Uniform coercive policy urged for all Canadian physicians

Project submission to the Saskatchewan College of Physicians discloses details

News Release

Protection of Conscience Project

The Protection of Conscience Project has charged that a controversial policy proposed by the College of Physicians and Surgeons of Saskatchewan is unjustified.

The policy, Conscientious Refusal, will require all Saskatchewan 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.

The Project noted that the burden of proof was on the policy’s supporters to prove that the policy is justified and that no less oppressive alternatives are available.  “They failed to do so,” states the submission. “The policy should be withdrawn.”

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” said the Project, describing the policy as “profoundly disrespectful of the moral agency of physicians.”

Using documents provided by the College, the Project’s submission traces the origin of the policy to a meeting in 2013. The meeting was apparently convened by the Conscience Research Group (CRG), activist academics whose goal is to compel physicians unwilling to provide morally contested procedures like abortion or euthanasia to refer patients to someone willing to do so. They presented a coercive model policy that had been drafted to achieve that goal.

According to a CPSS memo, College attendees included Saskatchewan Associate Registrar Bryan Salte, Dr. Gus Grant, Registrar of the College of Physicians and Surgeons of Nova Scotia, Andréa Foti of the Policy Department of the College of Physicians and Surgeons of Ontario and a representative of the Collège des Médecins du Québec. They agreed upon a text virtually identical to the CRG model.

In May, 2014, Bryan Salte proposed the policy to Registrars of the Colleges of British Columbia, Alberta, Manitoba and Ontario, who, he reported, agreed to review it and consider implementing it. He later urged all of the Registrars of Colleges of Physicians in Canada to adopt the coercive policy or one very like it, noting that “physician assisted suicide, in particular” would be present a challenge for administrators.

“Any College that is an outlier, either because it has adopted a different position than other Colleges, or because it has not developed a policy, will potentially be placed in a difficult position,” he warned.

The CPSS memo discloses that, unbeknownst to physicians, officials in several provinces have been making plans behind closed doors to suppress freedom of conscience in the medical profession.

“One of the disturbing aspects of the story,” notes the submission, “is what appears to be a pattern of concealment, selective disclosure, and false or misleading statements that all serve the purpose of supporting the policy.”

The Project’s most recent submission to the College of Physicians and Surgeons of Ontario identifies a similarly troubling pattern, describing briefing materials supplied to College Council in support of its controversial policy as “not only seriously deficient, but erroneous and seriously misleading.”

Project Submission to the College of Physicians and Surgeons of Saskatchewan (2015)

Project Submission to the College of Physicians and Surgeons of Ontario (2015)

Doctors who refuse to provide services on moral grounds could face discipline under new Ontario policy

National Post

Sharon Kirkey

Doctors who refuse to prescribe birth control or other medical services because of their personal values could face possible disciplinary actions, Canada’s largest medical regulator says.

Moral or religious convictions of a doctor cannot impede a patient’s access to care, the College of Physicians and Surgeons of Ontario said Friday in a 21-3 vote supporting an updated Professional and Human Rights policy.

The policy makes clear: “You cannot kick someone out of your office without care,” said Dr. Marc Gabel, past president of the college and chairman of the policy’s working group.

Some council members said the new code, which the college expects physicians to comply with or face complaints of professional misconduct, could lead to “state-run” medicine, while others said the church has no place in a doctor’s office. . . [Full text]

Ontario College of Physicians approves policy compelling doctors to abort, euthanize in some cases

LifeSite  News

Steve Weatherbe

TORONTO, March 6, 2015 (LifeSiteNews.com) – Ontario doctors could be compelled to perform abortions and euthanasia after the professional regulator’s ruling council approved its controversial new policy Friday morning in a 21-3 vote.

The College announced today in a news release that its new Professional Obligations and Human Rights policy “requires physicians to provide their patients with an effective referral to another health-care provider for those services the physician chooses not to provide for reasons of conscience or religion.”

But it does more, and requires doctors not only to refer but to provide service if required to alleviate “suffering.”

Commented one of the policy’s severest critics, Sean Murphy of the Protection of Conscience Project: “The Ontario College of Physicians has decided they are prepared to compel physicians to do what they consider is wrong, even homicide or suicide and punish them if they refuse. If institutions can order citizens to do what they believe is evil, what can they not do?” . . . [Full text]

UPDATED: Ontario doctors must refer for abortions, says College of Physicians

The Catholic Register

Michael Swan

TORONTO – Despite an overwhelmingly negative response from members of the public, physicians and organizations during a three-month online consultation, the Ontario College of Physicians and Surgeons voted 21-3 to force doctors to refer for abortions, contraception and other legal treatments or procedures even if they have moral or religious objections.

A last-minute submission from the Ontario Medical Association urging the college not to force doctors to act directly against their moral or religious convictions failed to sway the governing council of the college to reconsider wording that demands doctors provide “an effective referral to another health-care provider” despite personal convictions, whether religious or moral.

The college did not provide a statistical breakdown of the 16,000 submissions it received online, other than to say that 90 per cent were from members of the public and most were against the policy. . . [Full text]

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.


Contents

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