FREEDOM TO REFUSE

I am speaking to you this evening because it seems that I am caught up in a conscience problem. Whereas I’ve been told to inform you that the morning after pill regimen is not abortifacient, that it is safe and effective, and will help to reduce the number of unwanted pregnancies, my own studies and reflections on the matter tell me otherwise. And so, I refuse to participate in the ECP program.

I have been in the profession of pharmacy for 19 years now, eight of these as a student, and never before have I encountered the confusion that exists today with respect to how a pharmacist should behave in a given set of circumstances. It used to be that one’s main guideline was the principle of “do no harm”. Now our guideline is “do what the patient wants even if it harms him or her; after all, the patient is entitled to live in a risky way.”

This approach is based on secular bioethical principles. The American Pharmaceutical Association currently endorses 5 principles that should guide pharmacists in making ethical decisions. These are the following:

1) Nonmaleficence – requires that I avoid inflicting harm.

2) Benificence – that I actively prevent harm or provide benefit

3) Autonomy – that I accept the patient’s self determination

4) Loyalty - commitment, faithfulness, fidelity, and

5) Distributive justice – appropriate allocation of benefits and burdens.

(from Campbell CS, Constantine GH. The Normative Principles of Pharmacy Ethics. In: Weinstein BD, editor.

Each ethical value must be weighed with respect to the issue at hand and prioritized based on the particular situation. The problem with interpretations of this model, is that they tend to absolutize patient autonomy. This autonomy can reign higher than patient safety (ie. a patient may decide he has a right to die), and certainly higher than a professional’s freedom of conscience. This model is clearly unacceptable to all faithful theists (Jews, Christians, and Muslims), who believe that man’s autonomy is limited by his creatureliness.

(In fact, Value II 2) in our Code of Ethics states that “ A pharmacist aids patients in their expression of needs and values (I’m not sure what that means), and recognizes their right to live at risk.” ( This might be more meaningful to you if you try replacing the word ‘patient’ with ‘your child’ or ‘your loved one’).

That’s fine, but don’t force me to pull the trigger.

The first glimpse I got into the reality that something was going awry, is about 6 or 7 years ago when I was practicing in a Toronto Rehabilitation hospital. The Ontario College of Pharmacists sent us a draft of a proposed Code of Ethics, which stated something to the effect that what was right or good for the patient, was whatever the patient decided. I wrote back in disagreement. What was the point of having gone to school for 8 years (in my case)? I gave the example of a case I had at the hospital. It was a head-injury patient who had driven head-on into a truck under the influence of marijuana. Even after this horrible experience, the patient still wanted the right to smoke pot, because this was what helped him to relax and keep calm. If marijuana were legal, would it be objectively good to allow this patient to risk harming himself and others again, even if he insists that it is good for him? I don’t honestly remember whether or not the Ontario College agreed with me that it would not be good, but they at least acknowledged my contribution.

In today’s society respect for others has taken on a mistaken meaning. Out of respect for others we don’t have the right to tell them if they are doing something wrong. It is also a lack of respect to provoke any change in another person deliberately.

Recently a mother and her daughter came to the pharmacy to pick up a prescription for the bc pill. In this case the daughter was going to use it to regulate her cycles, not as a contraceptive. I warned her as I usually do with other medications about potential long-term effects, such as increased risk of breast, cervical, and liver cancers, as well as increased risk of depression and stroke. The mom was at first grateful, then thought about it and a few days later accused me of using my authority to scare her daughter. What can I do if the truth is scary? Hide it? In my view, this would be unethical, and I must inform the patient according to my conscience.

In fact, everything I do requires an exercise of moral conscience. Many times I have to advise the physician that he may have made an error in the dosage of a medication for a particular patient, or that there may be a drug incompatibility, and I do not dispense the drug, because to do so may harm the patient and would be immoral. At times I may also refuse to fill a prescription because the patient is over-dosing, and to dispense would be detrimental to his/her health. This type of decision, which is required by our licensing bodies, as an exercise of professional conscience, is actually an exercise of moral conscience-it is wrong to do harm- based on professional experience, training, etc.

So why all this hype right now about not imposing one’s morality on the patient? And if a patient wants a harmful chemical, why should I be obliged to provide it if this goes against my ethic?

Part of the problem conscientious objectors are faced with is that many in our society regard public laws as settling moral issues. Ie. once invitro fertilization, human cloning, or euthanasia are legal, they think everyone should cooperate in these practices. Another common misconception is that religion should have no influence on public policy, that it should be relegated to the private sphere, as though it were a personal feeling or whim. This has been proven wrong by the Surrey School Board ruling. How can healthcare workers be expected to leave their religious and moral beliefs at home when they go to work each day?

Things are getting so complicated, that I believe healthcare workers who want to practice according to their moral convictions will not have a leg to stand on unless there is some solid legal protection.

LET ME SUMMARIZE FOR YOU WHAT HAS BEEN GOING ON IN THE LEGAL SPHERE DURING THE PAST DECADE OR SO:

In last month’s Globe and Mail (March 15/01), there was an article entitled “ Law aims to protect Pharmacists”. It featured Ohio pharmacist Karen Brauer who was fired in 1996 after she refused to dispense an abortifacient drug. She is now slapping the company with a federal lawsuit for wrongful dismissal. She claims the company violated an Ohio law that allows individuals to follow their conscience and refuse to participate in medical procedures that result in abortion.

The company is alleging that dispensing pills is not a medical procedure and that pharmacists are not protected by the Conscience Law.

And as her case heads to court in May, the Fox network also reports that lawmakers in 4 states (Ohio, Indiana, Kansas, and Kentucky) are pushing legislation that would provide job protection to pharmacists who refuse to dispense legal drugs such as the morning after pill, on moral grounds. These bills are modeled on a 1998 South Dakota Law that lets pharmacists refuse to fill prescriptions if it conflicts with their beliefs.

Currently, 44 out of 50 US states as well as American Samoa, Guam, and the Virgin Islands, have enacted legislation granting protection of conscience for all healthcare workers. The United Kingdom has had protection of these rights since the original passing of England’s Abortion Act in 1967. France, Italy and New Zealand also have Conscience legislation.

Laws in a number of States allow pharmacists to refuse to dispense a prescription based on their professional judgement, but not based on personal convictions. Maria Bizecki, spokesperson for the Canadian group Concerned Pharmacists for Conscience reports from Alberta that pharmacists in a number of States have been reprimanded or fired for refusing to dispense abortifacient drugs. She herself was suspended last year.

Ofcourse, this problem is not only proper to pharmacists. Nurses and Social workers have also come under attack in recent years for refusing to participate in acts that were diametrically opposed to their conscience.

Ie. Nurse Joanne Van Halteren was assured during her hiring interview at Markham-Stouffville Hospital just outside of Toronto, that she would not have to assist in abortions. However, later on a change in hospital policy required all nurses to sign a form stating they would perform all procedures. After a five-year battle, she and seven other nurses won the right to refuse to assist in abortions. The nurses had taken their fight to the Ontario Human Rights Commission. It was not until April 1999 that the Hospital agreed to reinstate them to avoid a human rights inquiry. All nurses suffered stress-related illnesses, were harassed day in day out, saying it was ‘torture’, discouraging, and hard on their families, and they ended up paying thousands of dollars in legal expenses and suffered lost wages.

Closer to home, nurses at the Calgary Foothills Hospital were being forced to participate in late term eugenic abortions. Some had to watch babies slowly die after they survived the abortion.

And some of you may remember the case of Cecilia Moore. She was fired from the B.C. Welfare Department in 1985 for refusing to sign authorization for coverage of an abortion, because this went against her religious convictions. It took seven years before the B.C. Council of Human Rights ruled that she had been a victim of adverse effect discrimination.

In Canada attempts have been made to pass a “ Conscience Clause”, but so far no Canadian Legislature, Provincial or Federal, has approved such legislation. In 1997 Senator Stanley Haidasz introduced Bill S-7 into the Canadian Senate. The bill sought to amend the Criminal Code to protect healthcare workers from coercion in assisting in procedures posing avoidable risk to human life-ie. Abortion and assisted suicide. The Senator retired soon after. Senator Ray Perrault took up the Bill, but he has retired. I believe that now, after the election, it has to be re-introduced in the Senate before it can proceed.

In December of 1998 Reform MP Maurice Vellacot introduced a bill in the House of Commons. The bill (S-461) sought to amend the Criminal Code of Canada to make it an offense to force medical personnel to take part in or counsel for any medical procedure that offends a tenet of the practitioner that human life in inviolable, but it never reached a vote in the House. Mr. Vellacott has re-introduced the bill in this parliament. Several years ago, a private citizen proposed a conscience clause to BC political parties, but only the Reform Party and the Progressive Democratic Alliance accepted the idea of conscience legislation in principle. Gordon Wilson, head of the PDA at that time, is now an NDP cabinet minister.

In Ontario and in Alberta, private members bills were also introduced into legislature, but also died. (Code Blue, Liberty Magazine Jul/Aug.2000). Hopefully, bill 212 will be proposed again this year in Alberta.

WHY CONSCIENCE LEGISLATION?

You may be asking yourselves why the need for Conscience Legislation? Does the Canadian Charter of Rights and Freedoms not currently protect us?

Under the Charter, all Canadians have freedom of conscience and religion. However, most people will not bring their case before their provincial Human Rights Commission. Going through the Human Rights tribunal can be a long, grueling process. Furthermore, with the ever more persistent push for legalization of controversial treatments (abortion, assisted suicide, so-called emergency contraception, vaccinations against pregnancy, etc, to name only a few), I believe that those of us who do not want to participate in these procedures need to be protected by law.

It should be of no surprise to you that among those who most oppose Conscience Clause legislation are International Planned Parenthood Federation and the Canadian Abortion Rights Action League.

In 1998, in relation to enactment of the South Dakota Law shielding pharmacists from lawsuits, the Boston Globe (Associated Press,05/14/98) quoted Thelma Underberg, South Dakota director of the National Abortion and Reproductive Rights Action League. “They’re starting with what they can control”. While some welcomed the legal protection, others said the law works to undermine another freedom: a woman’s right to choose to have an abortion.

Dan Wunrow, executive director of the South Dakota Right to Life was quoted as saying that he hopes a pharmacist’s refusal will prompt a patient to give up trying to get the morningafter pills. But he said the law’s goal is to protect pharmacists and not necessarily to curb the number of abortions.

It is important to make it clear that a law protecting conscientious objectors would not be about blocking accessibility to these so-called legal treatments, but about giving healthcare workers the freedom to follow their conscience and protecting them from forced participation. There are those who accuse the conscientious objector of judging and imposing their morality on patients. Certainly we are not called upon to judge others, but we do have a duty to judge to the best of our ability whether a treatment is appropriate and safe, and to inform a patient truthfully about any possible harm that could result from a treatment. It only makes sense that we should be able to explain to a patient why we will not dispense. It would be foolish for me to say, "I won't give you this drug. Sorry, I can't tell you why." What I'm suggesting is basically the policy of the Canadian Medical Association, which indicates that objecting physicians should explain their position on abortion to a patient, so that a patient can choose to go elsewhere. But the CMA doesn't require silence, and it doesn't require referral. Certainly we should not have to participate in an action we believe is intended to harm human life, and/or we believe is detrimental to the common good of our society.

Last November the National Association of Pharmacy Regulatory Authorities put forward a proposal for a model conscience clause to be adopted by Pharmacy regulatory authorities across the country. However, this proposal is worthless in terms of protecting our freedom of conscience. The statement, which addresses the current issue of emergency contraception and the upcoming issues of RU-486 and euthanasia drugs, instructs that the dissenting pharmacists must prearrange access to an alternate source to enable the patient to obtain the service or product they need. As some of you may have heard, Canada Safeway in their pharmacy policy implemented this proposal, that is, until it was leaked out to the media last March 2000….

The document is entitled ‘Conscientious Objectors and Accommodation. It has now been withdrawn, replaced by the NAPRA clause, which is not much better.

“Company expectations regarding the question of what to do when a pharmacist refuses to fill or requests that he or we be exempt from filling certain prescriptions ie. euthanasia drugs, Ru486, morning after pill, on the basis of his or her religious beliefs. We believe that the pharmacist is the dispenser of medication. The prescription and its use is between the patient and their physician. If the drug is legally available and properly prescribed, we expect the prescription to be filled in a timely, courteous and professional manner----like any other prescription.

If another pharmacist is available at the time however, the objecting pharmacist may discreetly request that he or she fill the personally objectionable prescription. If another pharmacist is not immediately available to assist the customer, however, the objecting pharmacist must provide the service. The objecting pharmacist must make the request (not to fill certain prescriptions) in advance (as opposed to deciding on the spot) and may be asked to provide documentation to support the request for accommodation.

Safeway Limited has the right to see that its employees promptly serve its customers. The Company does not have to turn away business or direct a customer to a competitor under such circumstances. Further, the customer has a legal right to the prescription requested. –Obviously, economic self-interest seems to be a greater good than freedom of conscience and religion for pharmacists.

If the objecting pharmacist cannot comply with this requirement and provide service consistent with the requirements of their position, the pharmacist will not be scheduled to work in any store during any period of time when he or she would be the sole pharmacist on duty.”

The notion of refusal to participate with morally controversial drugs, which make up only a small percentage of the drug products pharmacists must deal with has nothing to do with abandoning patients’ needs, and much more to do with losing a patients’ business. (although if you kill off the patient you’ll lose his business anyway). In fact, a few months ago our BC Pharmacy Association sent a notice to all pharmacists strongly advising them not to sign a contract with the Ministry of Health for the ECP program because Pharmacare was only offering to pay a $15.00 counseling fee per patient, instead of the sought after $25.00. So, it’s OK to deny patients legal services for economic reasons, but not for moral reasons.???

Needless to say, members of Pharmacists for Life Int. do not consider NAPRA’s proposal a conscience clause. For them, referral for a death-causing drug is the same as being an accomplice to that death.

I BELIEVE THAT CONSCIENCE AND FREEDOM ARE NOTIONS THAT ARE POORLY UNDERSTOOD AND APPRECIATED IN OUR DAY

Essentially, conscience is a gift we possess that allows us to choose freely that which is good, and not just what is subjectively good for me, but what is good in the broader, objective sense. Unfortunately, most people today are guided more by subjective feelings than they are by appeals to rational, intellectual, and objective conceptions of right and wrong. These very people often accuse religious believers of following a private belief or feeling.

Freedom is a distinctive characteristic of human nature: it makes us capable of loving, of deciding, of choosing. There are few today who would deny that man is free, and it is this gift that makes us most like God. The Catholic Church calls it “the most noble good of human nature.”(Pius XII, address of April 10,1958)

In fact, we live in an era that is characterized by freedom (economic, political, and now even moral freedom).

Alan Wolfe, Director of the Boisi Center for Religious and American Public Life at Boston College has written a book called “Moral Freedom”. Moral freedom, he says, involves the sacred and the profane; it is freedom over the things that matter most. In North American society, the ultimate implication of the idea of human freedom is not that people are created in the image of a higher authority; rather, it is that any form of higher authority has to tailor its commandments to the needs of real people. Ironically, our professional associations do not believe that their members should have this freedom. They do not believe in moral absolutes that are imposed from above, so they wish to create their own moral principles based on secular bioethics- which may be binding on their members under pain of disciplinary action.

Everyone would agree that it is inhuman to force someone to do something against his/her conscience. (Even the BC Human Rights Commission awarded a drugstore employee $25,000 because, being a Jehovah’s Witness and having previously told his employer that it went against his beliefs to celebrate Christmas, he was forced to decorate the store with Poinsettias, which went against his conscience). Man’s dignity demands that he act according to a knowing and free choice, which is neither the result of blind interior impulse or of exterior coercion.

The notion of freedom of conscience is poorly understood because it has come to mean the right to do whatever one feels like doing without any consideration for others. In fact, freedom is not a licence and conscience can never reign supreme. It needs to be rightly formed. Dr. Budziszewski, Associate Professor of the Depts. of Government and Political Philosophy at the University of Texas and a specialist in ethical and political philosophy, has stated that a big part of the societal problems we are faced with today lies in the fact that for several generations now, students have been taught that there is no such a thing as conscience. “Freudians said there is no conscience but only superego, Behaviorists that there is no conscience but only inhibitions, Anthropologists have said there is no conscience but only mores, Sociologists no conscience but only socialization. Today the post-modernists say there is no conscience, only narratives”. These ways of speaking, says Budziszewski, share the belief that nothing is known to everyone—least of all fixed moral principles. ( See Prof. Budziszewski's article on the site, 'Handling Issues of Conscience' for more on this) .

One member of our ethics committee has stated that because thieves, murderers, and rapists follow their conscience, and look at what they do, therefore no one should have conscience as a basic human freedom. This illustrates how wrongly freedom of conscience could be understood. The invocation of freedom throughout the ages as a justification for vile actions, cannot take away our inherent capacity to choose the good freely. Our College member does not believe in objective moral norms, he claims to be a relativist, but does believe in his own judgement and that of like-minded people, so he wants everyone to conform to this judgement because it is safe and controlled. In other words, since we cannot agree on objective moral norms, he insists that we take his norms as gospel truth. He has even told pharmacists to leave the profession or find work elsewhere if they cannot comply with his own views.

NATURAL MORAL LAW

Obviously, conscience needs to be properly formed. A rightly formed conscience always seeks to follow a higher objective moral law, a law written in our very nature by our Maker. This law, which is often referred to by philosophers as the natural law, is what the Catholic Church calls a “participation in God’s wisdom and goodness, which expresses the dignity of the human person, forming the basis of his fundamental rights and duties (Cat. Cath. Ch.)” It is based on recognition of what is good in our human nature. Ie. most people would agree that valour is better than cowardice, generosity better than selfishness, and industriousness is better than laziness. (For those of you who have watched ‘The Gladiator’, how many of you would insist that Caesar’s son, said to be an immoral man by his own father, was fit to rule?) I won’t ask for a show of hands.

Interestingly, Alan Wolfe assembled a research team and spent a couple of years talking with people from all walks of life about what it means to lead a good and virtous life. He concentrated on four virtues that have been praised by theologians and philosophers for their moral seriousness: honesty, loyalty, forgiveness, and self-discipline. Most respondents did not think that virtue consists in subsuming their needs and desires to the authority of tradition. Some of them were not even sure that virtuous is what they wanted to be. Wolfe concluded that without firm moral instruction, Americans recognize the importance of virtues, but reinvent their meaning to make sense of the situations in which they find themselves.

Thousands of years ago, not only Christians, but also Greek poets wrote about the notion of a natural morality or law. Plato worked out a morality based on the 4 cardinal virtues of Prudence, Justice, Fortitude, and Temperance. The natural law does not impose itself upon us from outside as do the laws of physical nature; rather, it affects us from within, in the form of what Thomas Aquinas called deep inclinations that move us in the intimacy of our heart towards our spiritual goal. Aquinas speaks of 5 natural inclinations:

1) the desire for good

2) the instinct for self-preservation

3) the generation and bringing-up of children

4) the seeking of truth

5) the cultivation of social life

He then adds to these the contemplation of beauty. He states that the chief precepts of the natural law flow from these inclinations, as do our fundamental rights and duties.

( the above was extracted from: Ethics and Medics.1995vol.20no.2 . Servais Pinckaers. Veritatis Splendour: Human Freedom and the Natural Law)

The first precept of the natural law is that good is to be done and pursued and evil to be avoided. However, by itself the natural law can only go so far in showing us what is good about us, about our human nature, and then we need God’s help, His revelation. On this revelation are based the 10 commandments and ofcourse, the entire Gospels.

Concern about human dignity has become widespread in our time. Declarations of Human Rights” have tried to protect these rights and increase respect for them throughout the world. Though at times these declarations contain errors, they aspire to recognize the self-evident reality that every human being has an inherent dignity that must be recognized and respected. Each person is unique and is endowed with the gift of freedom, intelligence, the capacity to love, and to work, to create beautiful things. Most people would agree that a human being is much more than just a complicated animal.

Throughout the centuries, Christianity has played a vital role in defining human dignity. It has taught us that our dignity stems from the fact that we are children of a common Father, God. Each person is worth the blood of the Son of God. When God is taken out of the picture, our worth becomes obscured, but can still be deciphered by human reason alone. We can all agree that each person is worthy of being loved for his or her own sake. This is exemplified most clearly within family life, where each family member is loved for who he or she is, and not for their possessions or accomplishments.

Respect for human dignity requires respect for the natural moral law. It is this recognition of human dignity, of a human being’s intrinsic worth that restrains us from harming others (from lying to them, cheating them, injuring them physically or emotionally). Unlike the obvious consequences seen in the transgression of the physical laws of nature (ie.the law of gravity), the breaking of the laws written within our human nature can have more inconspicuous consequences, leaving us with deeper, more interior scars.

Some have expressed the concern that a healthcare worker’s freedom to refuse participation in a legal procedure will infringe on the patient’s freedom to choose. My answer to this is this: the pharmacist also has freedom to choose, and that freedom is not less worthy of respect than that of the patient.

A person has the freedom to choose, but is not the freer for choosing to harm oneself. Ie. Is a drug addict free? Is a woman who has had an abortion and is now at a higher risk of breast cancer and may be suffering from post abortion depression free?

The unfounded fear that we will impose our morality has caused our Licensing Bodies to adopt Codes of Ethics, which make it clear that the ethics of the profession as a whole must take precedence over individual ethics. (Mar/Apr 2000 College Bulletin). Note however, that the ethics of the Profession is actually a narrow and private ethical system to which only a couple of thousand subscribe, at best. We can contrast this with the great religious ethical systems that have hundreds of thousands or millions of followers. Why is the private ethical system of the College superior? This attitude of our College opens the door to a totalitarian type of regime, where the powerful rule over the weak or uninformed, and the weak act out of coercion, while shirking any responsibility for their actions because, after all, they are merely following orders.

Carried to its extreme, this is very dangerous. It is what happened in Nazi Germany, and what is happening today in China, where physicians are being forced to perform abortions, sometimes on women who do not even want them.

Our Ethics Committee has accused pharmacists of lying to patients, judging and preaching to them, and trying to dissuade them from recognized treatments under the guise of patient counselling. The College has been repeatedly asked to provide evidence to support the allegation and has been unable to do so, yet it refuses to retract and apologize. The Canadian Pharmaceutical Journal, which last year published an article attack on conscientious objectors that repeated these accusations - an article that was also full of legal and ethical errors - received two lengthy responses, one from a constitutional lawyer. It did not publish them. (They can be found at the Conscience Project website)

To what extent should we insist on exercising our freedom of conscience? Surely no one wants a physician or pharmacist who acts like a robot? In his Encyclical on Human Work, John Paul II says we are not cogs in a huge machine moved from above, and we cannot be made to feel like mere production instruments rather than true subjects of work with initiative of their own. In other words, a human person may never be treated as a thing, as an object, as a means to an end. If a treatment I am asked to dispense has as its main purpose or objective the direct destruction of human life, I should not be forced to participate in any way, and I should have a right to claim conscientious objector status without fear of loss of employment. This is how things should be, but not how they are at the present time.

One of the dangers we face today is that our healthcare system become depleted of conscientious healthcare worker, especially of those who respect life from conception to its natural end. Nowadays we hear of government departments that deliberately recruit from visible minorities. It is thought that those serving the public should reflect the people they serve, so as to provide them with services in a way respectful of their cultural traditions, and make them feel ‘at home’. Conscientious objectors reflect views that are held by a part of the population. Why should that part of the population be deprived of care by people who understand and share their deepest convictions?

Our current Code of Ethics (valueIX) rates a pharmacist’s moral beliefs on the same level as job action and pharmacy closure. It states:

“A pharmacist is not ethically obliged to provide requested pharmacy care when compliance would involve a violation of his or her moral beliefs (and I wish it would stop there). When that request falls within recognized forms of pharmacy care, however, there is a professional obligation to refer the patient to a pharmacist who is willing to provide the service. The pharmacist shall provide the requested pharmacy care if there is no other pharmacist within a reasonable distance or available within a reasonable time willing to provide the service.”

It all sounds very good, except that it does not solve the problem for conscientious objectors. We need to be sure that when we refuse to fill a prescription for the MAP, for example, we will not be disciplined for not then referring the patient to someone who will fill it. Referral in this case would make me an accomplice in an act that is meant to destroy a human life. It would also be akin to hypocrisy. Would you be willing to direct someone to another person so that they can cheat, lie, steal, obtain child pornography, etc.?

WHAT HAS BEEN DONE SO FAR FOR CONSCIENCE PROTECTION WITHIN THE PHARMACY PROFESSION?

As far as Canadian pharmacy goes, in 1994, Concerned Pharmacists for Conscience was founded by a group of Alberta pharmacists, sharing the concern of conscience clause protection. The group started by drafting an amendment to the Alberta Pharmaceutical Association’s bylaws and Code of Ethics in 1994, which would call for inclusion of a conscience clause. Following the 1995 annual general meeting of the Alberta Pharmaceutical Association, a conscience clause was voted in unanimously by its membership. However, the Association rejected it. So much for the ethics of the profession. The ethics of the profession really amounts to the private ethics of the small group of people who have statutory authority to govern the profession.

Since 1995, pharmacists from varied religions and cultural backgrounds, have responded in support of conscience clause protection. Pharmacists from across Canada, the US, and South America have sought input from Concerned Pharmacists for Conscience. In British Columbia we are also seeking a proper conscience clause. To this effect and supported by several colleagues, I submitted a resolution for discussion and to be voted upon at our annual general meeting on Oct.12, 2000. At the meeting we gained support from approx. 30% of attendees. We are hoping to educate pharmacists on this important issue in order to again propose an amendment in the near future. The advocacy group BC Pharmacists for Conscience is seeking support from the public and from pharmacists who acknowledge that freedom of conscience is a fundamental human freedom.

I invite you to check out the Protection of Conscience Project website at www.consciencelaws.org. Sean Murphy initiated this project in 1999 , recognizing that healthcare workers were increasingly at risk of being disciplined or losing employment because of their religious or moral beliefs. Sean is now Project Administrator. I first met him at a meeting of physicians and other healthcare workers presided by Senator Perrault. The Project has given me, and others in my dilemma, tremendous moral support and is a source of very rich information and practical help for conscience advocacy.

The wealth of information at the website includes up to date data on proposed laws for conscience legislation in Canada and in the US.

The time is ripe to get involve in conscience advocay.

In his Speech from the Throne, Mr. Dosanjh has stated:

“My government will take further action to secure a woman’s right to choose. These changes will help ensure abortion services and counseling are available outside of the Lower Mainland and Capital Region. They will protect the safety of patients and service providers. They will assist with the important work of finding safe and less invasive pharmaceutical alternatives to surgical abortions.”

Mr. Dosanjh, I too am a woman, and I want my choice not to participate in your plans protected. [Very timely!]