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ss nucleus - January 2017,  News review

News review

Conscientious objection attacked

'There should be better protections for patients from doctors' personal values', say Julian Savulescu and Udo Shucklenk in a controversial paper in Bioethics. (1) Envisaging 'screening' of medical students for conscientious objection before starting specialty training, the authors hope to establish a system whereby 'eligible patients could be guaranteed access to medical services that are subject to conscientious objections'.

Marni Soupcoff of the Canadian National Post objected strongly; 'those with the wrong opinions... need not apply'. The paper was also criticised by Larry Worthen of the Christian Medical and Dental Society of Canada, who said: 'In every jurisdiction in the world, conscientious objection is recognised in some form… are we going to get to the point where there's an ethics test at the beginning of medical school, and if you have too much in the way of ethics, you're going to be screened out?' (2)

Savulescu is a well-known opponent of conscientious objection, having written in the BMJ in 2006 that 'a doctors' conscience has little place in the delivery of modern medical care'. (3)

Call to extend embryo research limit

Prominent scientists have called for an extension of the maximum age at which a human embryo can be used in research. the current limit of 14 days in the UK has been in place since 1990, and was based on a report by Mary Warnock in 1984.

Speaking to the Observer, professor Simon Fishel of CARE fertility group said 'the benefits for medical research would be enormous. Certain tumours, developmental abnormalities, miscarriage: there is a whole raft of issues in medical science that we could start to understand if we could carry out research on embryos that are up to 28 days old'. (4)

Dr Anthony Mccarthy of the Society for the Protection of the Unborn Child said: 'In 1984 the Warnock report on embryo experimentation refused to examine closely when personhood began. Instead it came up with an arbitrary 14 day limit after which the destruction of new human embryos would be, not just permitted, but enforced. Now others… wish to expand the scope to create, keep and destroy those persons'. (5)

Colorado votes for assisted suicide

On 8 november 2016, voters in Colorado were not only choosing between Hillary Clinton and Donald Trump, but also voting on a proposition to change the law on assisted suicide.

Proposition 106, passed by a near 2-1 majority, created the 'Colorado End of life Options act', allowing over-18s with a terminal illness and a prognosis of less than six months to live to request and self-administer medication that would end their life. Two physicians would need to confirm the diagnosis. A conscience clause allows physicians to opt-out of providing the prescription, and indeed whole healthcare facilities to debar their staff from participating if the medication is to be taken on their premises.

References
  1. Savulescu J, Shucklenk U. Doctors Have no right to refuse Medical assistance in dying, abortion or contraception. Bioethics 2016; September
  2. The Christian Institute. 'doctors with a conscience need not apply'. The Christian Institute 13 October 2016
  3. Savulescu J. conscientious objection in medicine. BMJ 2006; 332:294
  4. McKie r. row over allowing research on 28-day embryos. Observer 4 december 2016
  5. Society for the Protection of Unborn Children. Scientists call for embryonic research limit to be doubled. Society for the Protection of Unborn Children 5 December 2016
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