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.”
Find article here.

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.”
Find abstract here.

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.”
Find article here.

Doctors Have no Right to Refuse Medical Assistance in Dying, Abortion or Contraception

Bioethics. doi:10.1111/bioe.12288
Authors: Savulescu, J. and Schuklenk, U.
“In an article in this journal, Christopher Cowley argues that we have ‘misunderstood the special nature of medicine, and have misunderstood the motivations of the conscientious objectors’. We have not. It is Cowley who has misunderstood the role of personal values in the profession of medicine. We argue that there should be better protections for patients from doctors’ personal values and there should be more severe restrictions on the right to conscientious objection, particularly in relation to assisted dying. We argue that eligible patients could be guaranteed access to medical services that are subject to conscientious objections by: (1) removing a right to conscientious objection; (2) selecting candidates into relevant medical specialities or general practice who do not have objections; (3) demonopolizing the provision of these services away from the medical profession.”
Find article here.

Mandating Disclosure of Conscience-Based Limitations on Medical Practice

American Journal of Law & Medicine March 2016 vol. 42 no. 1 85-128
Author: Nadia N. Sawicki
“Stakeholders in law, medicine, and religion are unable to reach consensus about how best to address conflicts between healthcare providers’ conscientious objections to treatment and patients’ rights to access medical care. Conscience laws that protect objecting providers and institutions from liability are criticized as too broad by patient advocates and as too narrow by defenders of religious freedom. This article posits that some of the tension between these stakeholders could be mitigated by statutory recognition of a duty on the part of healthcare institutions or providers to disclose conscientiously motivated limitations on practice.”
Find abstract here.

Health providers react to Bill C-14

CMAJ, early release online 25 April 2016
“Physician  and  nursing  organizations have cautiously welcomed the  federal  government’s  proposed  assisted  death  legislation,  but  concerns  remain  about  the  criteria  for  access  to  the  service  and  protections  for conscientious objectors.
The  proposed  Bill  C-14  restricts  assisted  death  to  mentally  competent  adults  who  have  a  serious  and  incurable  illness,  disease  or  disability,  and  for whom natural death is likely in the forseeable  future.  It  does  not  address  more  controversial  issues,  such  as  whether  assisted  death  should  be  available  to  children  or  people  with  mental illnesses.”
Find article here. See also BMJ Journal of Medical Ethics blogs ‘No to Conscientious Objection Accommodation in Health Care‘.

Trends and patterns in vaccination objection, Australia, 2002–2013

Med J Aust 2016; 204 (7): 275.
Authors: Frank H Beard, Brynley P Hull, Julie Leask, Aditi Dey and Peter B McIntyre
“Considerable media and public attention has been focused in recent years on the refusal by some parents to vaccinate their children as recommended by health authorities. Vaccination coverage has often been purported to be declining nationally as a result, particularly in more affluent inner-city suburbs (for example, 1). …Our study aimed to examine trends in registered vaccination objection and differences in the geographic and demographic distribution of objection across Australia, and to assess the contribution of unregistered objection to incomplete vaccination.”
Find article here.

Zubik v. Burwell Oral Arguments

Zubik v. Burwell Oral Arguments: Under Contraceptive Coverage Accommodation, Conscientious Objectors Or Collaborators?

Health Affairs blog, online 24 March 2016
Author: Timothy Jost
“On March 23, 2016 the Supreme Court once again heard oral arguments in a case involving the Affordable Care Act. The case, Zubik v. Burwell, does not involve a challenge to the constitutionality of the statute, as did National Federation of Independent Business v. Burwell, or even a claim that the government has violated the Affordable Care Act in its implementation of the statute, as did King v. Burwell, but rather a claim that a particular regulation implementing a particular provision of the ACA violates a separate statute, the Religious Freedom Restoration Act (RFRA).”
Find article here.

Conscientious objection and healthcare in the UK: why tribunals are not the answer

J Med Ethics 2016;42:69-72
Author: Christopher Cowley
“A recent issue of the journal Bioethics discussed whether conscientious objectors within the healthcare context should be required to give their reasons to a specially convened tribunal, who would have the power to reject the objection. This is modeled on the context of military conscription. Advocates for such a tribunal offer two different justifications, one based on determining the genuineness of the applicant’s beliefs, the other based on determining their reasonableness. I limit my discussion to a doctor’s objection to abortion in the UK, and argue against both justifications…”
Find abstract and links to commentaries in reply here.