Vatican Releases Declaration on Human Dignity

 On April 8, the Vatican's Dicastery for the Doctrine of the Faith published a Declaration on Human Dignity, “Dignitas Infinita" (full text).  An introduction to the Declaration by the Prefect of the Dicastery says in part:

The five-year course of the text’s preparation helps us to understand that the document before us reflects the gravity and centrality of the theme of dignity in Christian thought. The text required a considerable process of maturation to arrive at the final version that we have published today.

In its initial three sections, the Declaration recalls fundamental principles and theoretical premises, with the goal of offering important clarifications that can help avoid frequent confusion that surrounds the use of the term “dignity.” The fourth section presents some current and problematic situations in which the immense and inalienable dignity due to every human being is not sufficiently recognized. The Church sees the condemnation of these grave and current violations of human dignity as a necessary measure, for she sustains the deep conviction that we cannot separate faith from the defense of human dignity, evangelization from the promotion of a dignified life, and spirituality from a commitment to the dignity of every human being.

The items described at length in the fourth section as "grave violations of human dignity" are the drama of poverty, war, travail of migrants, human trafficking, sexual abuse, violence against women, abortion, surrogacy, euthanasia and assisted suicide, marginalization of people with disabilities, gender theory, sex change and digital violence. The document's discussion of gender identity has perhaps created the most controversy. The Document says in part:

It needs to be emphasized that ‘biological sex and the socio-cultural role of sex (gender) can be distinguished but not separated.’” Therefore, all attempts to obscure reference to the ineliminable sexual difference between man and woman are to be rejected: “We cannot separate the masculine and the feminine from God’s work of creation, which is prior to all our decisions and experiences, and where biological elements exist which are impossible to ignore.” Only by acknowledging and accepting this difference in reciprocity can each person fully discover themselves, their dignity, and their identity....

It follows that any sex-change intervention, as a rule, risks threatening the unique dignity the person has received from the moment of conception. This is not to exclude the possibility that a person with genital abnormalities that are already evident at birth or that develop later may choose to receive the assistance of healthcare professionals to resolve these abnormalities. However, in this case, such a medical procedure would not constitute a sex change in the sense intended here.

Asked at a Press Gaggle (full text) about President Biden's reaction to the Declaration, the White House Press Secretary said that it was not the President's role "to litigate internal church policy," but that the President has been clear that it is important to have protections for the transgender community and the broader LGBTQ+ community. 

Vox reports at greater length on the Vatican document.

Montreal Archdiocese Sues for Exemption from End-of-Life Care Requirements

 In Canada, the Archdiocese of Montreal has filed suit in a Quebec trial court seeking an exemption from amendments to the province's Act Respecting End-of-Life Care which require all palliative care homes to provide "medical aid in dying." The Archdiocese operates a 12-bed palliative care home in Montreal. The full text of the complaint in Les Oeuvres de Charite de L'Archeveque Catholique Romain de Montreal v. Procureur General du Quebec, (Couer Superieure, filed Feb. 2, 2024) is available only in French. An English Language Press Release from the Archdiocese describes the lawsuit in part::

To our profound dismay, the amendment to the Act respecting end-of-life care and other legislative provisions, SQ 2023, c. 15 (the new Act), effective since December 7, 2023, has regretfully prohibited palliative care homes from excluding "medical aid in dying" from their services.  

A consequence of this new law is that actions we find morally unacceptable may now occur on our property.....  

In essence, the Appeal is simply seeking permission for palliative care homes, similar to health professionals, to "refuse to administer medical aid in dying based on their personal convictions and [to] refuse to participate in its administration for the same reason."  

We strongly believe that by mandating all palliative care homes to provide "medical aid in dying" without considering their mission, values, and the support of their community, the new law significantly undermines the exercise of the right to freedom of religion and conscience, as well as the right to the peaceful enjoyment and free disposal of one's property, guaranteed by the Canadian Charter and the Quebec Charter.   

Palliative care homes, given that they operate as community organizations and not public institutions, should retain the ability to define their own mission and the services they are willing to offer, as was the practice until recently....

Canadian Press reports on the lawsuit.

Nevada Governor Vetoes Medical-Aid-In-Dying Bill

On Monday, Nevada Governor Joe Lombardo vetoed (full text of veto message) S.B. 239 (full text) which would have authorized physicians and advanced practice registered nurses to prescribe medications which a patient certified to be terminally ill could self-administer to end his or her own life. The Governor said in part:

Fortunately, expansions in palliative care services and continued improvements in advanced pain management make the end-of-life provisions in SB 239 unnecessary.

KLAS News reports on the governor's action.

Massachusetts Supreme Judicial Court Says No State Constitutional Right to Physician Assisted Suicide

In Kligler v. Attorney General, (MA Sup. Jud. Ct., Dec. 19, 2022), the Massachusetts Supreme Judicial Court held that the Massachusetts state constitution does not protect a right to physician-assisted suicide.  The court said in part:

[G]iven our long-standing opposition to suicide in all its forms, and the absence of modern precedent supporting an affirmative right to medical intervention that causes death, we cannot conclude that physician-assisted suicide ranks among those fundamental rights protected by the Massachusetts Declaration of Rights. Thus, application of the law of manslaughter to physician-assisted suicide would not impinge on an individual's right to substantive due process....

Application of the law of manslaughter to physician-assisted suicide passes constitutional muster because the law is reasonably related to the State's legitimate interests in preserving life; preventing suicide; protecting the integrity of the medical profession; ensuring that all end-of-life decisions are informed, voluntary, and rational; and "protecting vulnerable people from indifference, prejudice, and psychological and financial pressure to end their lives."

Justice Cypher filed a concurring opinion, saying in part:

I concur with the court that the plaintiffs' proposed physician-assisted suicide schema is, as a matter of right, too procedurally complex for us to adopt whole cloth..... In addition, I fully support the court's thoughtful and timely primer on substantive due process, which preserves the comprehensive approach as the proper test for identifying fundamental rights under our State Constitution.... I therefore concur in the judgment. 

However, based on the strength of our existing case law concerning end-of-life patient autonomy, in conjunction with current palliative treatments that are commensurate with physician-assisted suicide, I do "not foreclose the possibility that some applications" of our criminal statutes "may impose an intolerable intrusion on" patient freedom.... When that appropriate challenge (or challenger) does come forward, we must be ready to extend our State constitutional protections to terminally ill patients seeking to exercise what remains of their bodily autonomy.

Justice Wendlandt, joined in part by Chief Justice Budd, filed an opinion concurring in part and dissenting in part.  He said in part:

Because I agree with the court that there is no fundamental right to prescribe, or to receive a prescription for, medication to assist a terminally ill, mentally competent patient's suicide (physician-assisted suicide), I concur in the judgment as it concerns Steinbach. I also agree with the court that application of the criminal laws to physician-assisted suicide generally survives rational basis review. I write separately because, when a terminally ill, mentally competent patient approaches the final stage of the dying process, the Commonwealth's interest in criminalizing physician-assisted suicide reduces to a nullity, such that even under rational basis review, the State Constitution protects the nonfundamental right to physician-assisted suicide from application of the State's criminal laws.

WBUR News reports on the decision.

Christian Doctors Challenge New Mexico's Assisted Suicide Law

Suit was filed this week in a New Mexico federal district court by a physician and the Christian Medical & Dental Associations challenging the constitutionality of New Mexico's End-of-Life Options Act.  The complaint (full text) in Lacy v, Balderas, (D NM, filed 12/14/2022), alleges in part:

6. The Act purports to protect physicians who object to assisted suicide for reasons of conscience, saying they will not be required to “participate.” But that promise rings hollow. The Act does not define the word “participate,” requires conscientious objectors to facilitate suicide in material ways, and expressly prohibits professional associations like CMDA from taking action to ensure that their members advance—rather than undermine—their mission and message.

7. The Act compels objecting physicians to speak and inform terminally ill patients about the availability of assisted suicide.....

8. The Act forces objecting physicians to refer their patients to physicians or organizations who are “able and willing to carry out” the patient’s assisted suicide.....

9. The Act expressly prohibits professional associations like CMDA from suspending, denying, or revoking membership to physicians who participate in assisted suicide, violating CMDA’s right to associate with members who will present a consistent message. Id. at § 24-7C-7(B).

10. The State of New Mexico thus compels objecting health care professionals to speak a certain message about assisted suicide, and forces them to provide proximate, formal, and material cooperation in an unethical and sinful act.

ADF issued a press release announcing the filing of the lawsuit. 

California Assisted Suicide Law Violates Free Speech rights Of Objecting Doctors

In Christian Medical & Dental Association v. Bonta, (CD CA, Sept. 2, 2022), a California federal district court held likely unconstitutional a provision in the California End of Life Option Act which requires doctors who refuse on conscience, moral or ethical grounds to participate in procedures set out by the act to nevertheless document in a patient's record the date of the patient's request for an aid-in-dying drug. This notation serves as one of two required requests by a patient before the patient may obtain the drug. The court rejected the argument that this violates the free exercise rights of medical providers who object on religious grounds, saying in part:

The court recognizes that Plaintiffs have sincerely held religious beliefs, and that compliance with the documentation requirements contained in Section 443.14(e)(2) infringes on the free exercise of their religion. However, under clearly established doctrine in Smith, Lukumi, and Fulton, strict scrutiny does not apply to a neutral and generally applicable law, like the Act here.

The court also rejected equal protection and due process challenges. However, the court did conclude that plaintiffs are likely to succeed on their free speech challenges to the requirement, saying in part:

[T]he documentation requirement imposed by the Act “plainly alters the content” of non-participating health care providers’ speech.... The ultimate outcome of this requirement is that non-participating providers are compelled to participate in the Act through this documentation requirement, despite their objections to assisted suicide.

The court issued a preliminary injunction barring state enforcement of the requirement against objecting health care providers. ADF issued a press release announcing the decision.

Challenges To New Jersey's Assisted Suicide Act Are Rejected

In Petro v. Platkin, (NJ App., June 10, 2022), a New Jersey state appellate court dismissed constitutional challenges to New Jersey's Medical Aid in Dying for the Terminally Ill Act.  It held the plaintiffs-- a terminally ill resident, a physician and a pharmacist-- lack standing because their participation in the procedures permitted by the Act are completely voluntary.  The court also rejected claims that the statute violates the "single object" requirement of the state constitution or state constitutional provisions on the right to enjoy and defend life. It also rejected 1st Amendment free exercise claims, finding that the statute is a neutral law of general applicability.

Christian Doctors Challenge California Assisted Suicide Provisions

An organization of Christian healthcare professionals and one of its members filed suit yesterday in a California federal district court challenging the current version of California's End of Life Options Act (EOLA) on free exercise, free speech, due process and equal protection grounds. The complaint (full text) in Christian Medical & Dental Associations v. Bonta, (CDCA, filed 2/22/2022), alleges that changes made to EOLA last year by SB 380 remove previous protections and now require doctors to participate in assisted suicide in violation of their religious beliefs. It contends that SB 380 requires objecting physicians to:

a. Document the date of a patient’s initial assisted-suicide request, which counts as the first of two required oral requests;
b. Transfer the records ... to a subsequent physician who may complete the assisted suicide;
c. Diagnose whether a patient has a terminal disease, inform the patient of the medical prognosis, and determine whether a patient has the capacity to make decisions, all of which are statutorily required steps toward assisted suicide;
d. Provide information to a patient about the End of Life Options Act;
e. Provide a requesting patient with a referral to another provider who may complete the assisted suicide.

ADF issued a press release announcing the filing of the lawsuit. 

Austria's Constitutional Court Strikes Down Assisted Suicide Ban; Hijab Ban For Young Girls

Last Friday, Austria's Constitutional Court issued two important decisions. It held it unconstitutional to prohibit assisting suicide.  According to the Court's press release:

At the request of several people affected, including two seriously ill people, the Constitutional Court (VfGH) repealed the provision that makes assisting suicide a criminal offense:

The phrase “or help him” in Section 78 of the Criminal Code is unconstitutional. It violates the right to self-determination, because this fact forbids any kind of assistance under any circumstances.

The Court also struck down the ban on young school girls wearing religious head coverings. Its press release said in part:

Pursuant to Section 43a, Paragraph 1, Clause 1 of the School Education Act, schoolchildren are prohibited from wearing ideologically or religiously influenced clothing that involves covering their heads until the end of the school year in which they turn 10.

Two children and their parents opposed this regulation. The children are raised religiously in the sense of the Sunni or Shiite legal school of Islam. You see in this provision, which is ultimately aimed at the Islamic headscarf (hijab), a disproportionate interference with the right to religious freedom and religious child-rearing. 

With the decision announced today, the Constitutional Court (VfGH) has repealed this "headscarf ban" as unconstitutional....

A regulation that selectively picks out a certain religious or ideological conviction by deliberately privileging or disadvantaging such a belief requires a special objective justification with regard to the requirement of religious and ideological neutrality.

AFP reported on the headscarf decision. [Thanks to Scott Mange for the lead.]

UAE Liberalizes Personal Status and Penal Laws

The United Arab Emirates today announced liberalizing changes in its Sharia-based personal laws. The Hill, The National, and Emirates News Agency all report on the changes made by Presidential Decree to the Personal Status, Civil Transactions, Penal Code and Criminal Procedural laws.  The changes, many involving protections for foreigners living in the UAE, take effect immediately. They include:

• Repeal of the provisions allowing more lenient sentences for so-called "honor crimes".
• Divorces of foreigners who were married abroad will be governed by the laws of their home country instead of Sharia law.
• The law of a person's home country, rather than Sharia law, will govern division of assets on death where no will is left.
• Attempted suicide is decriminalized.
• "Good Samaritans" who intervene to help another person will not be held accountable for the person's injury or death.
• More severe punishments are set for harassment of women.
• Death penalty is prescribed for rape of a minor or of someone of limited mental capacity.
• Alcohol consumption in authorized areas by adults who do not have a license to consume liquor is decriminalized. Typically Muslims have been denied a license.
• Cohabitation by unmarried couples is decriminalized.
• Translators will be provided in courts for defendants and witnesses, and evidence involving indecent acts will not be made public.

New Jersey's Aid In Dying Act Is Upheld

In Petro v. Grewal, (NJ Super., April 1, 2020), a New Jersey state trial court dismissed a suit challenging the constitutionality of New Jersey's Medical Aid in Dying for the Terminally Ill Act.  Plaintiffs challenged the law on numerous grounds, including under the free exercise clause. First the court held that plaintiffs lack standing to challenge the law, saying in part:

Their deeply felt religious, ethical or professional objections to the Act do not suffice to establish standing, even under New Jersey's liberal standard.

The court however went on to also reject plaintiffs' claims on the merits. In part of its opinion, the court rejected plaintiffs' free exercise objections to the obligation of a doctor who refuses to provide aid in dying to transfer health care records to a patient's new doctor. The court said that the law is a neutral law of general applicability, and that the obligation to transfer records is "minimally burdensome."  North Jersey.com reports on the decision.

Priest and His Church Sued Over Insensitive Funeral Homily

Detroit News reports on a lawsuit filed on Wednesday in a Michigan state trial court seeking damages from priest  Rev. Don LaCuesta and Our Lady of Mount Carmel Catholic Church in Temperance, Michigan for a homily which La Cuesta delivered at the funeral of plaintiff's son last December.  At the funeral of the son, who had committed suicide, LaCuesta delivered this homily which condemned suicide, but added that God can forgive it.  The priest ignored a plea by the deceased's father during the funeral to stop.  After the funeral, the Archdiocese and the priest both issued apologies. The lawsuit alleges that plaintiff, mother of the deceased, "continues to suffer great pain of mind and body, shock, severe and permanent emotional distress … and difficulty in practicing religion through the church."

Canadian Court Says Assisted Suicide Law Is Unconstitutionally Restrictive

In Truchon v. Procureur General du Canada, (Quebec Superior Ct., Sept. 11, 2019) [opinion in French], a Quebec trial court judge held that portions of the Canadian and of Quebec's assisted suicide laws are unconstitutional because they are too restrictive. As summarized by Canadian Press:

Justice Christine Baudouin found in favour of two Quebecers struck by incurable degenerative diseases who'd argued they were denied a medically assisted death under laws that are discriminatory.

Baudouin ruled invalid the Criminal Code requirement that a natural death be "reasonably foreseeable" before someone can be eligible for assisted death. The condition has prevented some people from accessing the end-of-life procedure. She also invalidated a section of the Quebec law that says people must "be at the end of life."

But the court granted an exemption to Truchon and Gladu [the plaintiffs], allowing them to seek medical aid in dying during this period if they satisfy other conditions in the law.

Doctor Sues Over Hospital's Limits On Providing Aid-In-Dying Medications

Last month, a doctor and her terminally ill patient filed a lawsuit in a Colorado state court against Centura Health's St. Anthony Hospital challenging its religion-based policy of refusing to allow its physicians to prescribe medication for patients under the state's End of Life Options Act, or to assist in qualifying a patient for use of aid-in-dying medication. The complaint (full text) in Mahoney v. Morris, (CO Dist. Ct., filed 8/21/2019), alleges that the hospital's policy goes beyond the opt-out permitted by the Colorado statute which only permits hospitals to bar their physicians from writing prescriptions for assisted-suicide medications that will be used on hospital premises.

Last week, Centura Health fired plaintiff Dr. Barbara Morris, and filed a petition to remove the case to federal court, contending that the hospital, sponsored by Catholic and Seventh Day Adventist ministries, cannot be barred from dismissing an employee who violates its policy.  The Notice of Removal (full text) in Mahoney v. Morris, (D CO, filed 8/30/19) alleges that the hospital's rights under the Free Exercise and Establishment clauses would be violated if it cannot discipline its doctors for acting in opposition to its religious doctrines. It also invokes 42 U.S. Code § 2000e–1, the exemption from Title VII for religious institutions. Kaiser Health News reports on these developments. [Thanks to Michael Peabody for the lead.]

New Jersey Assisted Suicide Law Reinstated By Appeals Court

In Glassman v. Grewal, (NJ App.,  Aug. 27, 2019), a New Jersey state appeals court lifted the temporary restraining order entered by a trial courtearlier this month (see prior posting) preventing the state's Aid in Dying for the Terminally Ill Act from being enforced.The appeals court said in part:

Here, plaintiff failed to establish that injunctive relief was necessary to prevent irreparable harm and preserve the status quo.... The only harm identified by the court was the Executive Branch's failure to adopt enabling regulations. Neither the court nor plaintiff, however, identified how the absence of such regulations harmed him, irreparably or otherwise.... 

Further, as the Act makes clear, participation by physicians like plaintiff is entirely voluntary. The only requirement the Act imposes on health care providers who, based upon religious or other moral bases, voluntarily decide not to treat a fully-informed, terminally-ill patient interested in ending their lives, is to transfer any medical records to the new provider selected by the patient. See N.J.S.A. 26:16-17(c). We fail to discern how the administrative function of transferring those documents constitutes a matter of constitutional import, or an act contrary to a physician's professional obligations. In this regard, we note that a physician has long been required to transfer a patient's records on request, see N.J.A.C. 13:35-6.5, and does so without personal assent to any subsequent medical procedures.

A few hours later, the New Jersey Supreme Court refused to vacate the appeals court decision. (Full text of Supreme Court Order.) NorthJersey.com reports on the decisions.

Court Temporarily Enjoins New Jersey's Assisted Suicide Law

Fox29 News reports that on Wednesday, a New Jersey state trial court judge issued a temporary restraining order preventing the state's Aid in Dying for the Terminally Ill Act from being enforced.  The bill took effect on Aug. 1. (Background).  The suit challenging the Act was brought by an Orthodox Jewish physician who says that the law is an affront to religious doctors.  Sec. 26-16-17(c) of the Act provides:

If a health care professional is unable or unwilling to carry out a patient's request under P.L.2019, c.59 (C.26:16-1 et al.), and the patient transfers the patient’s care to a new health care professional or health care facility, the prior health care professional shall transfer, upon request, a copy of the patient's relevant records to the new health care professional or health care facility.

The lawsuit alleges that this requirement to transfer records violates doctors' rights to practice medicine without breaching the fiduciary duties of their patients as well as doctors' rights "to freely practice their religions in which human life is sacred and must not be taken." A hearing in the case is set for October.

Ontario Court Upholds Requirement That Objecting Doctors Refer Patients to Others

In Christian Medical and Dental Society of Canada v. College of Physicians and Surgeons of Ontario, (Ont. Ct. App., May 15, 2019), the Ontario Court of Appeal rejected a constitutional challenge to two policies of the College of Physicians and Surgeons of Ontario.  At issue is the requirement that physicians who object to providing any medical procedure or pharmaceuticals on the basis of religion or conscience must refer the patient to a non-objecting, available and accessible physician, health care professional or agency.  Physicians challenging the policies claimed they infringe their freedom of conscience and religion under Sec. 2(a) of the Canadian Charter of Rights and Freedoms by requiring them to be complicit in procedures such as abortion or aid in dying that violate their religious beliefs. In a 74-page opinion, the court held while the policies infringe religious liberty, the infringement is justified under Sec. 1 of the Charter, because they are reasonable limits, demonstrably justified in a free and democratic society. The Globe & Mail reports on the decision.

Appeals Court Vacates Invalidation of California's Assisted Suicide Law

In People ex rel Becerra v. Superior Court of Riverside County, (CA App., Nov. 27, 2018), a California state appellate court issued a writ of mandate ordering the trial court to vacate its decision striking down California's End of Life Option Act.  The Act legalizes physician-assisted suicide for the terminally ill.  The trial court had held that the Act was outside the scope of the proclamation calling the special session of the legislature that passed it.  The majority in the appellate court held that plaintiffs-- doctors and a Christian medical society-- lack standing to bring the challenge.  Judge Slough, dissenting in part, argued that the court should reach the merits of the challenge to the law and should hold that the law was constitutionally enacted.  Courthouse News Service reports on the decision.

VA Doctor's Statement Did Not Violate Establishment Clause

In Rose v. Borsos, 2018 U.S. Dist. LEXIS 139466 (ED TN, Aug. 17. 2018), a Tennessee federal district court dismissed a claim by a VA hospital patient that a VA doctor violated the Establishment Clause when the doctor told the patient that "God would forgive [him] for committing suicide because of uncontrolled pain."

Objectors To Assisted Suicide Lack Standing To Challenge Vermont Law

In Vermont Alliance for Ethical Health Care, Inc. v. Hoser, (D VT, April 5, 2017), a Vermont federal district court dismissed for lack of standing a suit challenging Vermont's law which protects physicians who prescribe a lethal dose of medication to terminally ill patients who meet specified requirements.  Plaintiffs, two organizations whose members are healthcare providers holding religious and ethical opposition to assisted suicide, sought injunctions shielding from professional disciplinary action healthcare providers who for religious or ethical reasons refuse to inform patients that assisted suicide is an available option.  the court said in part:

The prospect of imminent harm through the filing of disciplinary proceedings in the future is highly unlikely. The parties largely agree on a solution to their dilemma which satisfies both sides. They agree that making a false statement or ignoring a patient's inquiry is wrong. Both agree that directing a patient to a website explaining the conditions under which assisted suicide might be available will neither violate religious principles nor fall short of the physician's obligation to provide information to the patient.