Project Submission to the College of Physicians and Surgeons of Saskatchewan

Re: Conscientious Refusal

Abstract

The policy Conscientious Refusal requires all physicians who object to a procedure for reasons of conscience to facilitate the procedure by referring patients to a colleague who will provide it, even if it is homicide or suicide. No evidence was provided to justify the policy. None of the arguments provided to Council justify the policy, nor do the principles included in the text.

Conscientious Refusal fails to recognize that the practice of medicine is a moral enterprise, that morality is a human enterprise, and that physicians, no less than patients, are moral agents.

The original text virtually copied by Conscientious Refusal was written by believers: by people who believe that whatever is “legally permissible and publicly-funded” is morally acceptable- including euthanasia, assisted suicide and abortion. It is an assertion of those beliefs and an authoritarian attempt to compel others to conform to them. It is a partisan document that is profoundly disrespectful of the moral agency of physicians, not a compromise.

Conscientious Refusal advances the dangerous idea that a learned or privileged class, a profession or state institutions can legitimately compel people to do what they believe to be wrong and punish them if they refuse. This is not a limitation of fundamental freedoms, but a serious violation of human dignity. It is also incoherent, because it posits the existence of a moral or ethical duty to do what one believes to be wrong.

The Associate Registrar has made it clear that those who refuse to do what the policy demands will be disciplined by the College or forced out of the medical profession. This clashes seriously with the approach taken by the Supreme Court of Canada, which has affirmed that public policy must make room for physicians whose “concept of the good life” precludes their participation in abortion, euthanasia, assisted suicide or other morally contested procedures.

The burden of proof was on the Associate Registrar and the appointed committee to prove beyond doubt that Conscientious Refusal is justified and that no less authoritarian alternatives are available. They failed to discharge that burden; neither has College Council discharged it. The policy should be withdrawn.

I. Origin of the draft policy, Conscientious Refusal

II. Content of the proposed policy

III. Focus of this submission

IV. Justification for the proposed policy

V. The issues

VI. Response to the issues

VII. Discussion

VIII. Conclusions

Appendix “A”: Origin of the CPSS Draft Policy

Appendix “B”: Development of the CPSS Draft Policy

Appendix “C”: Interview of CPSS Associate Registrar

Appendix “D”: Ontario, Alberta, Manitoba and Saskatchewan College Policies

Appendix “E”: College of Physicians and Surgeons of Saskatchewan Re: Guideline: Unplanned Pregnancy

Appendix “F”: Morally Significant Participation

Appendix “G”: Notes on Referral, Abandonment and Fiduciary Duty

Project Submission to the College of Physicians and Surgeons of Ontario

Re: Professional Obligations and Human Rights

Abstract

The focus of this submission about Professional Obligations and Human Rights (POHR) is its demand for “effective referral” – the demand that physicians do what they believe to be wrong – even gravely wrong – even arranging homicide or suicide – and the implied threat that they will be punished if they refuse.

This is a dangerous and extraordinarily authoritarian policy, completely at odds with liberal democratic aspirations and our national traditions. The burden of proof is on the working group to prove beyond doubt that it is justified and that no reasonable alternatives are available. The working group has not done so.

The working group provided no evidence that such a policy is necessary, and there is evidence that it is not. The briefing materials supplied to Council in support of POHR were not only seriously deficient, but erroneous and seriously misleading. “Public sentiment” captured by a random poll does not justify the suppression of fundamental freedoms, and the results of consultation, when carefully considered, suggest that a policy of “effective referral” is highly controversial.

An example of a reasonable alternative is available from the Australian Medical Association – an example not offered to Council members by the working group, which, instead, completely misrepresented AMA policy.

This submission, supported by detailed analysis in the appendices, provides good reason for Council members to doubt that the requirement for effective referral in POHR is necessary or justifiable, or prudent policy. It also provides reason for them to believe that reasonable alternatives can be developed.

Council members unpersuaded by the working group or left in doubt about POHR should give the benefit of doubt to freedom of conscience and refuse to approve the draft policy in its present form. They should direct the working group to collaborate with those opposed to the present draft to produce a broadly acceptable text. If the real goal is to ensure access – not ideologically driven ethical cleansing – there is no reason to demand that physicians do what they believe to be wrong. If the College’s real goal is to ensure access to services – not to punish objecting physicians, or drive them out of family practice, or out of the profession – that goal is best served by connecting patients with physicians willing to help them.

Introduction

Reasons for doubt

III. POHR in practice

Appendix “A”: The Review Process

Appendix “B”: Unreliability of Jurisdictional Review by College Working Group

Appendix “C”: Consultation on Physicians and the Human Rights Code

Appendix “D”: A Case for Evidence-based Policy Making

Appendix “E”: Legal Criticism

Full text available on line at https://news.consciencelaws.orgpublications/submissions/submissions-013-001-cpso.aspx.

What is plagiarism? Saskatchewan College of Physicians provides “teachable moment” for students, teachers

Sean Murphy*

High school and post-secondary teachers plagued by the problem of plagiarism can thank the College of Physicians and Surgeons of Saskatchewan for providing them with a “teachable moment.”

Saskatchewan’s College of Physicians has published a draft policy intended to force objecting physicians to do what they believe to be wrong, including participation in euthanasia, assisted suicide, and abortion. The policy is virtually a word-for-word copy of the Model Conscientious Objection Policy proposed by euthanasia and abortion activists – without attribution.

Bryan Salte, speaking for the College, denied that the College document was taken from the Model Conscientious Objection Policy, though he did admit that it was a “significant source.”

Now Saskatchewan students have a comeback for teachers who award a “0” for plagiarism because they have copied most of a paper from a “significant source” on the internet. They can quote Mr. Salte.

On the other hand, Saskatchewan teachers might take this as a “teachable moment” to explain that it is unethical to pass off someone else’s work as one’s own – even if one likes it and agrees with it entirely and the real authors are pleased with the results.

It might even be a good topic for a class on ethics in medical research.

Supreme Court of Canada orders legalization of physician assisted suicide – AND euthanasia

Physicians unwilling to kill already face demands that they find someone who will

Protection of Conscience Project News Release

In a 9-0 ruling the Supreme Court of Canada struck down two sections of Canada’s Criminal Code “insofar as they prohibit physician-assisted death” in circumstances outlined by the Court. It appears that most or all of the major media outlets understood this to mean that the Court had legalized physician assisted suicide.

In fact, the Court has authorized physicians not only to help eligible patients commit suicide, but to kill them – whether or not they are capable of suicide. The ruling permits both physician assisted suicide and physician administered euthanasia in the case of competent adults who have clearly consented to being killed, and who have a grievous irremediable medical condition “including an illness, disease or disability” that causes “enduring suffering that is intolerable to the individual.”

The Court limited its ruling to the facts of the Carter case, but offered no opinion “on other situations” where physicians might be asked to kill patients or help them commit suicide. It is highly likely that the parameters set by the Court in Carter will be expanded in federal or provincial laws or in later litigation. It would certainly be a serious mistake to presume that the goalposts set in Carter will not be moved.

Even where euthanasia and assisted suicide are legal, most physicians are unwilling to do what the Supreme Court of Canada now expects Canadian physicians to do: lethally inject patients and write prescriptions for lethal medications.

However, acknowledging the joint intervention of the Protection of Conscience Project, Catholic Civil Rights League and Faith and Freedom Alliance and submissions by others, including the Canadian Medical Association, the Court stated: “In our view, nothing in the declaration of invalidity which we propose to issue would compel physicians to provide assistance in dying.”

The judges noted that “a physician’s decision to participate in assisted dying is a matter of conscience and, in some cases, of religious belief,” and that “the Charter rights of patients and physicians will need to be reconciled.”

Unfortunately, euthanasia activists understand “reconciliation” to mean that physicians unwilling to kill patients or help them kill themselves should be forced to refer them to a colleague willing to do so. This is the view of Dr. James Downar, a Toronto palliative care physician, who told the Canadian Medical Association Journal that it is critical to ensure all Canadians have access to “physician assisted dying.”

Commenting on the remarks attributed to Dr. Downar, Protection of Conscience Project Administrator Sean Murphy noted that many other palliative care physicians were concerned about ensuring access to palliative care, not finding physicians willing to kill patients.

“They certainly aren’t inclined to force colleagues to participate in assisted suicide and euthanasia,” he said. “Quite the contrary: many would refuse to direct patients to physicians willing to kill them or help them commit suicide.”

“Carter is not the last word on the euthanasia, assisted suicide and freedom of conscience,” he added, “but only the first of many to come.”

For details, see Supreme Court of Canada orders legalization of physician assisted suicide – AND euthanasia

A watchdog in need of a leash

Ontario College of Physicians manipulates consultation process

New Release

For immediate release

Protection of Conscience Project

It appears that the College of Physicians and Surgeons of Ontario is manipulating its consultation process to support a controversial draft policy intended to force doctors to do what they believe to be wrong.

The College is intervening in a Discussion Forum about Professional Obligations and Human Rights (POHR), apparently to discredit critics and defend the policy. The Forum is supposed to be used by the public to provide feedback on the policy, and to post emails and written submissions the College receives from the public.

But on 29 January the College posted a comment accusing Professor Margaret Somerville of misrepresenting its policy in a National Post column. The comment included a link to a letter to the National Post from College President, Dr. Carol Leet.

Not content with interfering in the consultation by posting its own statement, the College impersonated anonymous forum participants and used its statement to reply to comments supporting Professor Somerville’s “modest proposal.”

Someone at the College seems to have had second thoughts about impersonating participants, because the replies were revised a couple of days later to identify the College as the author. But the purported correction of participant responses still violates College policy.

Sean Murphy, Administrator of the Protection of Conscience Project, thinks College officials are interfering in the consultation because they are afraid that more people will begin to realize what the draft policy really means.

“In her National Post column, Professor Somerville succinctly critiqued the draft policy, and offered a reasonable alternative,” he said. “If Dr. Leet disagreed, she was within her rights to write a letter to the editor.”

“But,” he added, “interfering in the consultation process is unacceptable.”

Murphy observed that the College is supposed to be the watchdog protecting the public and profession from unethical conduct.

“It seems this watchdog needs a leash.”

For details, see A watchdog in need of a leash: Ontario College of Physicians manipulates consultation process

Category: Publications