Tuesday, January 10, 2006

European Experts, the Slovak Republic and the Holy See: Why “One Size Fits All” doesn’t work for Medicine (or Education) any longer.

The rhetoric of the day in most Western countries and increasingly elsewhere, such as South Africa, is of “pluralism” and “diversity”. Yet look carefully and what is going on can be anything but. Human rights can often be a cover for human wrongs and respect for diversity often boils down to a confrontation between the Godzilla of international power and regulations and the Bambi of religious diversity - - Bambi loses.

A recent example occurs in Europe and concerns the question of diversity within the state in relation to health care and medical ethics. We have often discussed the failure of what passes for contemporary ethics on this site (see, for example, Blogs Numbers 91, 99 and 101) several times in relation to Pharmacist associations that fail to comprehend the proper nature of conscientious objection or why a “duty of referral” is invalid. This article is to address the same sort of failure but on a national and international level and deals with the failure to respect valid alternative opinions to practices that have come to be accepted by some, but not all.

The question at issue is whether or not there is proper accommodation within the state for both divergent viewpoints and divergent standards when it is clear that an area (such as health care or education) can no longer reasonably claim to command a “one size fits all” standard. While the question of abortion is hotly debated, the fact that the Catholic faith and its institutions do not support abortion is something as clear as a spike. Here the question is whether the state - any state - or any international committee has the validity to tell the Catholic Church that its beliefs have no place in a free and democratic society. For that is what is going on here.

It is important to note how one side of an argument (say on abortion) seeks to claim dominance and use benign language (such as “standards”) to do so. It is important to keep these kinds of attempts front and centre so as to note how they work and to note that they can have national and international dimensions as we shall see.

The “one size fits all” folks - - those who favour state dominance usually, want to resist diversity yet they use that language and the other terms “equality” and “fairness” to mask their attempts at using state power in service of private coercion.

A stunning example of this institutionalized intolerance comes recently from a group of “European Experts” reviewing an agreement entered into by the Slovak Republic and the Holy See. The Draft Treaty may be found here: http://www.consciencelaws.org/Proposed-Conscience-Laws/International/Intl01.html

The European Experts’ Opinion may be found here once it is posted (it is not yet up): http://www.europa.eu.int/comm/justice_home/cfr_cdf/list_opinions_en.htm

Under the draft agreement, the Slovak Republic, among other things, "undertakes not to impose an obligation on the hospitals and healthcare facilities founded by the Catholic Church... to perform artificial abortions or assisted fertilizations". This is nothing but the formalization of what should be the case anyway. Some years ago in British Columbia, Canada, for example, a group called the Denominational Health Care Facilities Association struck an agreement with the provincial government to ensure that their “denominational values” were not going to be restricted by provincial Health Care restructuring. That group involved Jewish, Catholic and Protestant health facilities and the agreement they struck was a model of what should happen in an open society that tolerates genuine diversity.

One would have thought this was fine. Religious facilities such as hospitals or schools ought to be able to march to a different drum shouldn’t they? The belief by some on a contested matter (abortion) surely ought not to force everyone to go along with it. It is as if a Jewish kitchen in a Jewish health facility is being ordered by the state to serve pork! Abortion is as obnoxious to Catholics and their facilities as serving pork in the kitchen would be to Jewish ones. If you like pork, eat somewhere else. This means, in Israel, you may have to go farther to find some. Too bad, because the alternative runs roughshod over proper freedom and diversity.

With this background, let’s look a bit closer look at the European “experts” opinion. Under the guise of “one size fits all” (assumed, not expressed) they seek to bulldoze over diverse sub-communities with the Slovak Republic. The understanding of divergent delivery systems seems to stop when the pseudo pluralists (for so they are) review the matter.

An article posted recently on the BBC News website, (see BBC News Website: “Slovak Abortion Move Worries EU” Friday January 6, 2006 http://news.bbc.co.uk/2/hi/europe/4588450.stm) gives an interesting slant to the issues by failing completely to ask the questions about diversity and pluralism. Basically, it gives the impression that the only issue of relevance is whether women can get access to abortions in a largely Catholic country such as the Slovak Republic. The questions related to whether Catholic hospitals etc. should be subsumed to state policies is avoided in favour of a focus only on a woman’s “right of access to abortion”. The journalistic bias was showing rather badly here.

The answer for citizens who believe abortions to be valid health care and who have governments who do not (a perfectly reasonable viewpoint) is to set up their own delivery systems - - such as freestanding clinics. To attempt to command the international Godzilla to stamp out the regional Bambi is common but wrong. Here there are two “Bambis”: the Slovak Republic and the Catholic Health Facilities within it. The experts seek to use an analysis of what they deem to be state responsibilities to put pressure on the subsidiary institutions of a religious community. The “experts” fail to distinguish between the two. That is not fair or properly respectful of diversity.

It happens to be hospitals founded by Catholics that oppose abortion as murder that are entitled to hold this viewpoint and have nothing to do with the procedures. Religions, after all, have equality rights protection as well as pro-abortion women do.

The BBC, as you can see below, scarcely points out that the agreement is focused upon Catholic facilities. The Agreement, after all, was between the Slovak Government and the Holy See and the real issue, missed by the BBC, was that the "experts" seem to see a requirement to refer for abortions as something that can reasonably be required of a religious institution: it cannot. As earlier blogs on this site have shown, such a requirement is philosophically flawed and cannot be the basis for an ethical requirement of referral. The Canadian Medical Association, for example, no longer imposes a duty of referral on those conscientiously opposed to abortion and their right to do so. The “experts” pay no attention to religious qualms about moral cooperation with evil (as the Catholics would see it).

Professor Olivier De Schutter, for example, the head of the panel of lawyers from the EU Network of Independent Experts on Fundamental Rights, says the articles relating to religious conscientious objection raise the most concern. In an article on the Slovak Agreement he is quoted as saying that it was "far-reaching, considering a very large majority of healthcare providers in Slovakia are Catholics and might exercise their right to conscientious objection".
He said the treaty did not oblige medical staff in such cases to refer the person seeking advice to another healthcare provider. Why should it?

The BBC author (not identified) states: “human rights bodies have repeatedly said that when abortion is legal in a country, access to abortion must be provided to all without discrimination.” Well, yes and no. They have generally distinguished between religious hospitals and those that are not founded on this basis.

"The right to religious conscientious objection may be and should be respected, but with safeguards that make it possible for women to seek legal abortion," Professor de Schutter told the BBC's Europe Today programme. "This is the problem the draft text may be posing." Here we see the iron fist under the velvet glove of “diversity” and “tolerance” language.

The BBC article, continues: “Richard Fides, a spokesman for Slovakia's justice minister, rejected claims in some European media that the document was basically an abortion agreement.”

"That is sheer nonsense," he told the Slovak commercial television station TA3. "The objective of the agreement is to ensure that every individual can apply their right to the objection of conscience. It is neither right nor just for a doctor-gynecologist, who is for example a supporter of the culture of life, to be forced to perform an abortion."

The Slovak Republic and any others who try to come to agreements with religious bodies might be in for a tough ride from the Godzilla of International Human Rights. I, for one, hope they will have the courage of their convictions together with many countries (who understand the proper respect for diversity and religious freedom) to do likewise and ignore the opinion of “experts” such as those who authored this rather stilted document out of Europe. Fortunately, it is only an “Opinion” and has no binding legal authority and, if ignored by the legislators, no influence going forward except, perhaps, to give us further evidence of the way that threats to religion and genuine diversity now come packaged in the garb of human rights.

CENTREBLOG: Volume 109
Iain T. Benson©