Scotland’s Close Call on Forced Participation in Assisted Suicide Is Another Front in the Campaign to Degrade the Religious Freedom Rights of Healthcare Workers

We don’t usually associate camels with Scotland. Yet the old proverb about the camel’s nose under the tent applies to what nearly happened in the Scottish Parliament in Edinburgh. A legislative proposal before that body threatened to force medical professionals who object to assisted suicide to help end their patients’ lives – or face fines and firings.

The sponsor of the bill allowing terminally ill people to choose suicide added an amendment that removed the “no duty, no detriment” protections for caregivers who have religious or ethical objections to helping a patient commit suicide. It would have forced healers of conscience to either violate their religious or ethical convictions or to potentially lose their ability to practice medicine altogether.

The medical community fought back. The Royal College of Psychiatrists in Scotland protested that its members “could face pressure from colleagues and employers, or be placed in contentious situations without adequate legal backing.” Faced with this backlash, the bill’s sponsor backed down, stripping the provision from the bill.

The issue, however, remains a live one not only in the United Kingdom, but also in the United States.

Four years ago, it took the intervention of a federal court to protect the right of physicians in California to opt out of participating in assisted suicide when they have religious or ethical objections. This was made necessary by a clause in California law providing that, while doctors were not required to assist, they were required to “document” a patient’s request to die and to “educate” that patient about the procedure and its prescribed pharmaceuticals.

In other words, even physicians who refused to take part in the act itself were still compelled to facilitate it.

A federal judge sided with the Christian Medical and Dental Association, issuing an injunction preventing California from forcing physicians to participate in these aspects of assisted suicide. The court based its ruling on the provision’s likely violation of the physicians’ First Amendment right to the free exercise of religion.

Such laws – whether compelling assistance in assisted suicide or abortion – force healers to choose between their deepest convictions about life and their ability to practice medicine. Wherever one stands on these contentious moral questions, the idea of forcing physicians or other healthcare workers to participate against their conscience is a grave violation of their constitutional rights. It is no less offensive to liberty than trying to compel an atheist to take part in a religious ceremony.

Like many bad ideas, this one has a way of returning in new guises – through legislation, regulatory mandates, or quiet amendments buried in complex bills. It is also entirely unnecessary. In jurisdictions where assisted suicide or abortion are legal, there is no shortage of providers willing to provide these services.

The Scottish law, once passed, will be reviewed by the Labour government in Westminster, which may or may not clarify, modify, or perhaps restore the deleted provision. That review will determine whether this camel keeps its nose outside the tent – or pushes further in.

In the United States, at least, we can be grateful that federal courts rely on the ultimate backstop: the First Amendment.
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But constitutional rights survive not only in letter, but in practice, when people insist on them. And the continuing push to compel participation in procedures that violate conscience suggests this fight is far from over.

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