Category: Canada

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:

Contact:
Sean Murphy, Administrator,
Protection of Conscience Project
Email: protection@consciencelaws.org

No Other Options

Newly revealed documents depict a Canadian euthanasia regime that efficiently ushers the vulnerable to a “beautiful” death.

New Atlantis

Alexander Raikin

“I find that the act of offering the option of an assisted death is one of the most therapeutic things we do,” Stefanie Green tells me. She sees it in the faces of her patients — they’re “relieved.” Sometimes it actually means they’ll choose to live longer, to keep fighting, because now they know they can end their suffering if it becomes intolerable.

I wanted to know if Green, a physician specializing in euthanasia in British Columbia, is finding her job easier now than she did at first. “Is it more normal for me to be writing scripts and picking up lethal drugs and driving across town and doing this?” she asks back. It’s a rhetorical question. “Yeah, it’s oddly okay for me to be doing that. I don’t find it shocking anymore, but the events are still extraordinary.”

Green has her own term for these extraordinary events, drawing on her prior experience as an obstetrician, when she helped bring people into the world. “At both ‘deliveries,’ as I call them, I am invited into a most intimate moment in people’s lives,” she writes in her book.

The procedure, she assures me on our call, is “100 percent effective.” If her patient asks to die, and if her schedule, her ethics, and the law permits it, she will administer a lethal injection. . . continue reading

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 (protection@consciencelaws.org)

Ontario College of Physicians cautioned against disciplining physicians

Irremediability of mental illness, eligibility for euthanasia in dispute

News Release

For immediate release

Protection of Conscience Project

MAID (Medical Assistance in Dying, euthanasia/assisted suicide) becomes available in Canada for patients with mental illness alone in March, 2023. A patient must have an irremediable medical condition to be eligible for MAID, but a number of prominent Canadian psychiatrists insist that mental illness cannot be classified as an irremediable medical condition.

Now the College of Physicians and Surgeons of Ontario (CPSO) has been cautioned that it cannot discipline these physicians if they refuse to facilitate requests for euthanasia or assisted suicide from patients they consider ineligible for the services.

The comments are included in a submission from the Protection of Conscience Project on the CPSO’s draft revision of its MAID policy.

The submission also recommends that the CPSO explicitly reiterate its position that euthanasia/assisted suicide requests are not emergencies. A statement to that effect was deleted from the draft MAID policy, which now cites a resource suggesting that practitioners providing euthanasia/assisted suicide in the community should call 911 if they need help from paramedics emergency room staff to establish IV access.

Repeating a previous recommendation, the Project urged that responsible practitioners should be required to be present and remain with patients self-administering MAID drugs until death ensues. Failed unaccompanied self-administration can bring patients to hospital emergency rooms, causing conflict and distress. Successful unaccompanied self-administration could lead to delayed discovery of corpses in disturbing circumstances, triggering police and coroner investigations.

Practitioners unwilling to falsify death certificates for euthanasia/assisted suicide should not be forced to do so, says the Project, since falsification of death certificates is contrary to accepted international standards and can be considered deceptive, unethical or professionally ill-advised.

Finally, the Project recommends that the CPSO provide ethical direction or guidance about proceeding with euthanasia when an incapacitated patient who has signed a waiver of final consent has expressed ambivalence about proceeding. Ambivalence falls short of the Criminal Code threshold of refusal, so a practitioner can legally proceed if a patient has expressed only ambivalence.

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 (protection@consciencelaws.org)

The Protection of Freedom of Conscience Act Introduced in the House of Commons


News Release

FOR IMMEDIATE RELEASE

Kelly Block, M.P.

OTTAWA, Ontario – Earlier today, Kelly Block, Member of Parliament for Carlton Trail – Eagle Creek, tabled a private members bill to protect the conscience rights of medical professionals.

“Over the past two years, we have seen just how important our health care system is and how critical the medical professionals who work in that system are to Canadians,” said MP Block. “We need to create a work environment for medical professionals that protects them, supports them, and encourages them to continue in the critical work they do.”

The bill would amend the Criminal Code to make it a punishable offense to intimidate or coerce a medical professional to take part in medically assisted suicide as well as make it an offence to fire or refuse to hire a medical professional if the sole reason is their refusal to take part in medically assisted suicide.

Dr. Heidi Janz, adjunct professor at the University of Alberta and the chair of the Ending-of-Life Ethics Committee with the Council of Canadians with Disabilities, says, “Canada needs conscience-rights protections for medical professionals because Canadians with disabilities and chronic illnesses have a right to medical professionals who choose to stand against the systemic ableism that deems people to be better off dead than disabled. We have a right to safe doctors who will help us fight for our lives. In short, the human rights of Canadians with disabilities and chronic illnesses demand the protection of the conscience rights of medical professionals.”

When introducing the Bill in the House of Commons, MP Block said, “Medical professionals are facing increasing pressure to participate in assisted suicide, and this is causing many to question their ability to work in Canada. I encourage all my colleagues in this place to support this bill’s speedy passage and thereby demonstrate a deep commitment both to our amazing medical professionals and to the Canadian Charter of Rights and Freedoms.”

This Bill protects the doctor-patient relationship by ensuring doctors and other medical professionals are always able to recommend and provide the care they believe is best for their patient. Every patient deserves a second opinion. Conscience protections ensure that second opinions are always an option.

Media contact:
Email: Josh.Boyes.654@parl.gc.ca
Phone: 613-995-1551