Dr John Lee wrote to the World Medical Association (WMA) protesting proposed changes in i ethicalts policy statements on abortion and on euthanasia.

The proposed changes will be discussed at the at the WMA council meeting in April.

Lee says two of the proposals would "facilitate worldwide abortion and euthanasia by curtailing doctors' conscientious objection" by using".

They would do this by using deceptive language, by pressure being put on doctors by national regulatory bodies and by using legal force "... to weaken national laws protecting human life".

The WMA's Declaration of Oslo on Therapeutic Abortion was last updated in 2006.

This says the Association "requires the physician to maintain respect for human life," but "where the law allows therapeutic abortion to be performed, the procedure should be performed by a physician competent to do so in premises approved by the appropriate authority."

It goes on to say: "If the physician's convictions do not allow him or her to advise or perform an abortion, he or she may withdraw while ensuring the continuity of medical care by a qualified colleague."

Lee says the proposed revision removes any distinction between "a therapeutic abortion" and "an elective abortion".

It affirms "the physician who objects must nevertheless provide 'safe abortion' in some circumstances."

The proposal also appears to remove the 2006 declaration's reference to the "unborn child" and refers instead to the "foetus."

Lee said he has also been told Canada and the Netherlands have proposed changes to the WMA's euthanasia stance.

If passed, the changes would say the "WMA does not condemn physicians who follow their own conscience in deciding whether or not to participate in these activities" in jurisdictions where euthanasia and physician-assisted suicide are legal".

Lee says "By saying that the WMA does not condemn physicians who perform euthanasia where it is legal, the WMA is saying that euthanasia can be ethical if it is legal."

Furthermore, Lee says "based on the Canadian experience, acceptance of the ethical neutrality of medically-assisted death has resulted in almost immediate challenges for physicians who are unable to refer (patients to other doctors) because of moral, religious or ethical concerns.

"It is a serious problem, with physicians put in the impossible position of having to choose between their conscience and being allowed to continue to care for their patients.

"Doctors who exercise their right of conscientious objection to abortion and euthanasia will find themselves victims of coercion by their professional societies and the state," Lee wrote. "This oppression of the silent majority by the vocal minority cannot end well."

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• The Tablet
• National Catholic Reporter
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He was speaking to the president of the Pontifical Academy for Life and European World Medical Association representatives who met last week to discuss "end of life" issues.

"Greater wisdom is called for today, because of the temptation to insist on treatments that have powerful effects on the body, yet at times do not serve the integral good of the person."

This wisdom is needed to analyse issues in relation to "overzealous treatment," patient and doctor relationships, global inequality in healthcare, the need to be close to the sick and to pay attention to the needs of the most vulnerable.

Sometimes withdrawing from overzealous treatment is wiser than using them, he said.

Francis drew some of his comments from Pope Pius XII's 1957 address to anesthesiologists and intensive care specialists.

These included his comment that it is "morally licit to decide not to adopt therapeutic measures, or to discontinue them, when their use does not meet that ethical and humanistic standard that would later be called ‘due proportion in the use of remedies.'

"It thus makes possible a decision that is morally qualified as withdrawal of ‘overzealous treatment'," Francis said, adding that "such a decision responsibly acknowledges the limitations of our mortality, once it becomes clear that opposition to it is futile."

He said understanding this promotes a focus on accompanying the dying.

While it means ethically avoiding excessive treatments, "it is completely different from euthanasia, which is always wrong, in that the intent of euthanasia is to end life and cause death."

He acknowledged many cases and situations can be "difficult to evaluate," and that there is no one-size-fits-all rule that can be adopted.

"There needs to be a careful discernment of the moral object, the attending circumstances and the intentions of those involved," he wrote.

The patient needs to be at the centre of any discussions and have the right to decide on treatment by discussing it with their doctors.

These discussions include deciding the "proportionality of the remedy" and "refusing it if such proportionality is judged lacking," Francis said.

He also pointed out the "personal and relational elements of the patient's life and also death", which are "after all the last moment in life," must be considered when evaluating his or her care.

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• Crux
• Crux
• Catholic Herald
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