Category: Canada

Results of the first consultation on Physicians and the Human Rights Code

Sean Murphy*

In February, 2008, the  Ontario Human Rights Commission responded to a draft policy of the College of Physicians and Surgeons of Ontario with a submission recommending that physicians “must essentially ‘check their personal views at the door’ in providing medical care.”1

The College, in response, released a draft policy, Physicians and the Ontario Human Rights Code, stating, “there will be times when it may be necessary for physicians to set aside their personal beliefs in order to ensure that patients or potential patients are provided with the medical treatment and services they require.”2

As a result of the subsequent controversy and public pressure the demand that physicians abandon their moral or religious beliefs was dropped before Physicians and the Ontario Human Rights Code was adopted. The policy was slated for review by September, 2013, but a public announcement of the review was not made until June, 2014.  The first stage of a public consultation about the policy closed on 5 August, 2014.

In December, 2014, a working group at the College released a new policy draft called Professional Obligations and Human Rights (POHR)  for a second stage of consultation ending on 20 February, 2015. The most contentious element in POHR is a requirement that physicians who object to a procedure for reasons of conscience must help the patient find a colleague who will provide it.3

According to the College, POHR takes into account feedback received during the first consultation. When the new draft policy was released in December, Dr. Marc Gabel, then President of the College, stated that “public polling” by the College had demonstrated that “the vast majority of Ontarians believe that [objecting physicians] should be required to identify another physician who will provide the treatment, and make and/or coordinate a referral.”4

The “public polling” to which Dr. Gabel referred appears to be an on-line random survey of 800 Ontario residents conducted by the College in May, 2014. The participants were randomly selected “using a Voice Response system,” and College Council was told that the results can be generalized to the online population of the province (80% of adults), with an accuracy of +3.5% and a 95% level of confidence.5 Beyond that, the College has not disclosed details of the poll that would permit an independent assessment of its validity. Particularly on such an important question, this seems inconsistent with its commitment to greater transparency.6

An analysis of consultation feedback posted on the College website produces quite a different result.

College Council was told that the consultation produced 6,710 responses7 – an “unprecedented volume.”8 However, an unknown number of respondents contributed both to the On-line Survey and Discussion Forum, so the number of unduplicated consultation responses actually available for analysis may have been far less than 6,700. Less than half that number responded to a question about the extremely contentious issue of mandatory referral, and only 50% of that group supported it.9

In any case, an overwhelming majority of responses in a Discussion Forum supported freedom of conscience for physicians, but only about 2% advocated a policy of mandatory referral. Nor were On-line Survey responses supportive of a policy of mandatory referral, suggesting, instead, that such a policy is controversial.

A detailed analysis of the results of the consultation is available here.

[PDF Text]

Notes

1.  Submission of the Ontario Human Rights Commission to the College of Physicians and Surgeons of Ontario regarding the draft policies relating to establishing and ending physician-patient relationships. 14 February, 2008. (Accessed 2018-03-07)

2.  College of Physicians and Surgeons of Ontario, Physicians and the Ontario Human Rights Code, p. 4

3.  College of Physicians and Surgeons of Ontario, Professional Obligations and Human Rights (Draft, December, 2014)

4.  Gabel, M. “Dear Colleagues.” College of Physicians and Surgeons of Ontario, Dialogue, Vol. 10, Issue 4, 2014, p. 6. (Accessed 2018-03-07)

5.  College of Physicians and Surgeons of Ontario, Annual Meeting of Council, December 4-5, 2014, p. 330 (Accessed 2018-03-07)

6.College of Physicians and Surgeons of Ontario, Appendix 2, Transparency Principles (2013-09) Accessed 2018-03-07).

7.  College of Physicians and Surgeons of Ontario, Annual Meeting of Council, December 4-5, 2014, p. 328 (Accessed 2018-03-07)

8.  “Balancing MD and patient rights: Human rights draft policy open for consultation.”  Dialogue, Vol. 10, Issue 4, 2014, p. 49.  (Accessed 2018-03-07)

9.  3,104 responses. College of Physicians and Surgeons of Ontario, Physicians and the Ontario Human Rights Code Consultation: Online Survey Report and Analysis, Figure 4 (Accessed 2018-03-07)

Saskatchewan physicians to be forced to participate in killing their patients

For Immediate Release

Maurice Vellacott, MP Saskatoon-Wanuskewin

OTTAWA – “The assault on freedom of conscience that is spreading across our country ought to be of grave concern to every freedom-loving Canadian ,” MP Maurice Vellacott said upon learning of yet another province (this time his own) that plans to force physicians to participate in morally objectionable procedures, including those that kill. “No health care worker should be forced against their will to take part in the killing of another human being. It would be a grotesque violation of their human dignity.”

The College of Physicians and Surgeons of Saskatchewan (CPSS) has adopted in principle a policy[i]  which it basically “cut and paste” from the Conscience Research Group’s (CRG’s) Model Policy on Conscientious Objection in Medicine.[ii]

Mr. Vellcott asked a series of questions that paint a disturbing picture of the process, or lack thereof, that went into CPSS’s adoption of this objectionable policy:

“Was the CPSS aware that the drafters of the Model Policy, notably Professor Jocelyn Downie of Dalhousie University, are abortion and euthanasia activists?

Did the CPSS solicit input from anyone other than Professor Downie and her team at the CRG[iii] before adopting this policy?

Did the Saskatchewan College let on to anyone else that it was even considering this issue?

Is the CPSS aware that this policy was rejected by the Canadian Medical Association (CMA)?”

Mr. Vellacott explained: “Professor Downie and co-author Sanda Rodgers, in a 2006 guest editorial in the CMA Journal, ignited a firestorm of controversy when they falsely claimed that CMA policy requires physicians to make abortion referrals regardless of their conscientious/religious beliefs. As Sean Murphy, Administrator of the Protection of Conscience Project, points out in his recent news release, that claim was repudiated by the CMA and vehemently rejected by physicians. And partly as a result of that negative response, Professor Downie turned her attention to the regulatory Colleges to try to convince them to impose mandatory referral.”[iv]

Earlier this month, Mr. Vellacott spoke out against a similar draft policy of the College of Physicians and Surgeons of Ontario (CPSO). At that time, he expressed concerns that if the Supreme Court of Canada strikes down Canada’s current ban on euthanasia or assisted suicide, then CPSO’s policy would mean Ontario’s physicians would have a ‘duty to refer’ patients for these life-ending procedures. He stressed that no other jurisdiction that currently allows euthanasia or assisted suicide imposes such an obligation. [v]

“While the CPSO policy is not identical to the CPSS/CRG Model Policy, in principle it is the same—a coercive attempt to involve physicians in the killing of some of the most vulnerable members of our human family,” Mr. Vellacott said. “The sheer fact that these Colleges of Physicians and Surgeons feel that a coercive policy of referral for these controversial procedures is necessary, is itself testament to the fact that there is something inherently problematic about these procedures in the first place. If they were procedures just like any other medical procedure, there’d be no need to coerce physicians into sacrificing a fundamental part of who they are—their very consciences—in order to provide them.”

“No good can come from forcing a doctor to practice medicine in a way they find morally reprehensible. Killing the consciences of our medical doctors will cause inestimable harm to the people of Canada and society as a whole.”

“One cannot help but wonder, what is the real motivation of those pushing us down this dangerous path?  And will we have the courage and wisdom and foresight to stop it?”

For information on providing input to CPSS on its draft policy, visit: http://www.cps.sk.ca/CPSS/CouncilAndCommittees/Council_Consultations_and_Surveys.aspx

 – 30 –

 For further information and comment, call (613) 992-1966 or (613) 297-2249; email: maurice.vellacott.a1@parl.gc.ca

[i] The College of Physicians and Surgeons of Saskatchewan (CPSS) is currently seeking input on a conscientious objection policy dubbed “Conscientious Refusal,”  which it has adopted in principle. This policy would require physicians who object to providing certain “legally permissible and publicly-funded health services” to “make a timely referral to another health care provider who is willing and able to accept the patient and provide the service.” In cases where the patient’s “health or well-being” would be jeopardized by a delay in finding another physician, the physician would be forced to provide the service even when it “conflicts with physicians’ deeply held and considered moral or religious beliefs.” See: http://www.cps.sk.ca/Documents/Council/2015%201%2019%20Conscientious%20Objection%20policy%20approved%20in%20principle%20by%20Council.pdf

[ii] http://carolynmcleod.com/wp-content/uploads/2014/05/04_Downie-McLeod-Shaw.pdf

[iii] http://conscience.carolynmcleod.com/meet-the-team/

[iv] “Saskatchewan physicians to be forced to do what they believe to be wrong,” Protection of Conscience Project news release, Jan. 27, 2015

[v] See Jan. 8, 2015 news release  and Backgrounder.

All Saskatchewan doctors must refer for abortions: draft policy

 LifeSiteNews

Steve Weatherbe

Saskatchewan pro-life doctors will soon be forced to act against their consciences and required to refer patients who want treatments such as abortion to other doctors. And if no other doctor is available, doctors could be required to do abortions provided they are technically competent.

So says a draft policy of the Saskatchewan Physicians and Surgeons that the organization’s ruling council approved in principle on January 16.  It will vote again to enshrine the document in the professional code of ethics at its meetings on March 26 and 27, and provides member doctors just until March 6 to give feedback. . . [Full text]

   

Euthanasia is so accepted that doctors must now justify prolonging a life

National Post

Barbara Kay

In 1994, Dutch journalist Gerbert van Loenen’s partner Niek underwent surgery to remove what was thought to be a pea-sized brain tumour. More complicated than predicted, the operation resulted in a brain injury that left Niek permanently disabled, yet still able to enjoy quality of life.

Van Loenen willingly reorganized his life to care for Niek at home. But after four years, his career needs necessitated moving Niek to a wheelchair-accessible unit across the street from a nursing home, where he was content for six more years until the tumour returned, whereupon he died a natural death.

Van Loenen found himself brooding over certain friends’ reactions to their situation. “It would have been better if he had died,” one said at the outset. [Full text]

 

Saskatchewan physicians to be forced to do what they believe to be wrong

Policy wording supplied by abortion and euthanasia activists

Policy would apply to euthanasia, if legalized.

Protection of Conscience Project News Release

The College of Physicians and Surgeons of Saskatchewan is proposing a draft policy demanding that physicians who object to “legally permissible and publicly-funded health services” must direct patients to colleagues who will provide them.  If another physician is unavailable, the College demands that they provide “legally permissible and publicly-funded” services,  even if doing so “conflicts with physicians’ deeply held and considered moral or religious beliefs.”

Physicians usually refuse to participate in abortion because they believe it is wrong to kill what the criminal law refers to as a child that has not become a human being.1 The proposed policy will require them to find a physician willing to do the killing they won’t do.  Should the Supreme Court of Canada legalize euthanasia, the policy will require objecting physicians who refuse to kill patients to find someone who will.

The seamless fit between referral for abortion and referral for euthanasia is not surprising.  The draft College policy was largely written by abortion and euthanasia activists, notably Professor Jocelyn Downie of Dalhousie University.

In a 2006 guest editorial in the Canadian Medical Association Journal, Professor Downie and another law professor claimed that objecting physicians are obliged to refer patients for abortion.2  Their views were vehemently rejected by physicians and repudiated by the Canadian Medical Association.3  Partly as a result of the negative response, Professor Downie and her colleagues in the “Conscience Research Group” decided to convince Colleges of Physicians and Surgeons to impose it.4

Saskatchewan’s draft policy is taken almost verbatim from their “Model Conscientious Objection Policy.”

The Conscience Research Group is  a tax-funded initiative that includes Professors Downie and Daniel Weinstock.5   Both  were members of an “expert panel” that recommended that health care professionals who object to killing patients should be compelled to refer patients to someone who would,6 because (they claimed) it is agreed that they can be compelled to refer for “reproductive health services.”7

Current efforts by the College of Physicians and Surgeons of Ontario to suppress freedom of conscience in the medical profession may have been influenced by the Conscience Research Group.  However, the College in Saskatchewan is the first to copy and paste its preferred model into a draft policy.

The Project insists that it is incoherent and contrary to sound public policy to include a requirement to do what one believes to be wrong in a professional code of ethics. It is also an affront to the best traditions of liberal democracy, and, ultimately, dangerous.

The College Council has approved the policy in principle, but will accept feedback on it until 6 March, 2015.

Notes:

1.  Criminal Code, Section 238(1). (Accessed 2014-12-02)

2. Rodgers S. Downie J. “Abortion: Ensuring Access.” CMAJ July 4, 2006 vol. 175 no. 1 doi: 10.1503/cmaj.060548 (Accessed 2014-12-02).

3.  Blackmer J. Clarification of the CMA’s position on induced abortion. CMAJ April 24, 2007 vol. 176 no. 9 doi: 10.1503/cmaj.1070035 (Accessed 2014-02-22)

4.   McLeod C, Downie J. “Let Conscience Be Their Guide? Conscientious Refusals in Health Care.” Bioethics ISSN 0269-9702 (print); 1467-8519 (online) doi:10.1111/bioe.12075 Volume 28 Number 1 2014 pp ii–iv

5.   Let their conscience be their guide? Conscientious refusals in reproductive health care: Meet the team.(Accessed 2014-11-21)

6.  Schuklenk U, van Delden J.J.M, Downie J, McLean S, Upshur R, Weinstock D. Report of the Royal Society of Canada Expert Panel on End-of-Life Decision Making (November, 2011) p. 101 (Accessed 2014-02-23)

7.   Schuklenk U, van Delden J.J.M, Downie J, McLean S, Upshur R, Weinstock D. Report of the Royal Society of Canada Expert Panel on End-of-Life Decision Making (November, 2011) p. 62 (Accessed 2014-02-23)