New Frontiers in End-of-Life Ethics (and Policy): Scope, Advance Directives and Conscientious Objection

Bioethics, 31(6) 2017, 422-423
Author: Udo Schuklenk
“However, it would be premature to conclude that all arguments are settled now, if not in politics and law, and that, certainly in ethics, nothing much original could be added to the existing corpus of critical analysis and argument. In fact jurisdictions considering the decriminalization of medical aid in dying are grappling today with three issues that deserve further analysis.”
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Italy has introduced mandatory vaccinations and other countries should follow its lead

The Conversation, 2 June 2017
Author: Alberto Giubilini
“Parents will have to provide proof of vaccination when they enrol their children in nursery or preschool. In this respect, the Italian policy follows the example of vaccination policies in the US. But there’s one crucial difference: the Italian law doesn’t allow parents to opt out on the grounds of ‘conscientious objection’.”
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Conscientious objection in healthcare and the duty to refer

Journal of Medical Ethics 2017; 43:207-212.
Author: Cowley C
“Although some healthcare professionals have the legal right to conscientiously object to authorise or perform certain lawful medical services, they have an associated duty to provide the patient with enough information to seek out another professional willing to authorise or provide the service (the ‘duty to refer’).”
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Conscientious objection in healthcare: why tribunals might be the answer

Journal of Medical Ethics 2017; 43:213-217.
Author: Hughes JA
“A recent focus of the debate on conscientious objection in healthcare is the question of whether practitioners should have to justify their refusal to perform certain functions. A recent article by Cowley addresses a practical aspect of this controversy, namely the question of whether doctors claiming conscientious objector status in relation to abortion should be required, like their counterparts claiming exemption from military conscription, to defend their claim before a tribunal. Cowley argues against the use of tribunals in the medical case, on the grounds that there are likely to be fewer unjustified claims to conscientious objection in this context than in the military, and that in any case tribunals will not be an effective way of distinguishing genuine and false cases. I reject these arguments and propose a different conception of the role of a medical conscientious objection tribunal.”
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Conscientious refusal in healthcare: the Swedish solution

Journal of Medical Ethics 2017; 43:257-259.
Author: Munthe C
“The Swedish solution to the legal handling of professional conscientious refusal in healthcare is described. No legal right to conscientious refusal for any profession or class of professional tasks exists in Sweden, regardless of the religious or moral background of the objection. The background of this can be found in strong convictions about the importance of public service provision and related civic duties, and ideals about rule of law, equality and non-discrimination.”
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The BMA’s guidance on conscientious objection may be contrary to human rights law

Journal of Medical Ethics 2017; 43:260-263.
Author: Adenitire JO
“It is argued that the current policy of the British Medical Association (BMA) on conscientious objection is not aligned with recent human rights developments. These grant a right to conscientious objection to doctors in many more circumstances than the very few recognised by the BMA. However, this wide-ranging right may be overridden if the refusal to accommodate the conscientious objection is proportionate. It is shown that it is very likely that it is lawful to refuse to accommodate conscientious objections that would result in discrimination of protected groups. It is still uncertain, however, in what particular circumstances the objection may be lawfully refused, if it poses risks to the health and safety of patients. The BMA’s policy has not caught up with these human rights developments and ought to be changed.”
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Federal judge halts transgender health protections

The Hill, 31 December 2017
Author: Mallory Shelbourne
“A federal judge in Texas on Saturday halted enforcement of federal rules aimed at preventing doctors from discriminating against transgender individuals. U.S. District Judge Reed O’Connor granted the temporary injunction, saying the rules “likely violate” the Religious Freedom Restoration Act, according to The Associated Press.”
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Vaccine Refusal Revisited — The Limits of Public Health Persuasion and Coercion

N Engl J Med 2016; 375:1316-1317
Author: James Colgrove
“Many scientific, ethical, and political challenges that physicians and public health officials face today in dealing with vaccine refusal would be familiar to their counterparts of past eras. Their task entails balancing the use of coercive and persuasive approaches.”
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No Jab, No Pay — no planning for migrant children

Med J Aust 2016; 205 (7): 296-298.
Authors: Georgia A Paxton, Lauren Tyrrell, Sophie B Oldfield, Karen Kiang and Margie H Danchin
“The Social Services Legislation Amendment (No Jab, No Pay) Act 2015 (Cwlth) was passed in November 2015, closing the conscientious objection exemption to immunisation requirements for family assistance payments. The intention was to reinforce the importance of immunisation and protect public health, especially for children. While these aims are sound, there are far-reaching, presumably unintended, consequences for migrant and refugee children.”
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