Nova Scotia medical regulator: unwilling physicians must collaborate in euthanasia and other controversial procedures

News Release

For Immediate Release

Protection of Conscience Project

The College of Physicians and Surgeons of Nova Scotia (CPSNS) has adopted a new policy (Conscientious Objection) that will compel physicians unwilling to provide a service for reasons of conscience – including euthanasia – to help patients obtain the service elsewhere. The College adopted Conscientious Objection notwithstanding letters from at least 24 Nova Scotia physicians indicating that they would have to retire early or leave the province if the policy were ratified by the College Council.

The hostility of the CPSNS to physician freedom of conscience may reflect the College Registrar’s longstanding promotion of mandatory effective referral for abortion, euthanasia and assisted suicide. Nova Scotians will not be well-served by morally partisan CPSNS standards likely to cause physicians to emigrate, retire, restrict their practices or leave family medicine or palliative care.

It is unacceptable to compel unwilling physicians to become parties to killing their patients or to other procedures they believe to be gravely wrong and/or contrary to good medical practice. The Canadian Medical Association (CMA) has repeatedly gone on record against mandatory effective referral, and the College of Physicians and Surgeons of Alberta does not support it, contrary to what Conscientious Objection seems to imply by referencing these authorities.

The Protection of Conscience Project is a non-profit, non-denominational initiative that advocates for freedom of conscience among health care workers. It does not take a position on the acceptability of morally contested procedures. The Project’s critical review of Conscientious Objection addresses issues directly or indirectly related to the protection of physician freedom of conscience, including:

Sean Murphy, Administrator,
Protection of Conscience Project

New College of Physicians human rights policy includes some surprises, but tightens the screws on dissenting physicians

News Release

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:

  • 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:

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 (

Manitoba medical student expelled over ‘pro-gun and pro-life’ Facebook posts wins court ruling

Rafael Zaki said he was expelled for his conscientious and religious beliefs. The judge said the university appeared biased in its decision

The National Post

Tyler Dawson

A Manitoba medical student who was expelled after failing to satisfactorily apologize for his controversial views on guns and abortion has been granted a new adjudication of his expulsion.

Rafael Zaki, a Coptic Orthodox student at the University of Manitoba who was supposed to graduate in 2022, posted three items on his Facebook page in February 2019. He was expelled in August 2019

One year later, after losing two appeals within the university system, Zaki asked Manitoba’s Court of Queen’s Bench to review the decision made by the University Discipline Committee. Zaki said he was expelled “for holding conscientious and religious beliefs that abortion is harmful.” . . . continue reading

“We are being bullied to participate in medical assistance in dying”

Alert from a growing number of Canadian physicians

News Release

Physicians’ Alliance Against Euthanasia

Montréal, March 9, 2020 – The Physicians’ Alliance against Euthanasia has received reports that unwilling physicians are being pressured and bullied to participate in Medical Assistance in Dying (MAiD): euphemism for euthanasia and assisted suicide.  Fearing reprisals, physicians have asked that no information that could identify them be disclosed.

The pressure has been intense for many physicians, especially amongst palliative specialists, some leaving even before this latest development. Descriptions were made of toxic practice environments and fear of discipline by medical regulators.

“The anxiety, fear, and sadness surrounding my work bled into my family life, and I ultimately felt that I could not manage practicing palliative care at this stage of my life.”  (Former palliative care physician, March 2020)

In different locations across Canada over the last months to weeks there has been a change in certain hospital MAiD policies. The change seems intended to provoke crisis or confrontation: to force objecting physicians to facilitate MAiD, or to have to refuse — and face contrived allegations of “obstructing access.” 

Reports consistently focus on the MAiD providers refusing to accept full responsibility for the death of the patient and forcing other physicians to share responsibility for the death. If the physician asks to withdraw from care and allow the MAiD provider to take over as before, the MAiD provider resists assuming the natural pattern of care.

The reports we are hearing from distressed physicians describe deliberate disruption of arrangements that were previously working satisfactorily and that had permitted patients to have access to MAiD while still allowing for conscience objectors to not be involved in facilitating the patient’s death. This bullying and betrayal of collegial relationships can poison practice environments and compromise patient care. Such behavior should not be tolerated by health care administrators in Canada.

Canadian physicians having similar stories of bullying are encouraged to contact the by email:

Contact: Charmine Francis,Coordinator


Canadian Medical Protective Association: Most Responsible Physician: A key link in the coordination of care.

Lauren Vogel. Culture of bullying in medicine starts at the top.
Canadian Medical Association Journal (December, 2018

Camille Bains. Systemic change needed to address suicide among physicians in Canada, doctors say. CBC News/Canadian Press (May, 2019)

Gabrielle Horne. Physician, heal thyself: the potential crisis of conscience in Canadian medicine. What if your faith in doctors having conscience was shaken? Globe and Mail (May, 2019)

Medical schools should deny applicants who object to provide abortion, assisted death: bioethicist

Global News

Rachel Browne

A bioethicist is calling for medical schools to eliminate applicants who would oppose providing medical services over objections to them based on their personal beliefs.

The call from Udo Schuklenk, a Queen’s University professor and the Ontario Research Chair in Bioethics, comes as the Alberta government grappled with a controversial bill that would have allowed health-care providers to refuse to provide medical care if they object to it on religious or moral grounds. . . [Full text]