, wrote.
It is significant that the other four judges agreed with Lady Hale. It was a unanimous verdict that vindicated the long battle of the baking company and the family behind it.
“The judges have given a clear signal today. In fact, it couldn’t be any clearer. Family businesses like ours are free to focus on giving all their customers the best service they can – without being forced to promote other people’s campaigns”, Daniel McArthur, Asher’s General Manager, said. “I know a lot of people will be glad to hear this ruling today, because this ruling protects freedom of speech and freedom of conscience for everyone.”
Oppressive liberalism does not tolerate dissenting opinions. In many countries, activists have targeted florists, photographers, restaurants or bakeries that do not provide services for same-sex marriages, with the purpose of ruining their business. Here in Ireland we see that pro-life doctors will be required by law to refer women seeking abortions to pro-choice doctors.
As Lady Hale indicated, the bakery could as easily have been asked to bake a cake with a slogan denying the existence of God and would have been just as entitled to refuse to do that.
The Supreme Court has now said that declining to do something that promotes a viewpoint you do not support, is not a form of discrimination. This is a victory not only for free speech but also for freedom of conscience. People in business cannot be obliged to support with their work political views they don’t agree with.
This case also raises questions about state bodies, such as the Northern Ireland Equality Commission, that, rather than promoting freedom in all its forms, including religious freedom, often work more like ideological advocacy groups. This was an expensive and divisive case that could have been solved with common sense. The Ashers decided to fight for their own rights but this case will have wider implications and, hopefully, will inspire others not to submit to the pressure of society but to live according to conscience.
Minister Simon Harris has presented his abortion Bill in the Dáil and has confirmed that it will allow only a limited form of conscientious objection.
In the Bill, which is now being discussed in the Oireachtas, there is no provision for institutional conscientious objection, which means that hospitals with a religious ethos will be forced to offer abortions. Also, there is no provision for pharmacists working in hospitals.
A growing number of doctors, including some who supported the repeal of the 8th amendment, are asking the government to amend the Bill so that medical doctors should not be obliged to refer their patients for an abortion, which is a form of participation. However, Minister Harris doesn’t seem ready to concede any change on this matter.
Of all the deputies who have commented on the Bill, only Mattie McGrath has defended the conscience rights of physicians, nurses and midwife. He also made reference to a letter signed by 203 Irish medical doctors, expressing their “profound concern that the Irish College of General Practitioners has not made the issue of freedom of conscience a central part of its consultation with GPs regarding the Government’s proposed new legislation on abortion”.
Louise O’Reilly, speaking for Sinn Féin, said that they “do not agree that medical professionals who invoke the conscience clause should be exempt from referring a patient for the necessary medical treatment they seek.”
Labour Party spokesman for health, Alan Kelly, explicitly requested that institutions should not be granted conscientious objection, and so did Deputy Catherine Murphy. Speaking for the Social Democrats, she said: “While the Minister has assured me that there can be no conscientious objection on the part of institutions, it would be remiss of us to ignore the fact that certain boards of management potentially could instruct staff to adhere to internal regulations. We must ensure the legislation covers such eventualities.”
Deputy Ruth Coppinger (Solidarity – People Before Profit) claimed that “conscientious objection is used as a mechanism in other countries to act as a barrier to abortion. In parts of Italy pregnant women cannot access abortion because doctors refuse it”. A similar statement about Italy was made also by Joan Collins. Italy has a high number of conscientious objectors and for this reason it is a common target of pro-choice campaigners, but they never say that even if the percentage of objectors among doctors has increased with time, this does not affect the general provision of abortion as the requests have diminished significantly. (Read more about Italy here: https://ionainstitute.ie/abortion-rights-activist-target-conscientious-objection-with-false-information/)
Deputy Bríd Smith (Solidarity – People Before Profit) was the most extreme opponent of freedom of conscience: “we need a much stronger impetus whereby objecting doctors must refer on. That referral must be immediate and must never be denied. There has to be a criminal sanction for refusing to do so. If we are going to sanction practitioners criminally for helping women to make the choice, we must criminally sanction those who refuse to help them make that choice. I would like to see a body that polices that operation”.
Pressure to limit conscientious objection is coming from bodies that depend heavily on Government funding, such as the Irish Human Rights and Equality Commission, and the National Women’s Council of Ireland (NWCI). In their response to the Bill, the NWCI wrote: “Protection for women in the case of conscience-based refusal of care (so-called ‘conscientious objection’) requires a clear, legal and policy framework, governing the practice of conscientious objection by healthcare providers, coupled with an effective oversight and complaint mechanism for women”.
It has to be noted the use of the derogative expression “refusal of care”, employed also by Dr Peter Boylan at the Oireachtas Health Committee hearings last week, and by the Abortion Rights Campaign and other pro-abortion organizations in their comments to the Bill. This is a miserable attempt to portray abortion as a form of care, and to stigmatize those who do not want to be involved in its provision. But medical professionals refuse abortion precisely because it doesn’t take care of the second patient, i.e. the unborn child.
According to the Bill, abortion is “a medical procedure which is intended to end the life of a foetus”. How is this care?
“Refusal of care” is an offensive distortion of language. It ignores that conscientious objection is a right internationally recognized—see for instance article 10 of the EU Charter of Fundamental Rights—it is a common feature of abortion legislation across the globe, and no national or international treaty or charter ever refers to objectors in such demeaning terms.
The General Assembly of the World Medical Association (WMA) is taking place in Reykjavik (Iceland) this week, starting today. Important topics such as the participation of doctors in assisted suicide and abortion will be discussed.
The Canadian Medical Association (CMA) and Royal Dutch Medical Association (RDMA) will introduce proposed changes to the WMA policy against euthanasia and assisted suicide and, at the same time, they will invite other national associations to follow their proposals.
They want to change the code of ethics of the WMA, dropping its condemnation of euthanasia and assisted suicide that has been in place since its foundation, so that doctors working in countries where this is legal can participate in it.
If approved, those change will represent a profound betrayal of the medical profession. The role of doctors will no longer be to prevent and cure ill-health; instead their task will be to fulfill patients’ requests even when such requests are objectively harmful and even lethal.
The Canadian Medical Association (CMA) dropped its opposition to euthanasia in 2014 and now, in certain provinces, even physicians who do not want to perform the lethal procedure are obliged to refer patients to another doctor who will. (See more here: https://www.canadiansforconscience.ca/)
One could see similarities with the Irish abortion law. Minister Harris wants to oblige doctors who are conscientious objectors to refer their patients to others. This is a form of indirect participation and is morally unacceptable. If assisted suicide is introduced in Ireland, it is likely that objecting doctors will be obliged to make referrals too, as is already happening in Canada.
The same concerns were outlined in a letter written to the World Medical Journal by seven Canadian physicians, and endorsed by many others including Dr Balfour Mount, the father of palliative care in North America.
“As Canadians, we are saddened by this situation, but we hope that our experience and observations will serve as a warning for our colleagues in other countries, and their patients. Most important: The World Medical Association must recognize that accommodating the kind of radical change in medical culture underway in Canada is ill-advised. Mindful of the legacy of past WMA leaders, such as former Secretary General, Dr. Andre Wynen, who, based on his personal experience, stood courageously against any minimization of the dangers of euthanasia to patients and physicians, we advise against any compromising additions or modifications to existing WMA declarations, and strongly support a full defence of established policy against euthanasia and assisted suicide.”
Some of the authors of this letter are currently in Iceland to communicate their message to the participants of the General Assembly.
Never has killing patients, or helping them kill themselves, been part of the medical profession’s obligations. The aim of medicine has always been to save lives and if the World Medical Association changes their ethical code to prescribe doctors’ participation, even against their conscience, in euthanasia and medically-assisted suicide, this will have profound consequences for civic legislation all across the globe, including in Ireland.
Another topic discussed and submitted for a vote at the General Assembly will be the “Declaration on Medically-Indicated Abortion”.
According to the European Centre for Law and Justice (ECLJ), “the proposed revision of the Declaration violates the independence of physicians and their freedom of conscience”.
The vote on the Declaration will take place on Saturday and, in a letter sent to the delegates, the ECLJ asked them to oppose or amend it as its language is ambiguous.
The Declaration asks conscientious objectors to ensure “the continuity of medical care by a qualified colleague”. If “medical care” is interpreted as including abortion, which is what pro-choice activists demand, then the Declaration would imply that doctors could be forced to refer women to other professionals who perform abortions. (Minister Harris wants to impose a similar limitation on conscientious objection in Ireland).
This is not the current policy of the World Medical Association and every attempt to undermine and limit the conscience of physicians has to be opposed.