For immediate release
Protection of Conscience Project
A draft College of Physicians and Surgeons of Ontario (CPSO) policy on human rights updates a controversial requirement for “effective referral” for morally contested services. The policy survived a constitutional legal challenge, and the CPSO seems to consider this a license to make increasingly oppressive demands on dissenting physicians.
In addition, however, the draft includes some surprises:
- Physicians must provide effective referrals and “care” (i.e., morally contested procedures, treatment) in faith-based hospitals and hospices that don’t provide them.
- Physicians must incorporate policies of a socio-political doctrine into their practices, evoking the controversy about regulatory overreach in the Law Society of Ontario over a mandated statement of principles.
- A new policy provision validates the reasoning of physicians opposed to making effective referrals for reasons of conscience. It forbids physicians to comply with patient requests they believe to be discriminatory, applying to facilitation of discrimination the same reasoning applied by physicians who refuse to facilitate euthanasia and assisted suicide by effective referral.
These policy revisions are described in a submission by the Protection of Conscience Project () in response to the CPSO invitation for comment on Human Rights in the Provision of Health Services (Human Rights 2022).
Human Rights 2022 tightens the screws on physicians unwilling to provide or facilitate procedures for reasons of conscience. They are warned that “many patients” will need their help to get even services that patients can directly access.
Further, they must:
- follow up every effective referral and, if necessary, take additional steps to ensure that patients can access morally contested services;
- make formal clinical referrals for morally contested services provided by specialists.
Through Human Rights 2022 the CPSO forbids physicians to “express” moral judgement not only about patient beliefs, but about the services they seek. This is inconsistent with the Canadian Medical Association Code of Ethics and Professionalism and obstructs physician-patient matching, an effective strategy for accommodating patients and physicians and improving health outcomes. It also attacks physician freedom of conscience, which can only be exercised by expressing moral/ethical judgement about services.
In defending the effective referral policy, the CPSO assured the courts that physicians could avoid moral/ethical conflicts by changing their scope of practice: from palliative care to hair restoration, for example. A new provision in Human Rights 2022 seems intended to pressure physicians to extend their scope of practice/clinical competence to include services to which they object for reasons of conscience.
Finally, Human Rights 2022 includes a pejorative and unnecessary warning directed at objecting physicians, implying that are likely to lie, deceive, mislead and coerce their patients. Demeaning innuendos of this kind are considered a form of workplace harassment by the Ontario government.
The experience of the Protection of Conscience Project is that objecting practitioners are typically willing to work cooperatively with patients and others to accommodate patient access to services as long as cooperation does not involve collaboration: an act that establishes a causal connection to or de facto support for the services to which they object.
The Project submission includes an example of a single protection of conscience policy applicable to all services and procedures.
The Protection of Conscience Project is a non-profit, non-denominational initiative that supports health care workers who want to provide the best care for their patients without violating their own personal and professional integrity. It does not take a position on the acceptability of morally contested procedures.
Contact: Sean Murphy, Administrator (firstname.lastname@example.org)